Dáil Éireann díospóireacht -
Tuesday, 11 Nov 2003

Vol. 574 No. 1

Written Answers. - Ambulance Service.

Jerry Cowley

Ceist:

363 Dr. Cowley asked the Minister for Health and Children the ambulance response time for persons living in remote areas; the target time for transfer of casualties from a specified remote area to hospital; and if he will make a statement on the matter. [26094/03]

Minister for Health and Children (Mr. Martin):

The Eastern Regional Health Authority, ERHA, and each of the seven health boards are responsible for the provision of ambulance services in their functional areas.

Response times are an important measure of the operational efficiency of the ambulance service and are monitored on an ongoing basis by the individual health boards. Response times vary in each health board area depending on the geographical location of the ambulance centre in relation to the call-out location. My Department has therefore asked the regional chief executive of the ERHA and the chief executive officer of each health board to furnish the Deputy directly with the information which he has requested in relation to response times achieved in rural areas and the target time for transfer of casualties from a specified remote area to an acute hospital.

Policy on the development of emergency medical services in Ireland is set out in a number of documents, including the health strategy, Quality and Fairness – A Health System For You, Building Healthier Hearts, the Government's cardiovascular health strategy, and the Strategic Review of the Ambulance Service 2001.

The strategic review carried out an analysis of response times data in relation to emergency calls for the year 2000. The following table illustrates the percentage of emergency calls responded to within 20 minutes to enable comparison with previously published data.

Ambulance Service Area	% of Calls responded to within 20 minutes1997	% of Calls responded to within 20 minutes2000
Eastern Regional Health Authority	97%	97%
Midland Health Board	58%	80%
Mid-Western Health Board	78%	80%
North-Eastern Health Board	76%	82%
North-Western Health Board	53%	62%
South-Eastern Health Board	61%	66%
Southern Health Board	86%	84%
Western Health Board	56%	67%

In overall terms the analysis indicated a significant improvement in response times in relation to emergency calls. The improvement in response times was mainly due to progress in relation to two person crewing arrangements, decreased reliance on withdrawal of nurses from hospital wards, advances in command and control arrangements, enhanced professionalism of ambulance staff, advances in EMT training, higher specifications and better equipped ambulance fleet

In addition, it is widely accepted that the discontinuation of on-call arrangements and standardisation of work practices and procedures throughout all regions will further improve response times. My Department is pursuing these objectives in conjunction with the Health Boards Executive, HeBE, and the Health Boards Authority.

While the emergency ambulance service needs to be in a position to meet the demands placed upon it, it is also important to ensure that emergency medical technicians are in a position to provide efficient and effective intervention which may not only determine the survival of the patient but also the extent and length of hospital care required and the quality of life after discharge. In this regard the Pre-Hospital Emergency Care Council, PHECC, which was established in 2000 and whose primary function is to develop appropriate standards in pre-hospital emergency care, has submitted proposals to my Department in relation to the introduction of the emergency medical technician – advanced, EMT-A, programme to the ambulance service. I was pleased to announce policy approval earlier this year to this initiative and the development of the programme is now being progressed by my Department.

In line with its remit, the PHECC is also undertaking a number of research and development initiatives on response times standards, based on clinical need, in the Irish pre-hospital emergency care setting. Included are the development of a national electronic patient clinical record keeping and information system, spatial analysis research to identify where access to appropriate and timely pre-hospital emergency care may be an issue because of geographic location, the purpose of which will help to facilitate the prioritisation of the implementation of, for example, first responder schemes, and research on the international evidence on dispatch systems and their use for prioritising resources according to clinical need. The outcomes of these research and development initiatives will inform the further development of ambulance response times standards into the future.

I assure the Deputy that policy initiatives aimed at improving key aspects of the emergency medical service will continue to be pursued by my Department.