2026-04-21

120. Deputy Matt Carthy asked the Minister for Health the number of instances in 2023 to 2025, inclusive, when ambulances in Cavan and Monaghan did not arrive within the targeted timeframe; and the longest period that a person waited. [28365/26]

Tá ceist Uimh. 120 in ainm an Teachta Carthy á glacadh ag an Teachta Bennett.

The Dublin North and East region, which includes Cavan and Monaghan, has benefited from recent investment, with 12 additional paramedics in 2025 and a further 12 scheduled for this year. Six additional emergency medical technicians are planned for Cavan. This will help to preserve front-line ambulances for emergency calls. I highlight this because the National Ambulance Service is focused on addressing areas where there is a clear need for greater resourcing. A particular emphasis is on targeting potential applicants in areas of need, including the Cavan-Monaghan area, where there have been challenges with recruitment in the past. That is the only reason I set some of that out. I acknowledge that there have been challenges with recruitment, notwithstanding our desire to recruit more people in the area. The HSE has informed me that the National Ambulance Service's response performance in the region between 2023 and 2025 met the key performance indicator, KPI, targets in the HSE service plan. However, it is acknowledged that at times of high demand, some lower acuity patients have waited longer for a response. I also acknowledge that we would like the targets for purple and red calls to be higher in the first instance. I am not saying that KPIs are any sort of panacea; I am simply acknowledging that the performance in the north-east region has been better than the target. That is something, but we have a way to go to build on it. The Government is committed to the continued development of the National Ambulance Service in the context of both capacity and strategic reform. Since 2020, we have increased the budget for the National Ambulance Service by 60%. We have increased the personnel by 30%. This year, as I informed Deputy Cullinane, we really are trying to recruit. We have a targeted recruitment campaign. We have posts available. I will speak more to that, because, as Deputy Bennett is aware, we need to have better response times,

I welcome that additional staff have been employed. It is still not enough, however. More needs to be done. The National Ambulance Service used to make data available to help inform policymakers in coming forward with constructive solutions. Data indicates that the number of people who died by the time an ambulance actually reached their homes was up 70% in the eight years prior to 2024. There were over 95,000 instances in 2022 of people waiting more than one hour. However, when Sinn Féin recently sought updated information, the National Ambulance Service told us that there is no operational imperative to do so and that there is little or no clinical evidence underpinning response-time targets. That is despite coroners having found evidence of ambulance service capacity being the root cause of a person's death. Does the Minister think this information is relevant and important and that it should be made available to Members?

It is difficult to answer in light of some of the circumstances involved. The Deputy raised an individual case where somebody identified a specific reason. While I acknowledge that, in other cases it is not clear whether a patient, for example - it is awful to speak about it in this way - was going to die irrespective. I can understand the clinical constraints in providing broad data when dealing with many individual circumstances. It is because of the increased response times and the availability that we are trying to recruit. The recruitment competition in 2025 brought the highest number of applicants ever with over 1,000 people applying. I take some comfort in that. It will help fill the additional 263 posts that we have in the National Ambulance Service this year. It will provide for 21 additional crewed emergency ambulances for new intermediate care services on a 12-over-seven basis and a range of other investments.

I find it hard to believe that there are 263 posts that we cannot fill. I do not know if this is down to how we are advertising these posts that they are not being filled. As stated, this information, which I asked for previously, is very important in order that we can inform policy decisions. We cannot fix what is not measured. In terms of what needs to be done in order that the right people across the State have the ambulance service that they deserve and need, however, a few things are apparent. Our dedicated and highly educated newly qualified paramedics need a clear pathway to permanent employment in the National Ambulance Service. They are well needed because the service, by its own admission, is massively short-staffed by 2,000 workers. In Cavan and Monaghan, we need a 24-7 advanced paramedic. At a time when we have seen an overwhelming vote by National Ambulance Service workers for industrial action, up to strike action, will the Minister intervene on these matters?

I appreciate that the Deputy may find it difficult to see that we cannot fill posts but I assure her that it is true. Of last year's posts, there were 180, and 134 have been filled. I would like it to be 180 filled. This year we have provision for 263, which is obviously a considerable increase on last year, so the direction of travel in terms of our investment is very clear. This is not unique to the ambulance services; we have this difficulty across home support, we have it across recruiting into the medical profession generally and we have it with GPs. Across the board, we have posts that are unfilled and to which we are trying to recruit. I would welcome these positions being taken. As I said, there were 1,000 applicants. I take great comfort in that, that people want to do this, but it is also important to highlight that we are trying to have alternative care pathways as well. About 40% of patients now do not require, because of that intervention, subsequent conveyance or subsequent transfer to an emergency department, so those pathways are working well and we need to invest more in that as well. There is emergency department in the home, for example and all the different alternative emergency pathways.

Could I just ask about the 24-7 advanced paramedic that was taken away from Cavan and Monaghan?

I am sorry, that is not-----

Sorry. That is okay. I will table a parliamentary question to the Minister.