Air ambulance service waiting for lift-off

The gleaming helicopter is sitting in the hangar. It can be airborne within two and a half minutes. Paramedics have undergone training to work with the pilot during flight operations but the crew helmets are still wrapped in plastic on a shelf in the control room of the new €400,000 airbase.

Phones and computers have been installed, aeronautical maps are on the walls, and volunteer firefighters have been trained to operate a second-hand fire tender parked on the newly laid apron.

A backup generator hums outside as a wind-sock flutters in the wind on the grassy airstrip which runs alongside a stretch of the river Blackwater which flows through this quiet, rural valley between Millstreet and Banteer in north Cork.

After years of dreaming, tough negotiations and a mammoth fundraising effort, everything is finally in place at the base to launch Ireland’s first privately funded air ambulance service from Rathcoole Aerodrome.

It’s all been in place since January.

But Irish Community Rapid Response (ICRR), the charity which has raised tens of thousands of euro from the public to launch the life-saving service, is still waiting for ministerial approval before the aircraft and its crew can ‘go live’ as a dedicated asset of the country’s 999/112 emergency system.

ICRR says it is incurring payroll costs while it waits for this sign-off and it has warned that delays could cost lives.

“ICRR is grateful to the public for its ongoing overwhelming support for the service and urges the announcement of an imminent start date,” it told the Irish Examiner.

Existing air ambulance services have been proven to save lives, both in Ireland and abroad, and this is why getting the service into operation is imperative, as delays could cost lives.

ICRR is dedicated to the development of pre-hospital emergency care in Ireland. It operates a fleet of medically equipped rapid-response jeeps which allows volunteer doctors bring the equivalent of a hospital emergency room to serious life-threatening incidents for treatment on scene..

The control room at the ICRR air ambulance air base in Rathcoole, Millstreet, Co Cork.

Following years of planning and fundraising, ICRR last September unveiled its branded aircraft, an Augusta Westland AW109, and said that they hoped it would be operational within six weeks.

With its top speed of 260km/h, the AW109 can carry a pilot, two medics, a patient on a stretcher and a passenger.

The charity will fund the leasing and operation of the aircraft. The Department of Health will provide the paramedic personnel on board the aircraft. ICRR estimates that it will cost some €2m a year to operate the service. Despite some medics’ concerns that the air ambulance service will not be doctor-led from the start, as had been hoped, ICRR decided to press ahead with the launch of a paramedic-led service, prove that it works, and then work with the various agencies over the years to develop a doctor-led service. It has spent more than €50,000 on paramedic training and almost €400,000 on the development of the Irish Aviation Authority (IAA) approved airbase at a former aerodrome at Rathcoole.

The charity signed a service-level agreement with the HSE in January but it says it is still waiting for ministerial approval before it can become a declared asset of the HSE’s National Ambulance Service (NAS).

It is satisfied that the requirements and specifications, which it was tasked with, are all in place.

“The air ambulance project comprises a partnership approach to both funding and service delivery between ICRR, the HSE NAS, and the Department of Health,” it said.

The hangar and airbase developed at Rathcoole, near Millstreet, Co Cork.

“ICRR’s responsibility is to provide and fund the air base, the pilots, engineers and ground staff.

“The HSE NAS is providing the paramedical staff and integrating the service with the other emergency health services. The Department of Health is providing policy and service oversight.”

The charity has said that, in recent months, it has:

• Signed a detailed service level agreement with the other partners
• Developed the dedicated airbase near Millstreet which complies with health and safety and fire safety requirements
• Secured all the relevant IAA licences
• Secured a helicopter, which is in situ at the airbase, and service-ready
• Trained the pilots, engineers and ground staff who are all in place and ready to go
• Agreed a work rota with all service staff

It said the training of the paramedical staff, in accordance with aviation guidelines, has been completed and details of how the service will integrate with the National Emergency Operations Centre which handles all 112/999 calls, and with the state’s existing aeromedical service, based in Athlone, have been discussed and agreed.

“In the past year, ICRR has spent in excess of €50,000 on paramedic training, which was delivered last year together with the HSE NAS,” said ICRR. “€400,000 has been invested in the air ambulance base facilities. The charity is currently incurring staff payroll costs while awaiting the service going live.”

ICRR said the decision on when the air ambulance service will go live now rests with the Minister for Health, Simon Harris.

Minister Harris holds final responsibility to make this decision, based on recommendations he receives from the HSE NAS and the Department of Health,” said ICRR.

In a statement, the HSE said the NAS are continuing to work with the charity to implement the service.

“The NAS has completed the recruitment and training of six staff to operate the aeromedical services in the south of the country,” it said.

“The service will be resourced by two NAS practitioners on a roster basis, in line with other aeromedical services provided by NAS.

“A due diligence process is currently ongoing to ensure a model of safe, appropriate service delivery is in place. Once complete, a start date will be agreed.”

Initial plans to locate the air ambulance airbase at Cork Airport were abandoned for various reasons. But ICRR said the Rathcoole location provides several benefits over the airport, including its central location and its prevailing meteorological conditions which will give the air ambulance service an extra 37 days of flying annually than it would have had if it was based at the airport, where fog often hampers flight operations.

The fire tender, bought second hand from Weston Airport, on standby.

The AW109 will be able to operate during daylight hours only, seven days a week. The flight-time from Rathcoole to Cork Airport is about 10-minutes, it’s about 14 minutes to Bantry, about 22 minutes to Dingle, and about 25 minutes to Waterford.

Previously, ICRR founder John Kearney insisted that the new air ambulance service will be a national asset, capable of responding from Rathcoole to emergencies as far north as Malin Head, with enough fuel to fly a patient on to Dublin before having to refuel.

He has also pointed out that eight air ambulances service rural Romania, and that, in Wales, with a population of 3m, four charity-funded air ambulances cover an area a third the size of Ireland, with one aircraft dedicated entirely to transferring children. It started as a paramedic-led service and is now doctor-led.