A “huge increase” of more than 20 per cent in emergency calls since February has contributed to delays in ambulance response times to 999 calls, Minister for Health Stephen Donnelly has said.
As the Dáil debated a Sinn Féin motion on the National Ambulance Service and TDs highlighted cases of lengthy hours-long delays in response times to 999 calls in their constituencies, Mr Donnelly acknowledged that “the wait times for lower acuity, non-life threatening calls have presented a particular challenge recently”.
The service had been seeing “unusually high demand” which was “in line with the current experience of many areas of our acute health services” but it was a concern for everyone.
Sinn Féin health spokesman David Cullinane who introduced the motion called for the national capacity review to be completed and published and for the service to be properly resourced.
“Let’s put in place a strategy for national ambulance service that properly resources it, that increases the fleet” and that makes sure paramedics are fairly treated.
Mr Cullinane said there was a lot of “moral injury” involved in the impact on frontline staff who want to do the best for patients and who are exhausted and called out to emergencies hundreds of kilometres away shortly before their shift ends.
Geography
Ceann Comhairle Sean O Fearghaíl intervened and said it would appear “there are people involved in the dispatching of ambulances around the country that don’t have an even basic understanding of the geography of the country”.
Mr Cullinane said personnel can get a call-out to somewhere that’s up to 300 miles away, adding very lengthy hours to an already lengthy shift. He said an ambulance paramedic told him about going on a shift at 7.30pm last week “and his first call was to respond to a call that came in from a patient at 11.38am in the morning. And then he has to respond to that call, arriving six or seven hours later, and having them to deal with that challenge to no fault of his own.”
The Waterford TD added that it was so frustrating for personnel that “ambulances can be parked up for hours on end because they don’t have the beds to transfer patients from the ambulances into the hospital itself”.
He said there had been a lot of working groups established to look at some of these issues in relation to breaks and late call-outs at the end of shift but “they haven’t been actioned and what we need to see is even these small steps implemented as quickly as possible”.
The Minister said “extremely busy hospital EDs [emergency departments] which negatively impact on turnaround times” were also contributing to delays along with increased numbers of staff on sick leave, as was “the ongoing need for enhanced infection prevention and control measures”.
Mr Donnelly acknowledged that the HSE is not meeting the staged target that 80 per cent of ambulances will be released and available for new cases within 30 minutes of arrival at an emergency department with a patient and pressures in emergency departments are a significant contributing factor. The HSE commissioned a review and “the initial findings of this review are currently being assessed by the HSE”.
Paramedics
The Minister told TDs that regardless of the funding allocated there is a shortage of qualified paramedics. He said they are training an additional 200 student paramedics who are different stages of the paramedic degree programme.
He said more than €200 million was being invested in the service in the budget for next year, an increase of €30 million or 18 per cent since 2019. He said that a further €5.7 million had been allocated in targeted funding under the HSE Winter Plan and would focus on “see-and-treat” measures, which would reduce the need for patients to go to hospital and would maximise capacity to respond to 999 emergencies.
Labour Cork East TD Seán Sherlock said that ambulances being delayed at emergency departments had been going on “since Adam was a boy” but there had been no action.
People Before Profit TD Bríd Smith said “so many beds could be freed up and you wouldn’t have delays in emergency departments if home care packages were put in place”.
Solidarity TD Mick Barry said four ambulances had been involved in crashes in the past month in part linked to crew exhaustion.
Independent TD Michael Lowry said highly skilled ambulance service personnel should be withdrawn from involvement in the vaccination booster programme for the housebound.
He said it was ironic that health and safety regulations were ignored when it came to ambulance staff who are supposed to have a 45 minute break after 4½ hours but who work up to 16 hours with no breaks.
