Ambulance Service

Dáil Éireann Debate, Wednesday - 8 June 2011

Wednesday, 8 June 2011

Ceisteanna (168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179)

Gerry Adams

Ceist:

173 Deputy Gerry Adams asked the Minister for Health if he will provide details of each of the ambulance stations in counties Louth and Meath. [14548/11]

Gerry Adams

Ceist:

174 Deputy Gerry Adams asked the Minister for Health the number of ambulance teams based in each ambulance station in counties Louth and Meath for day and night cover. [14549/11]

Gerry Adams

Ceist:

175 Deputy Gerry Adams asked the Minister for Health the level of ambulance cover prior to July 2010 and the level of cover today. [14550/11]

Gerry Adams

Ceist:

176 Deputy Gerry Adams asked the Minister for Health the level of cover in County Louth and Navan, County Meath, on the morning of Thursday, 26 May 2011, when an emergency call was made in reference to the collapse of a person (details supplied); if there were two emergency ambulances available when the emergency call was received; and if not, the location of same. [14551/11]

Gerry Adams

Ceist:

177 Deputy Gerry Adams asked the Minister for Health his views on whether a 30-minute response time for an emergency call is unacceptable. [14552/11]

Gerry Adams

Ceist:

178 Deputy Gerry Adams asked the Minister for Health if he will establish an inquiry to determine the facts surrounding the death of a person (details supplied). [14553/11]

Gerry Adams

Ceist:

179 Deputy Gerry Adams asked the Minister for Health his views on whether the closure of the accident and emergency and acute medical services in County Louth has created a higher demand on the ambulance service; and if he will make a statement on the matter. [14554/11]

Gerry Adams

Ceist:

180 Deputy Gerry Adams asked the Minister for Health if he will order a review in the level of ambulance provision in County Louth. [14555/11]

Gerry Adams

Ceist:

181 Deputy Gerry Adams asked the Minister for Health the number of advanced paramedics stationed in County Louth. [14556/11]

Gerald Nash

Ceist:

191 Deputy Gerald Nash asked the Minister for Health if he will instruct the Health Information and Quality Authority to undertake a full investigation into the circumstances surrounding the response of the Health Service Executive ambulance service in the north east to the events surrounding the death of a person (details supplied) in Drogheda, County Louth; and if he will make a statement on the matter. [14616/11]

Gerald Nash

Ceist:

193 Deputy Gerald Nash asked the Minister for Health if he is satisfied that the ambulance service response times in the north east are adequate to meet the demands in the area in view of the events surrounding the death of a person (details supplied) in Drogheda, County Louth; if he will review the operation of the ambulance service in view of this tragedy; the immediate measures he will take to ensure improvements in emergency response times in the Drogheda area; and if he will make a statement on the matter. [14619/11]

Seamus Kirk

Ceist:

198 Deputy Seamus Kirk asked the Minister for Health if he will review ambulance cover in accident and emergency at Our Lady of Lourdes Hospital, Drogheda, County Louth in view of the tragic death of a person (details supplied); and if he will make a statement on the matter. [14666/11]

Freagraí scríofa

Minister for Health (Deputy James Reilly)

I propose to take Questions Nos. 173 to 181, inclusive, 191, 193 and 198 together.

Firstly I wish to offer my sincere condolences to the relatives of the person who has died. From what I have been informed, I understand that the man concerned had collapsed in the street and passers-by came to his help and called for an ambulance. It appears that it was subsequently decided at the scene, because of the man's condition, to take him direct to hospital by private vehicle and the ambulance was cancelled. The HSE's log of calls to the National Ambulance Service does bear out this version of events as the ambulance was cancelled nine minutes after the first 999 call had been received.

I commend the instincts that prompted people on the street to help a fellow human being in a dire situation. No one can predict the outcome when faced with such a dilemma. The emergency services can provide advice and support over the phone while an ambulance is awaited but the confusion on the ground may have made this difficult in this case. This case underlines the need for the reform and modernisation of the ambulance service currently underway. While it does not appear to have been an issue in this case, the move to two national call centres to prioritise and manage calls is clearly essential. It is critical that emergency ambulances are used for emergency services and that there is a rapid hand-over of patients at emergency departments.

Supported by my Department and by HIQA, the NAS is working to improve the management and integration of its services. This includes a reduction to two ambulance control centres nationally, with appropriate technology, a clinical lead for pre-hospital care, development and implementation of new performance indicators for pre-hospital care and development of standard national criteria in relation to non-emergency patient transport.

The HIQA report "Pre-Hospital Emergency Care: Key Performance Indicators for Emergency Response Times", published in January 2011, recommends response times for first responders and for ambulances. The HIQA response time standard for transporting ambulances is 18 minutes 59 seconds for life threatening emergencies in 75% of cases. The HSE has been recording this data since January 2011 and since March 2011 has advised me that it meets this standard throughout Ireland.

The table details the level of ambulance cover in the Louth and Meath region. I have been advised by the HSE that the level of service on 26 May 2011 was the same as the service provided prior to July 2010.

Station	Drogheda Ambulance Station	Dundalk Ambulance Station	Navan Ambulance Station	Dunshaughlin Ambulance Station	Ardee Ambulance Station
Day	2	3	3	1	1
Night	1	2	1	1	1

There are currently 4 staff who are trained as advanced paramedics for Louth. In addition, there is a rapid response vehicle staffed by an advanced paramedic based in Castleblayney who works regularly in the Louth area.

Following the transfer of emergency complex care to Our Lady of Lourdes Hospital, ambulance activity, including emergency, urgent and routine, has increased by over 600 calls in a full year. In response to this, the HSE has placed additional resources on an interim basis, which are currently under review to determine which configuration will deliver the best service. The NAS deploys resources on a dynamic basis, to meet surges in demand and ensure spatial application of emergency cover. Resources in any given area can be supplemented by re-deploying available capacity from surrounding areas.

In relation to the incident on 26 May, the HSE has carried out an investigation and has advised me as follows:

A 999 call was received from the Drogheda area at the National Ambulance (NAS) Service Command and Control Centre at 09:59 on 26 May 2011.

A number of emergency vehicles were already engaged on other 999 calls at the time. Vehicles parked at the local emergency department were awaiting the handing over of patients and were not free.

At 10:00, the nearest available emergency vehicle was dispatched to the scene. The ambulance had already been dispatched from Navan to provide cover in Drogheda and was not in Navan at the time of the call.

At 10.08 (9 minutes after receipt of the 999 call), a second 999 call was received from the scene, cancelling the ambulance as the patient was being transported by a private vehicle. In line with best practice the issue has also been referred by the HSE to its Serious Incident Team for assessment. The Health and Information and Quality Authority has sought a detailed briefing on the incident.

The National Ambulance Service has undergone significant change in order to ensure quality, safety and value for money. In line with other clinical areas, this process is ongoing as clinical needs and standards develop. I believe that these developments are in the best interests of patients, and that they are a key part of the Government's work to ensure high quality emergency care.