Ambulance shortage forcing firefighters to respond to medical emergencies, committee hears

Fire engines are sent to more than 3,000 medical emergencies a year in Dublin because no ambulance is available, a Dáil committee has heard.

The fire tenders carry life-saving equipment and are crewed by qualified paramedics but are unable to transport patients to hospital.

Asked whether the reliance on fire engines to respond to 999 medical calls compromises the health of patients, Dublin Fire Brigade (DFB) chief fire officer Dennis Keeley acknowledged that delays are likely to lead to adverse outcomes.

DFB has a finite number of ambulances, so when it has none available to respond to a 999 call, he said, it contacts the National Ambulance Service (NAS). Where the NAS does not have an ambulance available, the DFB dispatches a fire engine pending the availability of an ambulance.

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Last year, the DFB sought assistance from the NAS more than 63,000 times, the committee heard, only to be told no ambulance was available 76 per cent of the time.

Both organisations say they lack sufficient resources to meet the growing demand for ambulances from an ageing population, with more than 3,000 additional staff needed. At times over the winter, the NAS was receiving more than 2,000 calls a day.

Demand for ambulances is far outstripping capacity, with a 15 per cent increase in emergency call volumes last year, according to Robert Morton, director of the NAS. More patients are ringing directly for an ambulance, while GP referrals are declining.

Sinn Féin spokesman on health David Cullinane described the performance of the ambulance service in responding to calls as unacceptable.

Last December, fewer than one in five life-threatening situations in Dublin were responded to within the target maximum of 19 minutes, he pointed out. This “shocking” figure was out of sync with the performance outside the capital.

[ Dublin’s ambulance demand ‘far in excess’ of levels where performance standards can be met ]

December was a record month for calls due to the surge in respiratory viruses, Mr Keeley noted.

The two ambulance services operate separate control centres and reports have criticised the duplication of services in the capital. Mr Keeley said duplication has “dramatically improved” but cannot be totally eradicated.

Asked how often both services respond to a call in Dublin, officials said this happens about “10 to 20″ times a year.

The committee’s chairman, Sinn Féin TD Seán Crowe, said he would write to the HSE and Dublin City Council seeking a copy of a 2016 report on duplication of ambulance services in Dublin. The report has not been published but its contents were reported by The Irish Times last month after it was obtained under freedom of information.

Social Democrat TD Róisín Shortall said Dubliners were paying the price of big governance issues in ambulance services. She asked why the report had not been published.

[ Dublin ambulance services failing to respond on time in quarter of ‘life-threatening’ cases - report ]

Mr Morton said he did not know. A taskforce set up to examine governance issues affecting the ambulance service in Dublin met for the first time on Tuesday and is expected to report within six months.

NAS staff have suffered an average of 22 assaults a month over the last five years, Mr Morton also told the committee. At any one time, about six staff are off with injuries sustained at work.

Mr Morton said there has been a decline in physical assaults on staff but an increase in general aggression, often fuelled by alcohol and drugs.

Increasingly, he said, ambulances will seek to treat people in their home or bring them to locations other than hospitals rather than all going to hospital emergency departments.

[ Analysis: Dublin’s ambulance crisis goes on because authorities are not trying hard enough ]