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CONCERNS HAVE BEEN raised over leaked information that details a plan to remove Dublin’s ambulance service from Dublin Fire Brigade (DFB) by 2015.
It emerged yesterday that the plan, which was seen by the Irish Times, was drawn up before the announcement last month that the HSE and Dublin City Council was to review the capital’s ambulance service.
Review
Now SIPTU members in DFB have said they are “extremely concerned” at the proposal and the union has called for a fully independent review of the service.
SIPTU Organiser, Brendan O’Brien, said that the emergence of this document raises concerns that the outcome of the review “has already been decided”.
It strongly indicates that this review is merely to provide a fig leaf to the HSE and Dublin City Council in their apparent plans to remove this service from Dublin Fire Brigade.
He said that SIPTU members are also concerned that there has only been one additional ambulance provided to the DFB ambulance fleet over the last 20 years, despite the increase in population.
DFB SIPTU representative, Glen Ellis, said that DFB has been able to provide a level of service which is above the national average and compares favourably to best international standards, despite the holding up of ambulances at hospital accident and emergency units.
This is achieved by the internationally recognised fire based Emergency Medical Service which is provided by DFB. DFB receives 7 per cent of the total National Ambulance Service budget despite having to respond to 40 per cent of all ambulance calls nationally. This is done through the provision of 12 DFB ambulances, supported by the Dublin Fire Service.
The union wants the management of the HSE to concentrate on “providing the necessary resources for our colleagues in the National Ambulance Service” prior to placing a focus on the DFB.
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If something is not being done right it is being done by the HSE! The fire service do an excellent job providing this service why change it??
DFB are the Navy Seals of Irish EMTs!
@green Paramedics
What makes you think they are any more professional than any other full-time paramedic around the country?
So. In order to fix the NAS which isn’t working the HSE want to take over a system which is.
They cant match the service provided by DFB for the same cost.
The main problems highlighted in recent media relate to NAS services outside of Dublin with 1 or 2 ambulances covering a whole county.
The Dublin system is by no means perfect and needs improvements but taking the service away from DFB with their pool of 900 or so pre hospital practitioners is crazy
The DFB have a fabulous system of been able to mobilise backup to their crews from their resources and are giving a great service. A review is been carried out but figures need to be accurate. I don’t see 12 ambulances doing 40% of calls nationally. Costs of providing ambulance cover is expensive because it takes roughly 10 people to crew a 24/7 vehicle and cost of equipment is very expensive. Let’s get proper figures and factor in higher costs might be justified if a superior service is been returned.
This would be a very regressive step in the capital. Worldwide it is recognised that a Fire based EMS is the best way to provide world class quality service. If the service moves fully to the HSE you will no longer see a fire truck with up to 6 extra paramedics turning up to Cardiac Arrests , strokes, hangings or shootings and god love the NAS ambulance personnel who take over the workload they will be under resourced and under manned and we will be reading about unnecessary deaths in the capital every day
When i did my placement was with a private ambulance service .
Patient transfers from Mater General to Mater private on numerous occassions .so hse were paying stupid money for a 200 yard transfer even though hospitals are connected . The service provided by D.F.B. is unsurpassed in this country and many others and should’nt even being considered as an option
Bureaucratic idiots who should stop crunching numbers and look at the service on the ground .
I think it should be clarified that these hospitals are not physically connected. Also, emergency ambulances are not used to transfer these patients. Hence the use of private operators to ensure the patients health and wellbeing are catered for aswell as their dignity.
Bingo. So it’s only a money saving exercise and not an exercise in best practise. The hse is a joke and you couldn’t rely on one of there ambulances arriving within the allotted time. Why break something if it’s not broken.€9m per year to answer 40% of calls nationally sound great value for money to me. DFB do a great job the problem is the hse keeping ambulances at hospitals because of the lack of trolleys and even then they just about able to cope.
There are at least 4 or 5 new HSE Ambulance bases earmarked for Dublin already. The HSE are pulling the €9m or so budget to DFB. This in turn will cause redundancies in DFB as the HSE believe they can provide the service cheaper than DFB currently can. That said the HSE is struggling to provide a modern up to date service nationally!
We lost ambulance in cork fire service big mistake
@john Gorman – if dfb lost control of ambulance service ,
What is the HSE cost prediction!
And with how many ambulances ?
There would be an increase in cost!!
Certainly no savings.
As cardiac arrests, hangings, spinal cases etc … Would need 2 ambulances,
Where as now it’s 1 ambulance , with fire tender.
Some Q and A
“It will be terrible if the NAS takes over the DFB ambulances….”
How do you know this? It’s not happening until next year and it’s being done in stages. The NAS already has up to 11 emergency ambulances in Dublin at any one time. They will simply be supplemented by additional staff and vehicles. Its not like they don’t already provide emergency ambulances in Dublin and don’t know the city. What if it turns out this is actually an excellent service? Who’s to say it won’t be. Who’s to tell if the number of ambulances won’t increase? 120 paramedics being trained. More advanced paramedics being trained. The NAS motorcycle response unit will finally be “allowed” into the city centre where they belong. The NAS hasn’t been given a chance to prove itself as a sole provider of ambulances in Dublin. Is there a problem with Limerick city ambulance service? No. Is there a problem with Cork city ambulance service? No. And guess what, it’s the NAS.
“But response times in Dublin are highest in the country….”
Yes they are, simply because it is a densely populated capital city with hospitals never more than minutes away. And they will continue to be high regardless of who runs the service.
“The DFB response times are better that the NAS….”
Afraid not, that report was for Dublin response times, which includes NAS ambulances in Dublin.
“They’re bringing in fire based ems in the UK….”
No. They’re not. This was suggested at some local govt meeting where the fire service just said No.
“The fire ems model is proven to be the best….”.
Evidence of this please. New york for example has a fire based ems system, however this simply means the ambulance service uses the FDNY name, they do not work on fire engines at all. They are full time paramedics. More akin to the NAS than the DFB. New york also has Dept. of Health paramedics.
“People will suffer as a result of this….”
Certainly not as much as they are suffering as a result DFB withholding calls from nearby NAS ambulances to send one of their own from the other side of town. Thankfully the new National Ambulance Control will resolve all that. Automatic nearest ambulance dispatch.
“But you won’t have a fire engine with up to six paramedics on board going to serious calls….”.
Good. Why does anyone need six paramedics? No more than they need six plumbers to put in a new toilet. Fire engines are for putting out fires and should not be tied up at medical calls. CPGs state 3-4 practitioners for assistance, a response car or motorcycle para to support the ambulance crew will suffice. (for arrest, one on chest, one on airway, one doing obs.
“The DFB do 40% of calls nationally….”.
Around 35-40% of the population live in Dublin so no surprise there. Problem is the HSE have discovered that the NAS can do 100% of calls nationally for 4 million euro per annum less.
“NAS paramedics aren’t as good as the DFB paramedics….”.
http://www.healthcomplaints.ie or http://www.phecit.ie to make a complaint about care given by ambulance staff, otherwise just shut up.
“This can’t be happening”.
It is.
Nowhere has anybody said DFB Paramedics are better than NAS Paramedics they have merely complimented the care they received from the DFB in Dublin. Not really a big issue. And as for your constant claim that the DFB withhold calls from NAS to send a DFB Ambulance from the other side of the city this is a load of horse shite but if you firmly believe it then you could make your complaint to both the organisations you gave web addresses to in your Diatribe and also inform the Mobilisation officer in the control room Tara St im sure he will laugh long and hard at that one and show you how under resourced the whole Dublin area is at multiple times in the Day
It’s not horse shite Brian and it’s not a diatribe (had to google that one), I simply believe that 2 autonomous ambulance services operating in a small european city is ludicrous, especially when your fire crews are responding to medical calls when a fire could break out and the appliance can’t respond. And no I won’t make a complaint at this stage because the National Ambulance Control Centre’s automatic closest dispatch system will address this issue and by the time the issue raised comes to the risk assessment stage the new centre will be up and running. Also I doubt the mobi would act on the information. Just a hunch.
You wont make a complaint to the MOBI because you know he will show you that its not the case that DFB hold cases for themselves. I have previous experience as a call taker and when we recieve a call we allways dispatch the nearest available resource this included ringing the NAS controllers and i cant comment on how they run their side but we always document if the NAS had an Ambulance available or not. This is all recorded both on the system and on voice recordings it is very easy to produce the evidence against what you are saying happens. If a resource from NAS is sitting in the base as you say its not because we havent looked for it or kept it for ourselves. Also we have all our stations strategically placed so a fire engine on a Medical response would be covered by a neighbouring appliance and response times to any fire would be well inside best practice limits. Also im unsure how many Cardiac arrests or serious medical cases you have attended in your career but im sure you will agree id rather have 6 pairs of hands rather than 3or 4 no matter what color shirt they are wearing. Many hands make it easier. Your plumber analogy makes no sense as plumbing is a bad comparison although the plumber could put in a 6 inch soil pipe to remove all the shite you spout on this news app
That was a good one in fairness
I thank you sir at least you have a sense of humour
“The NAS has 11 ambulances available in Dublin at any one time”
Unfortunately they are often tied up with patient transport or in another county e.g. Swords in Meath or Monaghan – it’s happening
Last year ERAS were asked to take cases from DFB, of which over 13,000 were refused by ERAS as they had nothing available – that’s recorded on paper and recorded on taped phones
Just to be clear Singen I don’t think anyone genuinely believes that the Paramedics of the National Ambulance Service are any worse(or better) than DFB staff. For the most part when people talk about the HSE they are referring to the management system in place. I also assume you are a NAS Paramedic.
There may be some trolling on this posts with some individuals trying to enflame fighting between DFB and NAS staff for giggles or because they are working to an agenda.
To respond to each of your comments.
“It would be terrible if the NAS takes over Dublin Ambulance”
It would be terrible not because the NAS crews are bad but because there is no need. How about using all those resources you are claiming will come online to service the rest of the country where we constantly hear about people dying on the side of the road or in the back of a garda car whilst waiting for a response? Where we hear of ambulances being taken off the run because there are not enough paramedics to man them? Surely it makes sense to keep a functioning service functioning whilst improving the service nationally?
Cork and Limerick have populations the size of Tallaght so to compare cities is a bit of a misnomer. Again I am not slagging off these places but the sheer size of population in Dublin makes the comparison a false one.
“But response times in Dublin are highest in the country….”
“The DFB response times are better that the NAS….”
Simply put they are. This is down to geography and it is also down to a rapid turnaround time. Again no one is saying that the NATS crews are sitting on their arses doing nothing. However the system in Dublin (although right on its absolute limit) is working for the people in Dublin. So why mess around with it other than for political reasons and kingdom building?
“The fire ems model is proven to be the best….”
Its not just new york but also Berlin, Phoenix, Paris, Tokyo and many other major cities around the world. In integrated command and control system. Duel trained and skilled emergency personnel who are capable of adapting their roles depending on the conditions on the scene. You have a bus crash with many casualties then all the firefighters are also paramedics who can treat on scene. You have a bus crash in to chemical truck. You have loads of paramedics who can also fight the fire.
“People will suffer as a result of this….”
You have spoken of this witholding call thing on a number of occasions but when challenged as to why you have not complained or provided evidence you never give a straight answer. Why would we not call you out considering we look for you all the time?
The fact are that on many occasions the DFB look for a HSE ambulance and are told there are none. Suddenly something serious like an aircraft emergency comes in (another one of those events where duel trained firefighter paramedics would be useful) and suddenly 4 or 5 HSE ambulances appear out of the woodwork. Again I’m not blaming the crews but it is certainly strange how often it happens? Do you deny that ambulances have been sent to places like North County Dublin from as far away as Wicklow and Naas? Why wasn’t Swords ambulance sent? Or Kilbarrack? Or Finglas. In fact ANY DFB Ambulance would have been closer.
“But you won’t have a fire engine with up to six paramedics on board going to serious calls….”.
“Good. Why does anyone need six paramedics? No more than they need six plumbers to put in a new toilet”.
This comment makes me actually wonder if you are a paramedic at all? Having extra crew on scene for echo and Delta calls is a HUGE advantage and one that should be replicated around the country by dispatching Fire crews to all Echo and Delta calls. (Echo calls are respiratory and cardiac arrests. Delta are other life threatening calls).
Comparing one of these calls to a plumbing call is moronic in the extreme. Any arrest I have attended works much better when all hands are on deck. Any of the NAS Advanced paramedics (who do their practical training with the DFB) love the way we run arrests in the DFB. Fire Engines ARE for putting out fires but they also attend car crashes, chemical incidents, cardiac arrests and other serious medical and trauma incidents. Should they just sit in the station whilst someone is dying down the road? That sounds like the kind of public service that many have complained about for years. The “its not my job” brigade. Well it is our job to save life and we do it well whether we respond with a DFB ambulance or a HSE one.
“The DFB do 40% of calls nationally….”.
Yes we do. On a budget of €9.6 million. The HSE have a budget of nearly €130 million to do the other 60% of calls. Are you seriously expecting us to believe that they will somehow manage to make up 40% of the calls with just 6% of the budget? What will happen is the HSE will take it over with a yellow pack plan. It will be a disaster and they will throw money at it until it works. I guarantee within a few months the budget will have gone from a saving to a massive overrun. It is how the HSE do thing and always will be. Sure its not their money.
“NAS paramedics aren’t as good as the DFB paramedics….”.
I don’t think any rational, genuine person believes that. The fact that you are getting a bee in your bonnet about it just shows up insecurities that you might have.
“This can’t be happening”
IT BLOODY WELL SHOULDN’T!
Well said Garry
I agree it’s not a them and us argument. It’s about the best EMS system for the citizens
UK fire service proposed running front line a&e services a few years ago, wanting to utilise current NHS ambulance service for non urgent cases only. The proposal went no further than being read at a political conference before being rebuked by both politicians and the NHS as non viable. The need for HCPC para’s to study to level of degree was deemed too great an expense as would be necessary to train fire staff. Added to which fire unions stated they would not support any change to working rotas which would result in the most likely probability of their members working continuously, with little down time, during new shift patterns which would be required to cover both fire and paramedic duties. I know of only one fire service providing two ambulances to support the NHS, they are only dispatched to support the NHS and not fire crews, are dispatched by NHS call centre via fire control centre, crew are trained in BLS only and have no autonomous practice, can only transfer with a paramedic and can only practice under a paramedics supervision. Both vehicles are funded by fire service budget because of how much was underspent in the past financial year. Other fire services introduced ‘trauma techs’ trained to the level of ‘fpos’ most have removed the role because of serious clinical incidents from poor practice. The ‘advanced’ para system as run by DFB works well with competent clinicians, so much so its causing embarrassment to the HSE now wanting to claim it as its own.
@singen you speak the truth my friend, keep up the good work…
@tony kennedy i can assure you they were indeed connected . My point was nothing to do with it being emergency ambulances being used its the fact that this procedure is not in the interest of patients , or taxpayers if they are so stuck for money they could look at alot of other bogus procedures rather than losing an emergency system which is argueably the best in Europe
It’s a sad fact the paramedic service, as is being provided by DFB, is about to be used as a political tool to support the NAS; a service which is so under resourced and under funded it is unable to provide a national service of standard to meet with demand. If Dublin based crew is out of area then it follows there’s also an issue outside of Dublin but the press chooses to go for the big story of the capital city with a failing service. There should be no question of comparison between the clinical competence of either NAS or DFB clinicians as both have attained a national standard to attain registration with PHECC. As has happened in the UK, owing to the political pressures to reach national targets and times, there is most likely to be a national increase within the NAS in sole responders supported with the political line of their ‘advanced’ assessment skills, ability to initiate care while waiting for an ambulance resource to convey as may be required. Two of the bigger services in the UK have now initiated a move away from sole responders with secondary verbal triage of emergency calls ensuring appropriate dispatch of resources. These trusts have a clinical directorate willing to openly debate categorisation of calls by AMPDS type systems and will override calls following secondary triage. Six paramedics on a fire tender may not be of any greater benefit to a patient than one ‘advanced’ paramedic working alongside another paramedic.
have your say