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AN INTERNAL AMBULANCE Service report which warned of “extreme risks” to the health service as a consequence of badly designed management structures should be published, Tánaiste Micheál Martin has said.
Documents obtained by The Journal in April revealed significant concerns for National Ambulance Service (NAS) management structures and also concerns around staffing levels and funding.
The report entitled ‘NAS Organisational Redesign’ from 6 December 2022 was scathing in its criticism.
“The underdeveloped nature of the management structures in NAS has led to a number of significant issues creating a high and unsustainable level of risk exposure for the HSE,” the report author stated.
The matter was raised with Martin today during Leaders’ Questions in the Dáil by Independent TD Michael Lowry.
He told the Dáil that over the past eight years, the number of people who died before an ambulance reached their location increased by an alarming 70%. Last year alone, 1,108 people died before an ambulance arrived on the scene, he said.
“In one high-priority case, it took three hours and 15 minutes for an ambulance to arrive to a critically ill patient.” he said, stating the ambulance service is in a serious state of disarray.
Lowry told the Tánaiste the the centralised call-out system has failed, stating that the service was much more effective and efficient when managed in regional hubs.
“There is now a national system which is poorly managed and coordinated. Many personnel in the system have lost confidence in the functionality of the system. It is not cost effective,” he said.
Speaking about the report, which was reported on by The Journal, Lowry said it has been “kept under wraps”, highlighting that details could were only obtained under freedom of information by this publication.
“The findings confirm beyond doubt that every issue I and others in this House have raised were factual and verifiable, so much so that the report was deemed scathing in its criticism. It revealed that the ambulance structure is underdeveloped and under-resourced. Six areas were considered high risk or extreme risk,” he told Martin.
The Tánaiste said that investment in the National Ambulance Service has gone up by 37% since 2019, stating that it has an allocation this year of €231 million and a 23% increase in staff since that same year.
There has been significant growth in demand for services, with 389,000 calls received in 2023, the Tánaiste explained.
Lowry asked for a commitment that the complete findings of the report that is with the HSE be made public.
“It is a highly pressurised, stressful and tiring role. The ambulance service, if you will excuse the pun, is in need of resuscitation. The sooner we realise that and act on it, the better results we will get,” said the TD.
“The report should be published. I will speak to the Minister for Health about the up-to-date position. I understand it received significant media attention in one publication. If a report is commissioned by a service, it should be published openly by the HSE,” The Tánaisite said.
With reporting by Niall O’Connor
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The problem with the Ambulance service is too many managers and too many staff out on leave at any one time. Also a report need to be done on the type of calls the ambulances are getting called out to and how many are medical card holders. I have heard stories of a crew getting called out at 3am to a house during bad winters night to bring someone to hospital for a ingrowing toe nail.
@Liam23: Yes there’s no doubt there are spurious calls, it becomes irrelevant however if the patient has a medical card and penniless or is dripping with gold. They’re all ill and in desperate need of medical attention. If you’re relying on what ‘you heard from a mate or on social media’ your argument has no merrit, the facts are that the government has sat on this report for the last 18 months. In that time people have died. By it’s own figures 1,662 people died over the past 18 months since the report was compiled in December 2022 while waiting for an ambulance.
The report found that that management structures were causing a “highly worrying” situation where there was an “extreme risk to safety and wellbeing of staff, management of performance oversight, quality of service delivery and the ability to deliver an effective service based on patient needs”. You might wonder why anyone would work in an environment like that, maybe the obvious reason is these staff are dedicated to their jobs. That simple. As it happens the report found the NAS had the lowest turnover of staff in the HSE.
You may have also noticed that over the past 18 months there have been several incidents of A&E Departments throughout the country where patients suffered terribly, one just this week where elderly patients were treated on corridors and 13 ambulances were queued up. The Summer should be the quietest time of the year for hospitals. In this time the governments only answer has been an employment freeze, that will really fix things.
@Boyne Shark: All the stories I have heard are first hand from paramedics themselves, the centralised system isn’t fit for purpose, the grievances system isn’t fit for purpose, the turnover of staff is low due to a few issues be it being a job for life, a civil servant can’t be sacked or there is a high number out on ‘sick leave’.
Increase the population and not the services,sure what could go wrong. Why can’t the hse cope with larger influx of people arrivinginto the country,why can’t they magic up extra staff,beds,rooms,medical machines, what a joke.
I cant see any context for the call out wait times. I know they would have a service level agreement with the HSE for the waiting times for routine, urgent and emergency calls, so is the 3 hours 15 mins…3 hours over their SLA times or just double the length?
@Dramafree 2023: Just did a bit of digging so the 3 hour 15 minute response time should have been under 19 minutes….for context on the above situation. 10.26 times the expectations…
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