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Dáil Éireann díospóireacht -
Tuesday, 19 Jun 2018

Vol. 970 No. 4

Dublin Fire Brigade: Motion [Private Members]

I move:

"That Dáil Éireann:

recognises that:

— the Dublin Fire Brigade (DFB) has been providing crucial ambulance services to the citizens of Dublin City and County since 1898;

— DFB now operates with life-saving equipment and over 800 trained firefighter/paramedics working to provide immediate medical assistance to members of the public in need of treatment, 24/7, 365 days a year; and

— staff must be lauded for their ability to respond to thousands of emergency calls across the capital every year;

accepts that:

— there are concerns that the Health Service Executive is seeking to remove the delivery of Dublin's ambulance service from DFB and instead merge the service with the National Ambulance Service;

— such a proposal could have a huge negative impact on the delivery of services from the DFB call centre; and

— removing any element of DFB's fire-based Emergency Medical Service (EMS) system will have an adverse effect on safeguarding those in our community; and

calls on the Government to commit to:

— the provision of full support for the almost 1,000 personnel employed, to maximise service delivery and provide greater efficiency to protect those in fire stations across Dublin who provide a full-time fire, rescue, and ambulance service which serves the whole community;

— the design of a direct funding mechanism and the required additional capacity due to the increased population, to allow DFB to continue to operate all areas of their fire-based EMS; and

— the full retention of ambulance services provided by DFB across Dublin."

I wish to share time with my colleagues, Deputies Haughey, Darragh O'Brien and Curran. I will take six minutes.

I welcome the members of Dublin Fire Brigade emergency medical service, EMS, who are in the Gallery in numbers and who are outside Dáil Éireann tonight, and commend and thank them and their colleagues who throughout the capital - and of course, members of the National Ambulance Service throughout the country - keep us safe and respond so speedily and efficiently, and often heroically, in the service of their fellow citizens.

It is not a cliché to say we are disappointed on this side of the House to see that the Minister for Health is not here. I suppose that makes its own statement to those in the Gallery, those watching outside and those reading the accounts of this debate, in demonstration of the seriousness or otherwise with which the Government takes this motion from this side of the House.

My colleagues on this side of the House hope that this will be the last occasion on which this matter needs to feature on the Dáil agenda. My colleagues, Deputies Darragh O’Brien and Seán Haughey in this House, and Senators Clifford-Lee and Ardagh in the Seanad, have raised this matter repeatedly and will continue to raise it because no progress has been made.

No progress has been made in spite of the subject being previously raised during Private Members' business, Topical Issues and parliamentary questions, and that is merely within the Houses of the Oireachtas. No progress has been made in spite of a review group and an expert panel having been established to resolve the issue. That expert panel was made up in part of eminent servants of this city and State and the great bulk of its findings were accepted by all sides to this discussion with very little left to settle.

The Minister for Health, in correspondence, has suggested that there are no plans to allow Dublin Fire Brigade EMS to be taken over by the HSE. The Minister is also suggesting that he will support calls to consider future funding mechanisms. I welcome both of these sentiments. However, so much time has passed on this issue, and so many reviews and reports have been done without any action that the Minister, who is not here, will forgive me for being sceptical. Perhaps the Minister of State, Deputy Catherine Byrne, will accept my scepticism in his place.

I have to ask why the Minister of State at the Department of Health is even responding for the Government on this issue and ask why the Minister for Housing, Planning and Local Government is not here in her place because Dublin City Council is funded in part by the Department of Housing, Planning and Local Government. The Dublin Fire Brigade and ambulance service ought to be funded by that Department but it is not, and on this side of the House we will not be satisfied until the Minister of State present here tonight confirms that the future funding mechanisms that the senior Minister has in mind refer to the transfer of the funding of Dublin Fire Brigade and ambulance service from the Department of Health to the Department of Housing Planning and Local Government. The Taoiseach, in his time as Minister for Health, reinforced this fact in a Seanad debate in 2015, only three years ago, when he stated:

[T]he Dublin ambulance service has been provided by Dublin Fire Brigade under fire services legislation. Statutory responsibility for this service, therefore, rests [...] within the remit of my colleague, the Minister for the Environment, Community and Local Government.

However, here we have the charade again of where the Minister for Health and his Minister of State are taking the issue.

This is about a number of key issues, not least of which are patient safety and a patient-centred approach to emergency response. We support the overriding importance of a person-centred response by emergency services in Dublin and that is why we so strongly support the retention of the fire-based emergency medical service in the hands of Dublin Fire Brigade and ambulance service.

When we examine the Government's assertion that there is no threat to Dublin Fire Brigade and ambulance service, the facts do not support it. The passage of time does not support it. Dublin Fire Brigade certainly does not support the assertion. Events do not support it. Action does not support it. Ministerial and Government inaction, unfortunately, reinforces the opposite view.

In spite of the Minister's reassurances, there is compelling evidence that the retention of this service within Dublin City Council and, therefore, within the realm of Dublin Fire Brigade is under threat. We recall the HSE plan in 2013 - the first attempt to absorb the services of Dublin Fire Brigade into the HSE. An implementation plan was drawn up — that is an incontrovertible fact. However, for the fact that its existence was leaked to a national newspaper, we do not know where we would be regarding this argument.

Around the same time, Dublin City Council and the Dublin Fire Brigade were put on notice effectively that funding for the service was in question. The demand by the HSE to have one national call centre dispatching ambulances and fire services was the next attempt to strangle Dublin Fire Brigade. The idea that a chief fire officer would cede control, and more importantly, responsibility for responding to and dispatching personnel to incidents makes no common sense. Case history informs us that the national call centre does not always dispatch the Dublin Fire Brigade and ambulance service, even when it is more proximate to an incident than other services. For that reason, the Minister is correct that current call-taking arrangements represent an unacceptably high patient safety risk.

Added to this is a recent warning from SIPTU of staffing issues in the National Emergency Operations Centre, NEOC. The headquarters of the NEOC is apparently down 35 workers. If one has an agency of State, that initiated a process, developed that process into an implementation plan for absorbing another service into its own realm and won the support of the so-called custodians of the very same service they were meant to uphold and protect, controlling the budget and unwilling to divest itself of it, which then wants to control the very means by which Dublin Fire Brigade and ambulance gets to do its work, which is through calls, then there are at least grounds for suspecting that someone does not want one around.

I welcome the opportunity to contribute to the debate on this motion which aims to ensure that the full emergency services provided by Dublin Fire Brigade across the city and county remain as they are.

Dublin Fire Brigade, as the House will be aware, has been providing ambulance and emergency services for 120 years. It is worth putting on the record my own personal appreciation for the work that the men and women of Dublin Fire Brigade carry out on a daily basis. Too often, we take them for granted. We see incidents where they put their lives at risk to look after the welfare of the people of this city and I want to acknowledge the work they do.

The Minister has indicated that there is no threat to the future of Dublin Fire Brigade and the ambulance service it provides but the evidence, as put forward by my colleague, indicates the contrary. Last year Dublin Fire Brigade ambulance service responded to 115,000 calls. I do not want to get bogged down in the numbers but to make the point that the level of service being operated by Dublin Fire Brigade ambulance service in the capital is growing significantly year on year.

The ambulance service operated by Dublin Fire Brigade benefits from the fact that the firefighters are also all trained paramedics. There are 830 of them. That is quite different than many other ambulance services. We have seen reports on the fire service and ambulance service indicating that the standard in Dublin is second to none. Internationally, it is acknowledged to have one of the highest standards.

When we look at the level of funding provided, we must question the Government's actions. In 2017, the National Ambulance Service saw an increase in its funding. I know this because I asked the relevant parliamentary questions at the time. However, Dublin Fire Brigade ambulance service did not receive such an increase. In fact, it did not receive an increase in 2017, 2016 or 2015. That leads me to ask the following question.

At a time when the National Ambulance Service is seeing an increase in funding, at a time when the activity, requirement, demand and call-out activity is growing, why is it that the ambulance service operated by Dublin Fire Brigade, funded by the HSE through Dublin City Council is not seeing a marked increase in funding as well? There is an issue there and while the Minister has said it is not his intention and there is no plan to merge the ambulance services, he is not demonstrating it in terms of the funding levels. The questions have to be asked and I specifically ask the Minister of State to look at them.

Dublin Fire Brigade operates a fleet of 12 ambulances at the moment as I understand it, which is four fewer than it should have. There is a funding deficit. Some of the deficit is clearly made up by the city council but it is insufficient in terms of direct funding from the HSE. Why is it that the HSE is funding Dublin Fire Brigade ambulance services? Why is it not the Department of Communications, Climate Action and Environment directly rather than the HSE? If those issues were addressed they would allay some of the fears but the concern, as I have demonstrated clearly, is that the funding level to Dublin Fire Brigade's ambulance service has not kept pace with the National Ambulance Service over the last few years. Those concerns need to be addressed in the Minister of State's response to assure the members of Dublin Fire Brigade who are providing an excellent service for the people of our city that the service they are providing will be maintained, enhanced and supported by the Members of this House.

Dublin Fire Brigade provides emergency ambulance services in Dublin city and county by arrangement between Dublin City Council and the National Ambulance Service of the HSE. Dublin Fire Brigade has a proud tradition of providing the fire-based ambulance service in the capital. International best practice indicates that combining fire rescue and emergency services greatly improves the response to a crisis. A total of 830 Dublin Fire Brigade firefighters, men and women, are trained paramedics. They are available to provide immediate, emergency medical assistance and the benefits of this integrated service should not be underestimated. Dublin Fire Brigade has been providing the ambulance service in the Dublin area since 1898.

Dubliners are rightly proud of their fire brigade and ambulance service and regard it with great affection. The chief executive of Dublin City Council, Owen Keegan, has stated that he wishes to see a transfer of all call taking and dispatching for ambulances to the national control centre in Tallaght. He has also stated that this has been agreed by the chief executives of the other Dublin local authorities and the HSE. Three reports have been commissioned recently on the ambulance service: the Health Information and Quality Authority, HIQA, report published in December 2014, a joint review by the HSE and Dublin City Council of the Dublin ambulance service, and the independent Lightfoot Solutions review. I suggest that there are flaws in all of these reports and conflicts of interest in some cases. The Minister of State should be very conscious of that. The then Minister for Health, Deputy Leo Varadkar, informed the Seanad on 10 March 2015 that staff in Dublin Fire Brigade would be fully consulted before any changes were implemented. Such a consultation has clearly not taken place. Dublin City Council recently passed a motion to the effect that the elected members in all the Dublin local authorities and on the regional assembly should be consulted about any proposed changes. During the same debate on 10 March 2015, the then Minister, Deputy Varadkar, also clarified the position on statutory responsibility for the Dublin ambulance service.

The provisions of the motion speak for themselves. There are two statutory providers of emergency ambulance services and they should both receive equal treatment and parity of esteem. Concerns in the HIQA report in particular have to be addressed. The solution is not to transfer the call taking and dispatch functions from the Dublin Fire Brigade centre in Townsend Street to the National Ambulance Service centre in Tallaght. In my view, a technical solution, using technology and IT to bring about the necessary co-ordination between the call centres is possible and should be positively examined.

There is also the major issue of governance in Dublin Fire Brigade. It must be accepted that Dublin Fire Brigade services are provided under fire services legislation. Therefore, statutory responsibility for these services rests with Dublin City Council and ultimately the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy. The HSE and the Minister for Health, Deputy Harris, must look at this governance issue and accept what I have just said on that. As a result of the governing practice that is in place, Dublin Fire Brigade is being starved of resources and capacity and this is putting citizens at risk. A direct funding mechanism for Dublin Fire Brigade must be put in place. The expert panel on pre-hospital emergency care services in Dublin published its report in December 2015. These findings should be implemented in order to resolve the problems. Why is there no political will to do this? Why has this issue dragged on for so long?

Consultation is required under the provisions of section 32 of the Local Government (Dublin) Act 1993 which states that there must be consultation with local councillors in the four Dublin local authorities and the regional assembly. These procedures have not been followed in this case.

I will make one concluding remark. Our motion is no reflection on the personnel working in the National Ambulance Service. All we are asking for is that there is parity of esteem between the two statutory agencies in the delivery of these services. If it is not broken do not fix it.

I welcome the members of Dublin Fire Brigade who are here with us this evening in the Gallery and I welcome the many that I met earlier today. It has been a pleasure for me over the last four or five years to work with both current and retired members of Dublin Fire Brigade. My colleagues have covered in detail a lot of the items within our motion. I ask the Minister of State directly that this be the last time that we debate this issue. I have raised this on numerous occasions. We need to make sure that a clear message goes out from the Dáil tomorrow and this evening that Dáil Éireann supports the operation of Dublin Fire Brigade, the Dublin Fire Brigade ambulance service and the fire-based emergency medical system.

What we have in Dublin is being replicated in other cities across Europe and we have a city manager and people within the HSE tinkering with something that is working. Worse than tinkering, they are starving it in certain instances. My colleague, Deputy John Curran, has dealt with the funding aspects of the matter. We should be further expanding Dublin Fire Brigade's role within the greater Dublin area and looking at how it can be expanded into our other cities across the country, not restricting it. This is not a question of the National Ambulance Service or Dublin Fire Brigade. It never has been and those who seek to sow those divisions are being disingenuous at best. This is about the safety of the citizens of Dublin city and county. No more can we allow the foot dragging from this Government and the last Government. This is the last time this should be addressed. We need to ensure that Dublin Fire Brigade is resourced properly and that a clear statement goes out that there will be no unpicking of its independence and autonomy. We cannot have a system such as has been proposed in the HIQA report. I wrote a detailed letter to the Department of Health on 27 March 2018 highlighting a number of my concerns around the expert report and I use the word "expert" loosely in this regard. That letter has not been responded to yet. Answers given under freedom of information to private citizens contained more information than answers I got by way of parliamentary questions and that is simply not acceptable.

I want to move on in a positive vein in one respect because we want this issue resolved. I welcome the fact that the Government will not only not be opposing this Fianna Fáil motion but it will be supporting it. The Minister of State might confirm that in her response. If that is the case, that is a significant step forward. I spoke with the Minister, Deputy Harris, this evening and I suggested to him that after the planning of this motion I would sit down with him to work on the next steps forward. Our colleagues in Dublin Fire Brigade want to know what will happen next. A motion and debate in the Dáil and ventilation of the issues are good and well but the Fianna Fáil Party and I want to see a roadmap forward to investing in Dublin Fire Brigade. At the moment there should be 133 firefighters and paramedics and 36 officers on duty at all times maintaining front-line fire appliances. However, there were only 129 and 29 officers due to start work last night. There is a deficit in staff and appliances. We need at least another four ambulances within the service and we should be proud of the service that is there. This is a win win for the Government and the Dáil.

We need to send out a clear statement from this House that Mr. Owen Keegan and the executive of DCC do not run our fire service and they do not make policy. The Dáil makes policy and makes decisions on behalf of the people who elect us. Thousands of families in Dublin, including my own, have had experience of being looked after by the members of the DFB. The members of the fire brigade and their families do not deserve to be denigrated, to have funding withdrawn, or to have their service run down. They are immensely committed to their job and they have no down time whatsoever. They look after us 365 days a year, 24 hours a day, seven days a week. It behoves Government to look after them now and for the Dáil to speak with one voice to ensure we invest in Dublin Fire Brigade, its staff, crews and paramedics. I hope the Dáil agrees unanimously with the Fianna Fáil motion and early next week moves forward with an implementation plan to ensure this service remains one of the best in Europe and that we further invest in the service.

I welcome the men and women from Dublin Fire Brigade who are in the Visitors Gallery. I am taking this motion on behalf of the Minister for Health, Deputy Harris, who, unfortunately, cannot be here this evening. It is not any criticism of the Minister because I have a detailed reply to the Deputies and we may be able to settle some of the problems we face.

On behalf of the Minister, I accept the motion. I join Deputies across the House to commend the DFB for the excellent ambulance service it provides to the people of Dublin. The Dublin fire brigade has a long and very proud tradition of emergency medical service provision, which the Government is pleased to acknowledge. I assure the House that there are no plans afoot to remove responsibility for the delivery of Dublin's ambulance services from the fire brigade. I fully agree that any such move would have a negative impact on service delivery. Services would likely grind to a halt because the NAS does not have the capacity to take over the provision of emergency ambulance services in Dublin. Even if we wanted all such ambulance services to be provided by the NAS, that would not be achievable.

We are dependent on the approximately 800 men and women, dual qualified paramedic firefighters, who comprise the DFB workforce. I am happy that the fire brigade's Pre-Hospital Emergency Care Council, PHECC, registered paramedics are available to the HSE through a service arrangement. That workforce is a wonderful resource for all of us. They have been trained at the expense of the State and there is no reason whatsoever to think that the State might decide that we no longer require their expertise and their services. It is difficult to recruit trained paramedics; as in other medical disciplines we struggle to retain paramedic staff. Over recent years we have provided increased funding to the NAS to recruit and train additional paramedics and we will need to do so for many years to come. Even if we had unlimited funding, we would be unable to recruit at the level we require and, therefore, we need to do so on a phased basis. With the best will in the world, the NAS could not recruit at the level necessary to displace the DFB paramedic workforce and so cannot, and will not, take ownership of Dublin emergency ambulance service provision.

The Government is mindful of the great service that has been provided down through the years by the fire brigade and long may that service continue. As a former Lord Mayor of this city, it was a privilege to work with DFB. Its members were the escorts of the Lord Mayor and continue to do their duty on a daily basis to support the Lord Mayor in his or her role. The fire brigade provides emergency ambulance services in Dublin city and county by arrangement between DCC and the HSE.

The NAS also provides some emergency capacity in the greater Dublin area, as well as non-emergency patient transport. Over the years, funding issues have arisen between the HSE and DCC. It is timely to look again at how the funding arrangements between the two organisations work in an effort to ensure the service is put on a sound financial footing. The city council should be appropriately reimbursed for ambulance services provided on behalf of the HSE. In recent times there has been much improved co-ordination between the NAS and the fire brigade, particularly in respect of operations and clinical governance. I want both organisations to continue to work together to develop and improve ambulance service provision.

In that regard, we must address the current patient safety risk that prevails because of the existence of two separate call and dispatch centres in Dublin. Emergency 999 or 112 ambulance calls made in Dublin are transferred by the emergency call answering service to either the Dublin Fire Brigade east region communication centre or to the NAS's national emergency operations centre, NEOC, depending on where in Dublin the call originated. The NEOC in Tallaght is a state-of-the-art ambulance call centre which uses up to date digital telephony technology and bespoke computers to aid dispatch. The technology allows staff to have visibility of all NAS ambulance resources and, therefore, it can be guaranteed that the nearest available resource will always be dispatched by the service. The NEOC takes calls for the entire country apart from the Dublin area, and it also has a resilience site in Ballyshannon. If there are any difficulties in Tallaght for example, a power outage, the Ballyshannon centre will take over all call taking and dispatch operations.

A clinical hub went live in the NEOC in March 2018 and provides an alternative model of care for some patients. Certain low acuity calls are now transferred to the hub and the caller receives medical advice from nurses over the phone, and this may remove the need to dispatch an ambulance. Emergency calls for ambulances in the Dublin area are managed from the Dublin Fire Brigade control room in Townsend Street, Dublin. Fire brigade personnel take calls and dispatch resources for both ambulance and fire services. However, the analogue telephony system in Townsend Street is outdated and in need of replacement; calls are dispatched over the radio.

DFB has 12 ambulances and 21 fire appliances are available to be dispatched as first responders. In cases where the fire brigade does not have a resource available or where the resources are deemed to be too far away the call may be stacked to await a resource or telephone contact is made with the NEOC with a request that the NAS responds to the call. While mechanisms to transfer calls between the call centres exist this, by its nature, carries inherent risks and can give rise to delays, with potentially adverse implications for patients. In addition, each provider only has visibility of its own resources and, therefore, it is not possible to ensure the nearest available resource is dispatched to emergency calls in the Dublin area. Data from the NAS indicates that DFB requests for its assistance can be in the region of 1,000 per week. Sometimes the fire brigade passes calls in batches which presents challenges to the NAS in prioritising batched calls. This highlights that change is required in ambulance call taking and dispatch arrangements in Dublin.

Since the 1990s a number of reports have raised concerns about the existence of two call and dispatch centres in Dublin. The 1993 report of the review on ambulance services proposed that the two organisations should function as a single entity using a single command and control facility. A subsequent review was conducted in 2001 and that also promoted a single command and control centre and no duplication of services. In 2007, the city council and the HSE conducted a comprehensive review which identified 15 key recommendations. These were underpinned by the principle that any member of the public or health professional should have a single point of contact with the emergency ambulance services serving Dublin city and county and that they receive a response from the nearest appropriate emergency care resource in the shortest time.

Once again, an integrated command and control unit was advocated. In 2014, a review of the pre-hospital emergency care services was undertaken by the Health Information and Quality Authority. The report found that the NAS and DFB were not integrated, and identified poor levels of co-operation between both entities which was not always in the best interests of the patient.

I am pleased to note that in the following review in 2017, HIQA found evidence of a much better relationship between the NAS and the fire brigade. However, HIQA identified a high risk in respect of Dublin ambulance services stemming from overall capacity deficit and arrangements for call-handling and dispatch. HIQA warned that the current arrangements in place can result in high numbers of potential life-threatening calls being queued by DFB rather than receiving an immediate response. I imagine the House will agree that these successive independent reports over the decades highlight the urgent need for change in the call and dispatch function for ambulance services in the Dublin region.

The NAS has undergone a significant process of reform and modernisation in recent years. Several important service initiatives and developments have taken place. The significant reform programme aims to reconfigure the management and delivery of pre-hospital emergency care services, and includes plans to develop alternative pathways of care such as hear-and-treat clinical hubs and see-and-treat models as well as transferring patients to alternative destinations for treatment.

I want the people of Dublin to reap the benefits of these developments and innovations. However, as things currently stand, they do not. Dublin is the only area in the country where we cannot guarantee that the nearest available resources will be dispatched. Callers from certain parts of Dublin do not have access to clinical hubs.

Under Standing Order 144, the proposers have 20 minutes and the Government has ten minutes. I must ask the Minister of State to conclude as quickly as she can.

That is grand. The rest might be read into the record.

I apologise but we have to move on.

The next paragraph of the script refers to the Government supporting the motion.

We can facilitate that with the agreement of the House. Is that agreed? Agreed.

Moving the Dublin call-taking dispatch to the NEOC will address the shortcomings identified and ensure the provision of safe consistent high-quality services. There have been suggestions that we can find a technical solution by updating computers at Townsend Street.

On behalf of the Minister and myself, the Government will support the motion.

I apologise for rushing the Minister of State but I am governed by Standing Orders.

I warmly welcome the motion, which Sinn Féin enthusiastically supports. While I thank the Minister of State for attending, it is disappointing that neither the Minister for Health or the Minister for Housing, Planning and Local Government were available given the importance of the issue. Perhaps one or other of them might be in the House to wrap up the debate.

I echo the comments of others. The men and women of Dublin Fire Brigade save lives and we cannot say that often enough. They do so by putting their own lives at extraordinary risk. I welcome the members of DFB to the Gallery, and on behalf of the constituents I represent, I thank them for continuing to put their lives at risk to keep us safe.

The motion is similar to motions that have been passed unanimously by several Dublin local authorities, which gives a sense of the strong feeling among many political parties on the matter. The motion speaks to several significant concerns. One concern is that Dublin City Council does not see the fire brigade as a core service. Another concern is that the HSE wants to absorb the emergency medical services. A further concern is that the funding mechanisms are cumbersome and that DFB has not received its fair share of the increase in funding in recent times. Crucially, there are concerns over the proposed transfer of call-taking from fire brigade to the national control centre in Tallaght. Certainly, this proposal is one the fire services staff I spoke to earlier believe could cost lives.

What surprises me most of all, however, is that all these concerns fly in the face of the recommendations from the expert panel. The Minister of State rightly listed several reports from 2007 to the present. However, she did not mention the report of the expert group established to work out how best to respond to the concerns of the HIQA report. The fact that it was not mentioned suggests, notwithstanding Government support, the call of Deputy Darragh O'Brien for the Government to enthusiastically embrace the recommendations of this motion, which I fully support, has yet to surface.

I will outline the key issues I want to raise. The expert group recognised the validity of the two models of ambulance service and it called for parity of esteem among them. It called for full financing for the two services to be derived from the two lead Departments as well as greater co-operation, co-ordination, governance and clinical governance between the two providers. Crucially, the report called for the maintenance of call taking and dispatch of both services. What all of us would like to hear today is that the Government supports the recommendations of that expert group. What was the point of the city council setting up an expert group and giving it this work if it would not accept the recommendations? Since it seems the council does not fully support them at management level, it is time for the Government to step in and join the rest of us in calling on the council to do so.

The Government should do more than allow the motion to pass. It should ensure that those recommendations become core Government policy. Let us send a clear signal to Mr. Owen Keegan, Dublin City Council and the HSE to the effect that what they are currently trying to do is unacceptable and that we want a properly funded Dublin Fire Brigade with an emergency medical service and adequate funding. This will ensure that the men and women who put their lives at risk on a daily basis can continue to do so with full Government support and resourcing.

I welcome the members of Dublin Fire Brigade and my former colleagues from the union to the debate. I thank Fianna Fáil for tabling the motion.

The fire brigade does fantastic work. Much of this work goes unseen but that does not mean it is not important. The motion states that DFB has been providing crucial ambulance services to the citizens of Dublin city and county since 1898. Today the fire brigade provides immediate medical assistance 24 hours per day, seven days per week. Those who have been rescued, saved or transferred by the DFB cannot speak highly enough of them. I have in mind my grandmother. She is not with us anymore, but when the time came and she needed to be transferred to hospital, she was transferred by the DFB. Our family will be forever grateful for the care and compassion the personnel showed us.

Dublin Fire Brigade has the knowledge and experience to continue to deliver a full range of services to the capital. The provision of a fire-based ambulance service is regarded internationally as best practice. Combining fire, rescue and emergency services greatly improves the response to a crisis. There must be full support not only for the service but for the personnel who deliver that service. Instead of attacking the service, we need to maximise service delivery.

I echo what has been said by other Deputies. It is unfortunate that none of the senior Ministers could find time in their schedule to be present. I hope that does not send a negative message to the people who are in the Gallery or those who are outside.

There should be no barrier for staff in the DFB from career progression. We need to enhance the service and attract men and women to the service and ensure they can access continuing professional development.

I welcome the Minister of State's comment that she believes it is timely to look again at how the funding arrangements between the two organisations work as well as how to put the service on a sound financial footing. However, we need to understand what exactly this means to have confidence that the great service provided by the men and women of the fire brigade to the people of Dublin will continue.

Ba mhaith liom mo bhuíochas a ghabháil dóibh siúd a chuir an rún os comhair an Tí anocht, ach go háirithe na fir agus mná Briogáid Dóiteáin Bhaile Átha Cliath, mar thar na blianta, thug siad cuidiú, ní hamháin domsa agus do mo chlann ach do gach uile duine sa chathair seo a bhí i gcruachás agus a tháinig an briogáid dóiteáin chucu agus a thug cabhair cáime dóibh nuair a bhí gá ann, ach go háirithe i mo theanta féin ar an gCarnán nó fiú lasmuigh i dTamhlacht agus Sráid an Phiarsaigh, bhuail mé leo thar na blianta agus bhí siad an-mhaith, an-phroifisiúnta agus bhí an cuma ar an scéal go raibh siad ag caitheamh go maith lena chéile agus nach raibh aon choimhlint eatarthu. Ba mhaith liom a rá thar ceann gnáth lucht Bhaile Átha Cliath go bhfuil éacht á dhéanamh acu agus ba chóir go mbeadh siad an-bhródúil as sin.

Like others have done, I acknowledge the commitment, dedication, bravery and heroism of the members of the Dublin Fire Brigade, and other fire brigades in the State. I acknowledge the work they do, in many cases without proper resources. The Dublin Fire Brigade has a proud history.

There is an adage that if it is not broken, do not fix it. The first document I contributed within Sinn Féin was on the Dublin Fire Brigade in 2006. This is how far back there has been an attempt to undermine the Dublin Fire Brigade. I am aware that there are difficulties and that the model does not fit every aspect or requirement of a small island but rather than enhance it and roll out the Dublin Fire Brigade model throughout the State why does the Government want to change it? Why are other cities in other countries looking at the Dublin Fire Brigade model to roll it out? It is because the model works. It fixes people and it saves lives.

In comparison to other public services, the retention levels in the Dublin Fire Brigade are high, which is down to the fact that fire fighters are appreciated by the public. The Government started to undermine the service in recent years, and it looked as though the service was to be picked off bit by bit, to become parts of other services or through privatisation as originally intended with the proposed call-out centres and ambulance services. Luckily that attempt was lost in the courts.

For years I have believed there is a need for a proper roll out of the model, but there is also a need to properly resource the Dublin Fire Brigade. If the Dublin Fire Brigade cannot answer all the calls it is nothing to do with its commitment, it is to do with years of under investment in it. Its members would love to be able to answer each and every call that comes in; that is their focus and their job and it is why they joined the service in this city. It is why they undertook the huge amount of training, which stands to them when they respond to a call out, be it a road traffic accident or a person in difficulty in a house. The Dublin Fire Brigade wants services and ambulances and it wants additional staff, but the brigade has been starved of these resources.

The last piece of the Minister of State's contribution, or what she was trying to get at, exposes the Government's intentions which are to give the National Emergency Operations Centre, NEOC, all the medical call outs rather than enhancing the existing service of the Dublin Fire Brigade. If it is broken in Pearse Street, then fix it, or find another location, but do not take away a service that is used for the benefit of Dublin city dwellers.

Fire fighters with the Dublin Fire Brigade provide fire and emergency medical services to the citizens of Dublin. The Dublin Fire Brigade has more than 800 paramedics offering a world class service to the citizens of Dublin. These skills allow trained Dublin Fire Brigade personnel to assist ambulance and medical personnel in the trauma care of patients particularly for those involved in accidents. Dublin Fire Brigade personnel each day provide care for people with a range of traumas such as spinal injuries, burns, cardiopulmonary resuscitation, broken bones, oxygen therapy, defibrillation and other medical emergencies. Fire brigade personnel arriving at an incident or medical emergency can immediately begin the process of lifesaving because they are trained to do so. Such early intervention by the fire brigade ambulance services is crucial for both medical and trauma patients and gives them a greater chance of survival. When the ambulance service takes over the responsibility for the patient at the scene the fire brigade personnel can then offer a support role to the ambulance service. When the fire service is first to arrive at the scene of an incident, and where there is an injured or seriously ill patient, it is sensible and logical that fire brigade personnel should have the necessary skills and equipment to provide effective treatment and support for the patient until the ambulance services arrive. Having such skills allows fire brigade personnel to provide an effective and rapid response to life threatening medical emergencies, especially in locations where the fire brigade will be able to get to a call more quickly.

Why is this service so important? If a person has an obstructed airway, he or she will die in less than five minutes. Simply protecting the airway of a seriously ill patient will save his or her life. A defibrillator is most effective if used within four minutes of a cardiac arrest; after eight minutes have elapsed there is only a very small chance of a successful outcome for the patient. In rural areas such a service is very important because of the greater travel times involved and the delays caused by traffic and weather conditions. The Dublin Fire Brigade personnel are trained emergency service professionals and are the ideal people to carry out the function of first responders. They are not there to undermine the ambulance services but to enhance these services. If the Government is not opposing this motion, it is time for this House to send out a clear message to Owen Keegan in Dublin City Council and the HSE saying hands off, we love our fire service, it is a great service, there is no reason it should be undermined and we need more funding for our service.

I move amendment No. 1:

To insert the following after “ambulance services provided by DFB across Dublin.”:

— implement in full the Report of the Expert Panel into Pre-Hospital Emergency Care Services in Dublin, published in December 2015.”

The Labour Party fully supports the motion as proposed by Fianna Fáil. It is very welcome that there seems to be wholehearted support for it in the Chamber. I hope this means there really will be a strengthening of the resolve to maintain the service of the Dublin Fire Brigade as it is and to properly resource it, which is the main point that is being made here tonight. On behalf of the Labour Party, I propose an addendum, rather than an amendment, to implement in full the report of the expert panel into pre-hospital emergency care services in Dublin, which was published in December 2015. In proposing the addendum, the expert panel has made a detailed report and a detailed study. I believe it would add to the motion and I hope Fianna Fáil will accept it and add it to it.

As other Members have already said, the service is not broken. It does not, therefore, need to be fixed. It needs to be strengthened but it certainly does not need to be fixed or changed in any way. There is a unique advantage in the Dublin Fire Brigade that we may not have in other parts of the State in that all Dublin Fire Brigade fire fighters are fully trained paramedics, many of whom are advanced paramedics. When an ambulance is not available, or when it is on its way to a call out, the fire tender crew can support the person who is in need of medical intervention. This is especially useful when attending road accidents. Some of the crew can attend to the casualties while other crew manage traffic or the other duties required. This is a real positive. It also allows for crews to be rotated between fire service ambulance and fire tenders so they are always out on the road responding to calls. This system reduces crew burnout rates and allows crews, through regular application, to keep their skills finely tuned.

This is a very good and positive service. The one demand and the one need is to have the service properly resourced.

My understanding is that four more ambulances and their attendant personnel are required.

The expert group has made a number of detailed recommendations. The group comprised a retired chief fire officer with 40 years of experience, an experienced chartered accountant, a consultant in emergency medicine and a long-term council official. Clearly, they had a level of expertise. In their recommendation on call taking and dispatch, they wrote that, while there were inherent differences in the approach to this work in both organisations, it was the panel's recommendation that the models in both centres be retained. The panel also believed that the transfer of 999 EMS calls from the Dublin Fire Brigade to the national emergency service would have implications for the safe management of such a large increase in the volume of calls to the latter. Critically, the panel considered that the removal of any element of the fire-based EMS model would detrimentally affect the safe delivery of that service by the Dublin Fire Brigade to the patient. However, it recognised that both providers needed to work together. Following technical advice from Mason Advisory, the panel was satisfied that a technology-based solution would address those concerns and enable mobilisation of the nearest available resource without compromising patient safety. This follows on from the HIQA reported that was mentioned.

There are positive recommendations on how the national service and Dublin Fire Brigade could co-operate, but no one is suggesting that the Dublin Fire Brigade should transfer to the national service. The brigade is doing a very good job and Dublin people are satisfied with its work. It is safe compared with services elsewhere and it should be maintained and strengthened.

I wish to acknowledge a conversation I had with a councillor, Ms Alison Gilliland, chair of Dublin City Council's special committee on fire and ambulance services and emergency management. On behalf of that committee, she has presented motions to the council, as have other councillors.

We hope that tonight's debate will lead to an assurance that the Dublin Fire Brigade will continue delivering its excellent service and that it will be adequately resourced to do its important job.

I thank Fianna Fáil for tabling this motion on the most important of issues. The provision of fire safety and critical ambulance services is something that cannot remain unresolved and in limbo. Fire brigade personnel have been in a permanent state of industrial unrest for more than three years. It is not their fault, but the fault of the Dublin City Council CEO and a lack of leadership from the Government. It is a testament to the commitment of the Dublin Fire Brigade to the citizens of Dublin that its industrial unrest has not resulted in large-scale industrial action. We welcome this motion as an opportunity to bring home to the Government the need to resolve these issues once and for all.

We are lucky in Dublin to have two ambulance services, one run by the National Ambulance Service, NAS, and one run by the Dublin Fire Brigade. We are especially lucky to be served by the latter. The Dublin Fire Brigade offers a combined service of fire and paramedics, which is a global standard used by 97% of the major cities in the US. We sometimes look at other countries' practices and lament that we do not have them as well, but we have had this service for 120 years.

The calls in the motion must be delivered upon. We need to see full and demonstrable support for the Dublin Fire Brigade from the Government. We cannot forget the sacrifices made by the Dublin Fire Brigade when the country was in an economic crisis. It implemented cost saving measures through internal agreement. Difficult measures were agreed upon between workers and management without ever affecting the vital service those workers provided to our city and county. We must not forget that. In this era of distrust in public bodies and institutions and when scandals emerge in many corners of our society, the Dublin Fire Brigade remains an organisation that is trusted by the majority of Dubliners. We cannot put a price on that, and this trust must not be damaged.

As per the Labour Party amendment, we ask that the Government and the House support the Dublin Fire Brigade. We ask that the Government implement the recommendations of the pre-hospital emergency care services report, which has been lying on a shelf for three years. Its recommendations need to be implemented immediately. The report's conclusion states that the governance structures as set out previously would provide the Dublin Fire Brigade and the NAS the autonomy to plan strategically and develop operations and training to the level required of a professional emergency service. The panel asserted that the removal of any element of the Dublin Fire Brigade's fire-based EMS system would have an adverse effect on patient care and, therefore, it did not support the proposal to transfer call taking and dispatch functions from the Dublin Fire Brigade to the NAS. It was the panel's recommendation that the call taking and dispatch models in both centres be retained.

The panel's main recommendations included addressing operational deficiencies within the Dublin Fire Brigade as well as the implementation of an integrated ambulance service by the NAS and Dublin Fire Brigade. The report also highlighted the need for a new funding structure from the Department of Housing, Planning and Local Government alongside the necessity for individual improvements and collaboration between the two providers in the area of call taking and dispatch.

We need to implement these recommendations without delay and provide certainty to the workers of the Dublin Fire Brigade, whom I welcome to the Chamber. We need to provide certainty to the people of Dublin city and county, who trust and respect the service provided. People need to be proud of the service, as we in the Labour Party are. I am proud of the fire service workers from my full-time service in the Swords station and my retained service in Balbriggan and Skerries. We want to let them continue the great work they do on behalf of the people of Dublin.

I welcome the women and men of the Dublin Fire Brigade. They were like a small army on the plinth in this evening's sunshine. We are all proud of them, given their history - fighting recent hotel fires, the accident on Wellington Quay and the Stardust fire, the memory of which is still fresh in our minds 37 years later. There will be an initiative in Croke Park this weekend to campaign once again for real justice following that fire, which has left a mark on the history of this city and the fire brigade.

When I was a councillor, an expert group was set up in what I believe was an attempt to take the Dublin Fire Brigade out of the control of Dublin City Council dressed up as an examination of the functionality and efficiency of the brigade. Sir Ken Knight was brought over from, I believe, the Manchester region. He was an experienced firefighter who had been knighted for his work and expertise. If memory serves, Dublin City Council spent approximately €100,000 on producing his report, which then sat on a shelf and was never taken down again because Mr. Owen Keegan did not agree with its recommendations. After returning to the system he had worked under in London and beyond, Sir Ken Knight recommended that the efficiencies the Dublin Fire Brigade had achieved with its combined model of paramedics, ambulances and fire engines be applied in Britain because it was such an impressive system. He estimated that he could save approximately £200 million for the British system, but we wasted €100,000 on this expert's report and left it sitting on the shelf to gather dust because Mr. Keegan did not agree with it. As he had done as county manager at Dún Laoghaire-Rathdown County Council, he pushed hard to unburden Dublin City Council's budget of the men and women of the Dublin Fire Brigade and their work.

This is an important point when one considers the language. Mr. Keegan came into the council not as a manager, but as a CEO. He started to make decisions that were not about the health and safety of the city or the interests of the men and women of the Dublin Fire Brigade and those whom they served, but about efficiencies and running a corporate entity as opposed to a city with all of its complexities.

The men and women of the Dublin Fire Brigade consistently fought to defend the system and won.

Thankfully, they are here tonight for this motion. They are here because that system is under attack again.

I welcome the Government's recognition of the role played by Dublin Fire Brigade and its endorsement of the motion. Like Deputy Ó Snodaigh, I am a little worried about what it actually means. The Minister of State acknowledged in her speech, copies of which we will give to the firefighters afterwards, "the National Ambulance Service could not recruit at the level necessary to displace the Dublin Fire Brigade paramedic workforce and so cannot, and will not, take ownership of Dublin emergency ambulance service provision." That is a welcome acknowledgement. Dublin Fire Brigade received 7% of the funding that is used to answer 40% of the calls on a national level. Dublin is home to one third of the country's population and the most complex health and safety issues with which those with responsibility in this regard have to deal probably arise. There is evidence that the number of such issues in the city is going to increase. Earlier, we heard reports of the number of accidents and road fatalities increasing again - year on year and month on month - compared with last year. More importantly, episodes relating to climate change, flooding, wind damage, downed cables, falling trees and sea levels rising are going to cause major problems. Throughout the country, not just in Dublin, we have witnessed the heroism of Dublin Fire Brigade and other firefighters and emergency service personnel during recent flood and storm events. These services are going to be required more and more, not less and less.

In the context of its review, details of which were published in March 2017 and which involved an examination of the progress made in implementing recommendations of pre-hospital emergency care services - in other words, ambulance services - HIQA states:

A key finding of this Review relates to the provision of services in Dublin. HIQA found a high level of risk associated with a lack of collective ambulance capacity and arrangements for call handling and dispatch.

This short, two-page document does not indicate exactly what that teases out but I suspect that the problem with the high level of risk is not associated with the service delivered by Dublin Fire Brigade but rather with the lack of delivery on the part of the HSE. This is not intended as a criticism of the men and women who work in the paramedic ambulance service of the HSE; it is a criticism of the HSE itself. Such criticism is not unusual. In light of the recent scandal relating to CervicalCheck, the HSE is well deserving of criticism. I worry, however, that the criticism is misplaced. The Minister of State indicated that what is proposed is to transfer all ambulance call-taking and dispatch functions to the NEOC such that all such services across the State will be consolidated in one centre. She also said that this is required because the current call-taking arrangements represent an unacceptably high patient safety risk and give rise to delays in the allocation of ambulance resources to patients, including in potentially life-threatening situations. I do not believe that the evidence shows us that this applies to the delivery of service by the men and women of Dublin Fire Brigade. Rather, it applies to the inefficiencies relating to and lack of leadership and, often, mismanagement on the part of the HSE. I want to offer a caution about that.

We live in a society where we sometimes forget to talk to the people who know what they are talking about. I refer to those who are out every day in fire stations, on the streets - where major problems can arise - attending accidents, in houses picking up people who are dying or sick and dealing with the impacts of climate change. Unless we talk to them and hear exactly what they have to say about the changes required - if they are required - and how they can be delivered, then we will run into trouble. We will certainly run ourselves into trouble and towards a lesser standard of service delivery if we rely on what I believe to be a broken HSE. The latter has proven, most recently in its handling and mismanagement of health cases of dying women, that it cannot be trusted. That sounds quite dramatic but I am of the view that before any of this is be implemented, we need to talk in a serious way to the men and women of Dublin Fire Brigade and, indeed, to those who are responsible for operating the National Ambulance Service. My brother, who has since passed away, worked for the service. As somebody who was dedicated to his work, for many years he was frustrated that the workers were never listened to when they put across proposals that might help to deliver a better and more efficient service in order to create a better, safer and healthier city for all.

I support the motion. I thank Fianna Fáil for tabling it. I support it because of the men and women here tonight and their colleagues throughout the fire service and the ambulance service. I am here tonight to state that intention about the motion. I accept the motion and I will talk to the firefighters between now and any vote taking place on Thursday in order to discover what they think. While the Government is accepting the motion in general, there are parts of the response relating to the NEOC with which I am not happy. I reckon the firefighters are not happy with them either. The Joint Committee on Health could possibly set up a subgroup to work with the firefighters and the ambulance service to look at the report from HIQA in order to ensure that the resources the firefighters need are provided. The matter could then be referred back to the Dáil. It should not be placed on the long finger over a period. There should be a time limit of two or three months; whatever is negotiated with the firefighters and the National Ambulance Service workers. That might work. I would like to hear what the firefighters and ambulance service workers have to say about that but the committee could work to move this matter on. I do not think there would be general agreement with the Government's proposals.

In 2017, 233 people were rescued by Dublin Fire Brigade. Some 43 persons were rescued from fires, 70 river rescues were attended and there were 79 road traffic collision rescues. All full-time firefighters are trained as paramedics and rotate continuously between firefighting and providing emergency medical services. Dublin Fire Brigade's 12 emergency ambulances, of which it needs more, are staffed by paramedics who are available to respond 24 hours a day, 365 days per year. In addition, there are 21 front-line fire appliances, of which more are needed, with up to 120 paramedics available to respond on a daily basis. All full-time firefighters are trained to paramedic standard and are required to maintain Pre-Hospital Emergency Care Council, PHECC, registration as paramedic practitioners. All trained firefighters are trained to an emergency first responder level. Tangible clinical outcomes in 2017, illustrating the work of fire brigade emergency medical service, include: 61,462 patients treated and transported to hospital - that is a huge number; 3,527 critical medical incidents managed; and 435 cardiac arrests manage. Also in 2017, Dublin Fire Brigade assisted in the delivery of 12 pre-hospital childbirths and mobilised in 86,405 emergency ambulance instances. That is a tremendous response from the men and women of these services.

I want to make particular reference to Dublin City Council because it has already been alluded to here. In 2014, the HSE had been attempting to take control of the Dublin ambulance service from Dublin Fire Brigade. In March 2014, the director of the HSE's National Ambulance Service was called before Dublin City Council councillors to answer questions about his intentions towards Dublin Fire Brigade's ambulance service. The decision to do this was taken amid growing controversy at the time about a HSE plan - drawn up in 2013 - to take control of Dublin ambulance service from Dublin Fire Brigade by the end of 2015. The plan in question was drawn up in advance of the HSE-Dublin City Council review of the capital's ambulance service, which was announced in February 2014.

In the same month and year, at a meeting of the council's environment committee, the chief fire officer gave a presentation where he said the major issue for the fire brigade was funding. He said the fire brigade had provided the ambulance service in Dublin since 1898 on behalf of the city council, while the HSE provides for services outside Dublin. The council agrees a figure annually with the HSE. In that year it was approximately €9.8 million. The chief fire officer stated that the fire brigade's 12 ambulances were working at full capacity and even with the backup of 22 fire tenders, which often responded to 999 emergency ambulance call-outs, the brigade was not able to meet HIQA targets due to factors outside its control. Those factors were resources in areas that included ambulances and personnel. The chief fire officer stated that it had been impossible to reach an agreement on a sustainable funding model with the HSE over the years. That was in 2014.

Members from all parties and none across the council support the fire brigade service. It appears to me that the chief executive officer of Dublin City Council, Owen Keegan, and the HSE are intent on breaking an effective, efficient, state-of-the-art model of service developed over 120 years by removing Dublin Fire Brigade's ability to maintain a full fire-based emergency medical service, EMS. As other speakers have said, the model is working, so why change it? Why not expand it? Why not resource it? Why not satisfy HIQA standards and support the service?

In the time remaining I will read an email I received from a firefighter in recent days. He gives a sense of the pride the workers have in the service:

[The Dublin Fire Brigade service which] we in the service are extremely proud of, and have provided to the city for 120 years, is now under a very real threat of been removed from us and the citizens of Dublin. The HSE has proposed the removal of the delivery of this fire/EMS service from the DFB and instead merge the service with the National Ambulance Service. I know first hand the value of Dublin File Brigade providing an ambulance service and having the back up of every firefighter being highly trained in fire, rescue and paramedic or advanced paramedic skills. From a personal point of view, the comfort that I take from knowing that any of the crew members responding to an incident with me, are capable of performing life saving interventions at the scene of an emergency, makes my response a lot easier.

In today's world, where there is a constant threat of a large scale terrorist attack or even a small scale attack with high casualty numbers, running alongside the normal everyday emergencies, Dublin Fire Brigade is capable of providing in excess of 100 paramedics on-scene within a very short time frame.

Last year Dublin Fire Brigade Emergency Regional Control Centre processed in excess of 114,000 ambulance calls and 23,576 fire calls. This year to-date the figures are 56,029 for ambulance calls and 9,033 for fire calls. Dublin Fire Brigade has 12 emergency ambulances strategically located throughout the city and county. Our service is at capacity, so not only is full retention of the service an urgent matter but an increase in capacity is also required as a matter of urgency.

He goes on to state:

The National Ambulance Service, NAS, provides an emergency ambulance service to the whole of the country. At times where Dublin Fire Brigade are at capacity a request is made to the NAS for resources and vice versa, [obviously when needed]. Last year the response from NAS to [the Dublin Fire Brigade] requests for resources was 75% negative, i.e., they could not provide us with an ambulance. The opposite response, where NAS requested resources from the DFB was met with 80% positive response. [That is down to resources and that must be addressed. That is the point the writer of the email is making.]

Ambulance calls are categorised in accordance with the priority of the emergency, the most urgent calls are designated Echo calls, with Delta being urgent but not life threatening. Within the DFB response protocols, a fire appliance, staffed by an officer and 4 firefighters-paramedics is automatically dispatched to all Echo calls. Delta calls may also have a fire appliance attached if the situation warrants one. This dual response capability is a key component to our strength as an emergency service and cannot be mimicked by the NAS.

That point must be taken on board. I would like to hear the response of the workers involved in the direct front line. They are the people who save lives and they are putting their lives at risk. I think we should respect them and resource them properly. I wish to emphasise that point. We should link in with the committee to see whether we can move the issue on and bring the proper services into Dublin and across the country.

I am grateful for the opportunity to speak on this motion today. First, I commend the work of the fire brigade service, many of whose members are in the Gallery, on providing a crucial service to the citizens of Dublin city and county. While I am from west Cork, most weeks I spend three days in Dublin and I may well need the fire brigade service at some stage. While tonight's issues are very much focused on the Dublin Fire Brigade service, the west Cork fire brigade service also has problems which need to be highlighted. I will only touch on that briefly today.

I disagree with the HSE's proposal to remove the delivery of Dublin's ambulance service from Dublin Fire Brigade and, instead to merge it with the National Ambulance Service. At present, Dublin Fire Brigade has 800 trained firefighter-paramedics to provide immediate medical assistance to members of the public in need of treatment on a 24-7 basis, 365 days a year. If the ambulance service in Dublin is removed from Dublin Fire Brigade it will impact negatively on the delivery of this vital service and have an adverse effect on safeguarding the community of Dublin. Instead, the Government should be looking at ways to maximise service delivery and to provide greater measures to protect the hard-working firemen who risk their lives every day in order to keep others safe.

In my area of west Cork, the firefighters do tremendous work also and should be recognised for that. It is a disgrace that Bantry and Bandon fire stations have water tankers that are broken. They must be replaced immediately. Bantry's water tanker was put off the road in February of this year and Bandon's water tanker has been off the road in recent years. A water tanker is a very important asset to a fire service fleet, as it can carry up to 2,000 gallons of water. In many cases when a fire brigade is called out to a fire there is no water fire hydrant and that is when a water tanker is vital. It is outrageous that west Cork currently does not have any water tankers and that the nearest ones are in Mallow and Middleton. In a recent fire at a farm in west Cork, five fire stations had to be called out because of the extent of the fire where there was no hydrant and extra water was needed. They had no water tanker and if they had, all these stations would not have been needed.

I will return to the issue at hand. I call on the Government to retain the delivery of Dublin's ambulance service through Dublin Fire Brigade and not to merge Dublin's ambulance service with the National Ambulance Service.

I am happy to speak on the motion this evening which I support. I compliment my Fianna Fáil colleagues on tabling the motion. I got very worried when I read in the motion that there are concerns that the Health Service Executive is seeking to remove the delivery of Dublin's ambulance service from Dublin Fire Brigade and instead to merge the service with the National Ambulance Service. I agree with the motion that such a proposal could have a hugely negative impact on the delivery of services from the Dublin Fire Brigade call centre and that removing any element of its fire-based emergency medical service, EMS, system will have an adverse effect on safeguarding communities. That is what we are all about here. Our primary duty as elected politicians is to safeguard the people in our communities.

How can anyone in this day and age think it is a good or progressive move to merge any service within the fold of a completely dysfunctional HSE or even the National Ambulance Service? The HSE gets more dysfunctional by the hour. It beggars belief that a health service that is so dysfunctional and chaotic would even seek to have such a move sanctioned. However, it would, because it has no shame. We saw today that Professor Hillery resigned. More people will resign and flee from the HSE because it is utterly dysfunctional, power-grabbing, self-serving and unaccountable. There are many good workers on the ground but not at management level. I am afraid that despite the heroic work being performed by ambulance personnel right across the State, the same, sadly, cannot be said of the National Ambulance Service itself.

In my county of Tipperary - in Clonmel, Thurles, Cashel, Tipperary town and Nenagh - we only have one ambulance each to cover night duty from Monday to Sunday each week. I do not blame the ambulance crews, drivers or paramedics. I blame management. It is all about management. To hell with the people and to hell with the crews according to the HSE bible. It is absolutely appalling to think that a single ambulance is being provided to cover night duty in each of the towns concerned. The hinterland of the towns could stretch 20 miles up into the mountains of Hollyford, the Galtee Mountains or the Knockmealdowns. The towns are major urban centres, not to mention the surrounding rural localities, which rely on efficient ambulance services.

I am informed by the NAS that despite recommendations from its first ever capacity review on the urgent need to recruit additional staff, this will only occur over the next four years. This is disgusting and represents a blatant disregard for people's safety and lives and for ambulance crews. This is unacceptable, given the ongoing chaos and numbers attending emergency departments in South Tipperary General Hospital and University Hospital Limerick and the numbers of patients waiting on trolleys. There also seems to be a significant disparity in the level of ambulances and rapid response vehicles that are assigned to day duties for each of these towns. Cashel, Roscrea and Tipperary town, for example, have only one ambulance each, covering duty from Monday to Sunday while Nenagh has one ambulance and an initial rapid response vehicle covering the same time period.

The NAS is talking about developing a single, cohesive, strategic plan for ambulance services called Vision 2020 - God help us. Any visions the HSE had are a distant fog on the mountain peaks and are disappearing by the hour. How many more strategies do we need? Given all of this, is it any wonder that Dublin Fire Brigade is terrified of having its ambulance service subsumed within the NAS, never mind the HSE? I salute the members of fire brigade. A good friend of mine from Tipperary, Mr. Michael O'Donnell, is a proud member and he educated me about the fire brigade when I came to Dublin first because I was not aware of the situation with regard to the fire brigade providing an ambulance service. They do an excellent job and as the saying goes, "If it's not broken, don't fix it". We must not allow the HSE to get its greedy and greasy paws on this service. All it wants is prestige and self-preservation and to hell with the people. I salute the Dublin Fire Brigade whose members do their duty gallantly. They always do so when we come up here for All Ireland and other matches. We will not be here this year, unfortunately, but we will be here next year. Comhghairdeas leo go léir.

I welcome the members of Dublin Fire Brigade who are in the Public Gallery and thank them and all of their colleagues throughout the country for the excellent work they do to protect people and property. They attend accidents on our roads and many times they encounter horrendous situations, including in our cities and on our motorways, where lives are lost. The DFB does excellent work. Why we do not leave them alone to continue doing so? When I hear the words "reconfiguration of services", I know that means a reduction in services. We have found that to be the case in Kerry, whereby a so-called reconfiguration of the ambulance service was simply a reduction. In many instances now, it can be an hour or more before an ambulance arrives in parts of Kerry because the service is stretched to the limit. A Tralee-based ambulance that comes out of Cork University Hospital has to press a button to report availability for work and can end up in Kinsale or Kanturk rather than back in Tralee. When that happens, Kerry is left without an ambulance.

I thank the ambulance workers for the great work they are doing. I also thank the members of the fire service in Kerry in places like Sneem, Kenmare, Killarney, Tralee and Listowel. They do great work protecting people when fires break out. I saw them at work on the night a local pub was burned down and they did everything they could to save as much property as possible. They do everything really. They do their level best and while they might not really put their lives in danger, they have a tough time. When they are called out, they have to get on the road within minutes. Everything depends on them doing that. We depend on them so much.

I ask the Government to leave Dublin Fire Brigade alone and let it continue to do the work it has been doing for the past 50 or 60 years.

It is 120 years, in fact.

I thank my colleagues, Deputy Lahart, our Dublin spokesperson, and Deputies Darragh O'Brien and Haughey for tabling the motion, which involved a lot of work on their part. I welcome all of the Dublin Fire Brigade workers who are in the Gallery and I thank all of the people who were outside the Dáil earlier who spoke to us. Unfortunately, I did not see any Government representatives there today but I know that the front-line workers would have liked to engage with members of Fine Gael and with Independent members of Government. I met many members of the fire brigade last weekend at Huntstown Community Centre. They brought with them the true spirit of DFB. They were out in the community, teaching and engaging with children and providing a community service. That might not be valued under the HSE's key performance indicator index or the various outputs of the Department of Health but we must value DFB as a community service first and foremost, which is not recognised.

Last year, I visited Blanchardstown fire station which covers a wide area, including Dublin west and beyond. I spoke with workers there who are disillusioned with this Government's offer of what can only be described as qualified support. I read the speech delivered by the Minister of State. While the Government accepts the motion, it is only doing so on a qualified basis. Why does the Government not offer full support to the workers in Dublin Fire Brigade? It would have been worthwhile for members of Government to have met the men and women of the fire brigade and heard what they have to say on this important matter. They understand the issues at play much better than the Minister of State or anyone in the Department of Health. This is important because we are talking about life and death and people in an incredibly vulnerable situation getting the necessary care in an emergency. It is as stark as that.

I firmly believe in the old adage, "If it ain't broke, don't fix it". Regrettably, there are plenty of things broken in Ireland today. We have a housing and homelessness crisis, with more than 3,000 children homeless, and we do not have many solutions from Government. No one can claim the health service is operating well and that the HSE is fit for purpose to deliver healthcare. However, it wants to absorb a service that is working well and is not broken. We have chaos in the Department of Justice and Equality, teachers who cannot pay their rent and a massive haemorrhaging of personnel in the Defence Forces. The Government is again not fixing something that is broken. The elderly are struggling to get by on a week-to-week basis because their pensions are being raided. These issues require fixing now. These are the issues upon which the Government should focus on rather than only offering qualified support to the workers in DFB.

Dublin Fire Brigade provides an exemplary, world class ambulance service which saves lives on a daily basis and has done so for more than 100 years. The men and women of the fire brigade know what they are doing. They provide a stellar service 24 hours a day, 365 days of the year. They operate such a good model that other countries have tried to replicate it. A person who has a heart attack in Dublin is more likely to survive than in most other cities in the world. This is precisely because our firefighters are all trained paramedics. Reports have found that we rank second in the world in terms of recovery from heart attacks. Only Seattle performed better and that city studied the Dublin model when designing its own system. This is one of the few areas in which we are a world leader and the Government should not try to undo that by allowing the service to be absorbed into the HSE. Our current model combining fire, rescue and emergency services is internationally recognised as best practice because it works. This model keeps people alive and it is the difference between life and death.

I have received a massive volume of calls and emails from members of DFB and from worried members of the public. Much of their concern stems from the dearth of information about what is being planned. A commitment was given and the Taoiseach himself stated previously that any changes to the ambulance services provided by DFB would only be considered after lengthy engagement but this has not happened. Fianna Fáil and the public want to improve the capabilities of fire brigade to make it even better than it is now, not to remove or absorb it. Year on year, as the population grows, calls have increased for additional recruitment but staffing levels are not keeping pace with demand. This means we are heading towards a major problem unless we recruit more workers and empower and resource fire brigade. It is tragic that this continues across many aspects of our front-line health services.

A technical solution can be found, despite the qualified support from the Minister of State earlier. According to the men and women of DFB, increased co-ordination between Tallaght and Townsend Street will transform the service. A comprehensive co-ordination programme, resulting in accidents and emergencies being responded to as quickly as possible, would only cost between €10,000 and €20,000 and should be supported by this Government.

I welcome the representatives of Dublin Fire Brigade. I support the motion before the House. The Minister of State, Deputy Catherine Byrne, said earlier that the Government will support the motion. Her words in expressing support for the motion need to be followed up with actions. That is what is important to us. All of us raise issues with the HSE day in, day out. It is proposed to take responsibility for ambulances from Dublin Fire Brigade and give it to the HSE even though it is having great difficulty in dealing with itself. As Deputy Haughey said earlier, "If it is not broken, do not fix it."

Most of the points I wanted to make have been very well made already. I want to touch on a couple of other aspects of the fire service nationally. Dave Carroll, who is the chief fire officer for County Tipperary and the president of the Chief Fire Officers Association, recently told the association's annual conference that the recruitment and retention of firefighters is a major concern nationally. He said in his speech the association must:

acknowledge the very real difficulties that our retained services are facing in terms of recruitment and retention of personnel. Notwithstanding the incredible commitment given to our communities by members of the retained fire service, it is clear that the current model is not fit for purpose. This model essentially places our fire-fighters on call 24/7 for 365 days a year with limited time off outside of this.

In many parts of the country where part-time arrangements are necessary, part-time firefighters are expected to live very close to their fire stations, which limits the kind of work they can get outside firefighting. Mr. Carroll continued:

This model evolved back in the 1950s and 60s and is patently unsuitable for today's lifestyle. The increased urbanisation of Ireland presents further challenges as primary employment migrates from the villages and towns to the larger urban centres. If one thing is abundantly clear it is that there is no easy solution, but neither is there an option to do nothing - the system is not far from falling over so we must arrest that fall, and arrest it now.

Those are not my words, or the words of someone making a political charge. Those are the words of the chief fire officer for County Tipperary, who is the president of the national Chief Fire Officers Association. His comments speak for themselves. The serious problem he has highlighted needs to be addressed. We expect part-time firemen to live nearby and to be on call 24 hours a day, 365 days a year. This seriously limits their potential to earn a living, especially as the income provided to part-time firefighters is quite modest.

I would like to mention another issue that has emerged lately. We need the 218 fire stations in this country because the first responders based in them do an excellent job in fire prevention and, when tragic cases arise, in making sure loss of life, injury and damage to property are limited. The Department is proposing to close Ballyshannon and Bundoran fire stations in south Donegal and to replace them with a single station. I ask the Minister of State, Deputy Jim Daly, to raise this matter personally with the Department and to respond to me. The two stations in question, which are serving the local area very well, sadly respond to many calls throughout the year. There was a significant tragedy in Bundoran in 1980, when ten people lost their lives in a fire at the Central Hotel. A whole family was wiped out. Indeed, such was the extent of the fire that one body was never found.

In 2009, a Fianna Fáil-led Government approved the construction of two new fire stations for both towns and both communities. The stations cover a very wide catchment. Indeed, Ballyshannon is the only fire station in the South that provides cover in Northern Ireland. There are several stations in Northern Ireland, including those in Derry and Strabane, that provide cover to the South from the North. Ballyshannon is the only fire station in the South that provides cover in the North. The area it covers stretches into north Leitrim and north Sligo and up towards central Donegal. The original 2009 plan, which was approved by the Department and the Government of the day, involved the construction of two new fire stations. That was the policy of the council. An expert report that was published recently was agnostic on the need to close one of the stations. It simply referred to response times. The community in this part of the country will not accept the stripping out of services and the closure of critical infrastructure of this kind. The Taoiseach and his colleagues, including the Minister of State, Deputy Jim Daly, and Deputies in Sligo and the north west, appear for weekly photo calls to announce plans for things like Ireland 2040. At the same time, it is delivering the closure of critical infrastructure like Ballyshannon fire station. I ask the Minister of State to look into this retrograde decision and do all he can to have it reversed.

Gabhaim buíochas leis an gCeann Comhairle as ucht deis a thabhairt dom labhairt ar an ábhar seo. I thank Deputies for their contributions to this evening's debate. It is clear that Deputies across the House enjoy a shared appreciation of the important role Dublin Fire Brigade plays in the provision of emergency ambulance services in Dublin. I applaud and salute the men and women of Dublin Fire Brigade, who are at the forefront of emergency services provision. People on the front line of emergency services are heroes who dedicate their lives for the safety and protection of others. Their work and dedication help the rest of us to sleep a little easier. I can confirm that there are no proposals to replace the fire-based emergency medical service that has served the people of Dublin well for many generations. I can also confirm that there are no proposals to merge Dublin Fire Brigade and the National Ambulance Service. However, there is a need to consider funding mechanisms to ensure Dublin City Council is adequately reimbursed for the ambulance services provided by Dublin Fire Brigade on behalf of the HSE. We also need to look at ambulance capacity in Dublin and we will do this. A capacity review identified a requirement for increased ambulance resources in the eastern region, which covers counties Dublin, Kildare and Wicklow. The capacity review underlines the need for a multi-annual programme involving phased investment in ambulance manpower, vehicles and technology.

I assure the House that the Government is committed to the delivery of a high-quality pre-hospital emergency care service throughout the country. Over recent years, additional investment has been directed towards pre-hospital emergency care each year. An additional €10.7 million, including €2.8 million to fund new developments, has been made available this year. New developments include the development of alternative pathways to care. For example, a "hear and treat" clinical hub has been in operation in the national emergency operations centre since March of this year. This will help to divert some lower acuity patients to alternative care pathways and will, in time, free up some emergency capacity. At present, the clinical hub is only available to callers whose emergency calls are routed through the national emergency operations centre, which is operated by the National Ambulance Service.

As we heard earlier, there are two separate call centres in Dublin, one operated by the National Ambulance Service and the other by Dublin Fire Brigade. The existence of two call centres in the capital presents a real risk to patient safety, which we urgently need to address. It is clear that our current call-taking arrangements give rise to delays in the allocation of ambulance resources to patients, including in potentially life-threatening situations. A single point of contact is needed to address patient safety risks which have been identified by successive reports over the decades. While technical solutions have been proposed and independently examined, it has been determined that none of them will resolve the patient safety concerns. We need Dublin Fire Brigade and the National Ambulance Service to have a more co-ordinated and integrated approach to call-taking and dispatch. To that end, a mediation process is under way between Dublin City Council and staff associations. I hope this process will conclude shortly, will pave the way for a safer and more responsive ambulance service for the people of Dublin and will ensure new innovations such as the clinical hub will be available to callers all over the country. I believe the conclusion of the mediation process will also help to provide certainty to Dublin Fire Brigade personnel regarding the continuation of the fire-based emergency medical service delivery model.

I would like to share time with Deputy Lahart.

Is that agreed? Agreed.

I commend my colleagues, Deputies John Lahart, Seán Haughey and Darragh O'Brien, who have raised this important issue. We know about the services that are out there but it is only when we need a service that we really appreciate the work that is done by many people, including people in my own area. I come from County Sligo, which is in the north west. We have a fire service in Ballymote. I can verify that when one rings the emergency number and then hears the sound of the fire engine coming, it is some relief to know it is on its way.

We should commend those who work in the fire and ambulance services. They are taken for granted a bit. It is only when one needs the service that one fully appreciates the work they do.

I come from Ballymote, County Sligo. We have a good fire service there. As my colleague, Deputy MacSharry mentioned, we have a fire station in Ballyshannon that is to be recommended for closure, which is quite wrong. As was said earlier, funding was committed for two fire stations, one in Bundoran and one in Ballyshannon. These are rural towns in which the population can increase tenfold in the summer time and in the tourist season. I cannot understand why any of those services would be shut down. It is a retrograde step and I ask the Minister of State to have a talk with the officials in his Department to try to get it resolved. The people of the north west deserve better than what is being proposed.

The retained fire service people work extremely hard. They attend fires and road traffic accidents. It is fine for us who are in our beds at night when these people get a call. They have to go out and God only knows what they face. That is on a regular basis. I do not think their work is fully appreciated by the Government. In my home town, the people who supply that service must live within a mile and a half of the station and to be there within five minutes of the alarm going off. Ballymote, County Sligo has one of the best rural fire stations in the country time-wise and response-wise. That is on the record. These people cannot get ordinary work like anybody else. One constituent of mine works one day a week and cannot move more than five minutes away from the fire station because he is contracted 24-7 and has no choice but to be in that locality. He has been refused jobseeker's allowance. That is very wrong. He is paid about €70 for the day. When he was getting jobseeker's payments, he was paid about €140. He had a net gain of about €10 a day but the man wanted to work. Now he is told that because he works that one day, he must give up the fire brigade and not work to qualify for a jobseeker's payment. There is something badly wrong if the likes of this can go on. It is unfair for people who are putting their lives at risk day in, day out. They work for us by doing a very dangerous job and they deserve better. Another Minister has informed me that because it is one day and the same day every week, that man's jobseeker's payment should not be stopped. I ask the Minister of State to check that out for me.

The retirement age for retained firemen at present is 55, with an extra three years when people are medically fit to do it That age limit should be raised to 63. We are expecting people not to be able to get their pension until they are 68 now. Provided they are medically fit to carry on, that age limit should be raised in order that they can carry on into the future. They are experienced people.

The acceptance of this motion by the Government is welcome. Even since this morning, its willingness has changed, not just in not opposing the motion as amended but in supporting it. This represents a victory for Dublin Fire Brigade and its emergency ambulance service and their supporters. However, the devil is very much in the detail. The Ministers of State have kept saying there is no threat to Dublin Fire Brigade and ambulance service and no plan to absorb it into the HSE or place it under the control of the HSE. We must look again at where the notion of that threat came from.

An agency of the State, the HSE, initiated a process to absorb Dublin Fire Brigade and ambulance service into the HSE. It developed an implementation plan and won the support of the so-called custodians of that service, namely, the city and county managers. The HSE controlled the budget and was unwilling to divest itself of it to Dublin Fire Brigade. The HSE wanted to control the very means by which Dublin Fire Brigade and ambulance service gets to do its work by controlling the call and dispatch centre. It was then by stealth that the HSE sought to absorb the services of Dublin Fire Brigade into and unto itself. That is where that threat came from and the notion that the Government had no idea about it is just folly.

Anybody close to this issue will notice the difference in tone in the Minister of State's scripted speech this evening, the first response to the motion. It is completely different from the tone on previous occasions when we raised this issue and for that we are grateful. However, there are still a couple of uninformed stings in the initial contribution by the Minister of State, Deputy Catherine Byrne, who stated:

[Dublin Fire Brigade] requests for [National Ambulance Service] assistance can be in the region of 1,000 per week. Sometimes [Dublin Fire Brigade] passes calls in batches which presents challenges to the [National Ambulance Service].

This is a question of capacity. Dublin Fire Brigade had 82,000 mobilisations last year. If it is not responding it is because it does not have the tenders or ambulances. It is a question of capacity and resources. I do not like the little implication in the Minister of State's speech that it is the fault of Dublin Fire Brigade and ambulance service that it did not respond to calls and batches of calls were handed back to the National Ambulance Service.

We would like to see the full implementation of the report of the expert panel on pre-hospital emergency care services in Dublin, which was published in 2015. We believe, as recommended in that report, that the installation should take place of terminals in both call centres, to which Deputy Jack Chambers referred, with additional resources and funding. The Minister of State, Deputy Jim Daly, has gestured towards that tonight and it is new. When the Minister for Health, Deputy Harris, discussed this a number of months ago it was not countenanced. I acknowledge the real progress that has been made. However, the call centre issue is not resolved although it is covered in the report of the expert panel. The measure has a cost of €20,000. We suggest that it would be possible to trial this technology for a period acceptable to the HSE, the national call centre, Dublin Fire Brigade and Dublin City Council. As the motion is calling for that anyway, in agreeing to support it, the Government is indicating that it is essentially put in place.

Many messages go out from this Chamber to the fire officers and crews who are in the Gallery this evening. One is a message to Owen Keegan. The Minister has essentially gone over the city manager's head. The city manager was ready to divest himself of an aspect of a service of which he is meant to be custodian. Legislation provides that he is custodian. A Minister has given him an answer. Because crews of Dublin Fire Brigade and ambulance service's fire-based EMS service have at least four paramedics, sometimes including an advanced paramedic - I am told it takes at least four paramedics to deal with a cardiac arrest - 27 lives were saved in 2017 and 20 lives were saved in 2016.

I am happy to commend the motion, together with my colleagues who have spoken tonight, including Deputies Jack Chambers, Haughey, Darragh O'Brien, and Curran.

I am very happy the Government is supportive of it and that it has changed its tune considerably since the last time we raised the issue but the devil is in the detail and we, along with members and representatives of the Dublin Fire Brigade, will be looking for a meeting with the Minister in the next two weeks to drive this process through to completion.

Amendment No. 1 in the name of Deputy Jan O'Sullivan was moved. It was not an addendum but an amendment.

Amendment agreed to.
Motion, as amended, agreed to.
The Dáil adjourned at 9.50 p.m. until 10.30 a.m. on Wednesday, 20 June 2018.
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