I am sure the father of the House has acknowledged that I remained seated in spite of his anxiety to come in again. Having crossed swords on a number of occasions he expressed his dissatisfaction to me after the proceedings in the House had concluded and therefore I am most reluctant to become embroiled in any controversy concerning the Deputy.
I am grateful to you, a Cheann Comhairle, for allowing me to address this matter and to the Minister for coming in to reply to what is a serious problem. I am anxious in the few minutes available to me to raise four or five brief points on the need to upgrade the status of the ambulance service in the State. I am aware that at present the Department of Health is conducting an ongoing review of this matter. I hope the Minister will enlighten us as to when this review will be completed and the action, if any, he proposes to take in that regard.
There is a need to seriously consider upgrading the status of an ambulance call from the present essential service call to that of emergency service call. We all know that the designated emergency number, 999, is available to any member of the community who wishes to call an ambulance. However, the response of ambulance personnel and paramedics is on many occasions not that expected of an emergency service. There is no great difficulty during the day; the problem arises with calls for an ambulance between 1 a.m. and 8 a.m. It is necessary for the member of the ambulance personnel who is on call to rise from his or her bed, report to the hospital, procure the ambulance and drive perhaps up to 40 miles or more to the scene of the emergency. I hope some improvement can be made in this regard so that there will be an around-the-clock roster to deal with emergency calls, particularly in parts of the country with national primary routes.
As regards the training for ambulance personnel, it is my understanding that there is not a rigid training regime whereby refresher courses or further training may be undertaken. Perhaps the Minister would consider that matter. I understand that three out of every four ambulance personnel receive no training whatever for an urgent cardiac call. There is need to upgrade the status of training in that regard.
The physical state of many of our ambulances leaves a lot to be desired. Many of them have up to 200,000 miles on the clock and are in excess of ten years old. I know there is some health board allocation for fleet replacement but an overall policy with a clearly defined framework is essential to ensure the safety of patients in an ambulance. Ambulance equipment is also a matter of concern and basic stocks such as pillows and sheets may not be readily available. Medical equipment, much of it essential, is lacking in many ambulances. I hope that as a result of the review being undertaken by the Department the highest level of care and attention will be available to everybody irrespective of the part of the country from which they come. The equipment in many rural ambulances, particularly in the Western Health Board and North-Western Health Board areas, is unacceptable.
It is important that there be strict ruling on the question of ambulance personnel. At present the driver of an ambulance is accompanied by perhaps a hospital porter, a nurse or whoever is available at the time to go out on an emergency call. This is clearly insufficient because in many cases nurses are unable to perform the physical tasks of lifting a heavy patient by way of stretcher or otherwise. A two man crew is needed in ambulances.
My final point relates to Dublin where because there is no overall framework within which ambulances operate, there has been on occasion a duplication of ambulance calls, with two ambulances from different areas going to the same patient. That underlines a lack of coordination and efficiency. I hope the Minister addresses this problem by way of an overall national ambulance policy or a national ambulance authority.
