HSE has no answers on state of ambulance fleet

The HSE cannot say how many ambulances have broken down, how many instances have occurred with a patient on board, and how many of these vehicles are still on the roads — despite major concerns over the safety of the fleet.

A HSE official confirmed the situation as part of an ongoing Irish Examiner freedom of information request.

Earlier this week, the independent watchdog, the Health Information Quality Authority (Hiqa), published a 187-page report underlining a series of concerns that are hampering the under-resourced service.

The document, which can be read at irishexaminer.com, warned that the country’s 266-strong ambulance fleet is clearly unable to meet demands.

Among a number of high-profile issues raised by the watchdog’s report was that almost one in five ambulances in use is more than eight years old and has more than 400,000km on the clock.

This is despite the fact HSE rules state any ambulance over seven years old must be replaced for safety reasons.

A HSE vehicle replacement system is running two years behind schedule, meaning that despite Health Minister Leo Varadkar promising to invest an extra €5.4m in the general ambulance service next year, the problems are unlikely to be resolved soon.

In July, this newspaper requested information on how badly affected the ambulance fleet has been by a failure to replace and repair damaged vehicles — and how this is impacting on patients.

Among the questions were:

-The number of vehicles which have broken down since the recession began;

-The type of breakdown involved, for example engine failure, and how long they kept a vehicle off the road;

-How many of the vehicles involved were carrying patients, what their outcome was and whether any died;

-How many of these ambulances have suffered more than one breakdown;

-Where the incidents occurred;

-And the number of vehicles taken off the road due to the serious safety concerns.

The information should be accessible through the HSE’s invoicing for repair work, and based on the individual codes under which each ambulance’s information would be placed.

However, a HSE official overseeing the request has said the details cannot be supplied as the service “does not have a mechanism to indicate a vehicle as a breakdown” or “anything like a database” of records.

The HSE has instead asked that the request be confined to “engine failures” over one particular month due to the scope and “arduous” nature of the query.

Meanwhile, while accepting the Hiqa findings that there are severe difficulties in the service, the HSE said it does not have the money to address a list of concerns.

The HSE is due to publish a capacity review on the system before Christmas. However, while it is hoped this may help further highlight and address specific gaps, ambulance unions said previous concerns about the fleet have been “ignored”.

40-minute wait for medical aid following seizures

By Anne Lucey

The ambulance service has confirmed that an ambulance had to be sent from Macroom in Co Cork after a man who collapsed with apparent seizures waited almost 40 minutes for emergency medical help.

Gardaí waited with the seriously ill man at Killarney District Court on Tuesday as he appeared to suffer from seizures.

The man, who is originally from the US and has been living in Killarney for some years, was attending court on an adjourned matter, but collapsed while on his way to the body of the court from the tiered seating at the back.

Gardaí and members of the public rushed to give him assistance and called an ambulance some minutes after 3pm. The court continued to sit as gardaí attended to the man.

Eventually he was carried outside by gardaí and laid on the floor of the foyer.

However, it was while waiting for a paramedic car, followed by an ambulance, that the man suffered seizures and was heard from the foyer area shouting and groaning.

Gardaí who assisted him said they feared for the man but they understood the ambulance had to come from Co Cork.

“The National Ambulance Service said it confirms a 999/112 call was received for the Killarney area at 15:09hrs on Tuesday 2nd December 2014,” said gardaí.

“The nearest available resource was dispatched from Macroom to the incident and arrived at the scene at 15:47hrs. At the time the call was received a number of emergency resources in the area were engaged on other emergency calls.”

Ambulances waiting

Rural areas already concerned about “reforms” to their ambulance services have been told they may now face longer target call-out times because of their isolated locations.

Health Minister Leo Varadkar confirmed the move was being considered after the publication of a damning Hiqa report into the crisis-hit sector.

Speaking on RTÉ’s Prime Time, Mr Varadkar said he was concerned at the findings and insisted action would be taken. However, he added: “In rural areas or remote areas it may never be possible to meet eight-minute targets, and that’s why we need more community response, which we’re going to have.”

Campaigners have already noted the minister’s comments appear to ignore the fact the same Hiqa report raised clear concerns over the lack of community and advanced paramedic staff in the system — an issue which is likely to be raised in the HSE’s upcoming capacity review of the service.

A separate Hiqa document earlier this week also said it may not be financially worthwhile to place thousands of defibrillators around the country, based on the amount of lives they would save.