The National Ambulance Service (NAS) has been the subject of three separate independent reviews in recent years. The first of these, HIQA’s review of NAS governance arrangements, was published in December 2014. The second, the NAS Capacity review, which examined overall resource levels and the distribution of resources against demand and activity, was published recently. The third review, an independent review of services in the greater Dublin area, was jointly commissioned by the HSE and Dublin City Council; this review is expected to be completed shortly.
An action plan addressing the recommendations of the HIQA and Capacity reviews is currently being implemented. On completion of the Dublin service review the action plan will be updated, as appropriate.
The Capacity Review makes it clear that we need a very significant programme of investment in our ambulance services. In that context, a phased investment in a multi-annual programme involving manpower, vehicles and technology is required. The Deputy will be aware that the Programme for Partnership Government commits to additional annual investment in terms of ambulance personnel and vehicles. In 2016, additional funding of €7.2m has been provided for the NAS which includes €2m for new developments.
The Capacity Review identifies particular difficulties serving rural areas. Population density in Ireland is significantly different to that of many other countries. Outside the greater Dublin area, the population is widely dispersed with a relatively large population living in rural areas. Because of this population distribution, Ireland has a far higher percentage of activity in rural areas than other ambulance services.
The report recommends expansion of the Community First Responders (CFR) scheme as a means to address the needs of rural communities. This had also been recommended in the 2014 HIQA report. The Deputy may wish to note that the CFR scheme has been expanded in recent years and currently 135 groups are operating in 18 counties nationally. Additional funding of €0.3m has been provided in 2016 for further expansion of the scheme.
In relation to support from the Fire Services, the position is that a significant degree of co-operation already exists between the NAS and the Fire Services in providing an emergency first responder service. However, there may be scope to further utilise fire services as a first responder for certain types of calls, where this is warranted. This will be explored with the Department of the Environment, Community and Local Government, and local authorities.
