Ambulance service - Long delays are putting lives at risk

THE longer it takes the ambulance service to get emergency patients to hospital, the greater the risk to their safety and lives.

Not even an organisation like the HSE, which has a regrettable image of spin-doctoring when crises crop up in the health system, can dispute that basic fact.

However, according to official figures obtained under the Freedom of Information Act, published by the Irish Examiner today, patients in rural areas up and down the country regularly face ambulance journey times that are almost 50% longer than accepted international standards.

Widely accepted recommendations regard the first 60 minutes after an emergency medical incident as the “golden hour” for a patient’s survival. But in parts of rural Ireland, including south Tipperary, Carlow, Mayo, Galway, Waterford and Wexford, emergency patients face delays of up to an hour-and-a-half before they reach hospital. As far as the victims are concerned, that time lag of a “black half-hour”, could mean the difference between life and death.

Significantly, the official journey times, measured from the moment an ambulance leaves its base until the patient arrives at the hospital, reveal further worrying evidence of Ireland’s growing urban-rural divide. They show, for instance, that seriously ill patients in country areas face waiting times up to six times longer than their city counterparts before getting to hospital.

In some cases, the accuracy of the figures is open to question. Frankly, it is hard to believe the average times estimated for ambulances to get to Cork from Skibbereen (33 minutes), Clonakilty (32 minutes) and Bantry (22 minutes).

Defending the indefensible, the HSE denies that patient safety is being put in jeopardy by lengthy travel times. It insists some delays were the result of necessary stabilising of patients at the scene of a major accident or injury. And while it considers the “golden hour” concept in response to trauma cases as “important”, the HSE argues that at the scene of an accident responses such as the use of defibrillators, pre-hospital clot-busting drugs, morphine and advanced airway management techniques must also be considered.

Fine Gael health spokesman Dr James Reilly dismissed this response as “absolute nonsense, a distortion of reality… the most contrived, disingenuous answer” he had ever come across. Very few ambulances, he claimed, had all these pre-hospital resources in place. Meanwhile, Labour’s Jan O’Sullivan claimed lives were being put at risk by the failure to address rural health concerns.

It is unclear to what extent ambulance journey times are influenced by long distances, poor road conditions and traffic congestion. Be that as it may, it is clearly in the public interest to get patients to accident and emergency services as quickly as possible.

It goes without saying that delays can be fatal. Unless there are exceptional circumstances, it is crucial for the “golden hour” target to be achieved.

For lives to be put at risk because ambulance journeys are taking too long is utterly unacceptable. It is clear from the official figures that the service is in urgent need of a radical overhaul if the international “golden hour” benchmark is to become the standard in Ireland.