2026-03-18

I wish to discuss the HSE's failure to offer 76 newly qualified paramedics full-time jobs upon graduation. We do not come in here too many times with a solution to a particular issue. It is fair to say that the reason this issue has been somewhat resolved is the action taken by many of those graduates who obviously made contact with many people in this House and beyond. It was good to see the number of people protesting outside this House, which they should not have to do. I had been contacted by multiple people, including some of the graduate paramedics themselves and members of their families who are incredibly worried. One of the paramedics sent me this email. It states: For the past three years, I have been working under a series of one-year, specified purpose contracts (SPC) in order to progress through my training as a paramedic. My most recent SPC expired on the 13th of January. I received email communication from [the National Ambulance Service] NAS Human Resources on February 20th asking me to sign a 16-week contract extension. The email stated that the purpose of the extension was to enable me to continue my employment with NAS for long enough to apply for a permanent position through an internal recruitment competition. I was not given any details, whatsoever, about the recruitment competition or the permanent positions to which it relates. This change from established practices was wrong. It was disgraceful. There is no other way of saying it. When I spoke to many of the senior paramedics outside, they said that one of the issues is that there has been a difficulty in filling certain positions in certain stations. Prior to this, not only would the graduates have gone through the college course and placement but, on graduation, they would have received the role. In addition, the role would generally have been within 45 km of their home. I brought this issue up with the Taoiseach and he came back to Deputy Kerrane the next day and said these graduates would get a position but they would still have to go through the process. He said the graduates had been asked to select three preferred locations in a region from the available vacancies and that every effort would be made to accommodate their first preferences. The fear is that someone from Dundalk could end up in Cork. People have those sorts of worries. The good news that emerged last week is that contact had been made and we heard that the competition was being dropped. That is only right, and it is down to the necessary action that was taken by many of the graduates. I would like some sort of explanation as to how this hiccup happened. The graduates are being promised that every effort will be taken to ensure they can be placed as close to home as possible. Will the Minister of State come back to me on that? A huge number of issues remain unresolved in relation to advanced paramedics. There are only two privileging courses. The Irish Society of Paramedicine wrote to me. It probably wrote to many others also. The email stated: From our perspective as frontline workers in [the National Ambulance Service] NAS, the resolution of this issue offers a small amount of hope for the future. Worryingly, morale among frontline NAS staff has been very low for quite some time now. We witnessed, first-hand, the damage this most recent situation did to staff morale, new and seasoned staff alike. The successful resolution of this issue has helped, but we have quite the journey still ahead of us.

I thank the Deputy for raising this very serious issue. I too have been speaking to a lot of ambulance paramedics. It is important to clarify for the record that there is no recruitment embargo in the National Ambulance Service, and there is absolutely no failure to offer permanent employment to paramedic graduates. Every paramedic who is graduating in 2026 will be offered a full-time, permanent contract with the National Ambulance Service. In fact, following constructive engagement between the HSE and representative unions last week, as the Deputy stated, agreement has now been reached on the arrangements for the transition of all of this year's graduates into permanent roles. The HSE has confirmed that full-time, permanent contracts will be available for all graduates completing their training in 2026. These roles will be drawn from funded and approved vacancies, including posts arising from retirements and promotions, as well as new posts linked to service development under the national service plan. The HSE has confirmed that there are more than enough vacancies to accommodate all of this year's graduates, and there will be a permanent job for everyone. Under the revised arrangements, graduates will now be assigned to permanent posts as close as possible to their home address following the completion of the staff transfer process for existing NAS personnel. When speaking to ambulance paramedics, that is something that was constantly raised with me. Where locations are oversubscribed, assignments will be made based on original recruitment panel placement, ensuring a fair and transparent approach. This reflects both operational requirements and existing agreed processes within the service. Since 2022, the Government has invested an additional €75 million in the NAS, with staffing increasing by 761 posts in that time. In 2026 we will see further major investment in the NAS, with approval for the recruitment of an additional 263 whole-time equivalent posts and €20 million in new funding. This will help to improve ambulance response performance by delivering 21 extra crewed ambulances operating at peak demand, as well as four additional intermediate care vehicles, and will further develop NAS alternative care pathways, including community paramedic services. The NAS is also establishing a new helicopter emergency medical service in the west north-west and a new NAS tertiary education site in Cork to further support paramedic education and training. The investment in 2026 will also see significant increases in NAS capital funding, including €34 million for renewal and expansion of the NAS fleet of emergency ambulances and other response vehicles. Graduates play a vital role in maintaining workforce capacity and safe service levels, and supporting new developments, particularly in the context of this sustained funding and expansion of services. As the NAS works to place all graduates in permanent positions, they have been given a 16-week extension to their current training contract to ensure continuity of service and employment for them. There will be no interruption in employment and no graduate left without a pathway to a permanent position. In summary, we are seeing a structured and agreed transition of graduates into permanent posts within an expanding national emergency service.

We need to ensure that is delivered as close to home as possible and that we see transparency in the process. The fear relates to what will happen in the future. We are very glad this solution has arisen but the problem should not have arisen. There should not have been a need for these discussions between the union and the HSE because this was an absolute breach of trust. Also, we are talking about 76 of those who are graduating now, but there were 400 altogether, so we need to ensure that they will also face the same set of circumstances, that they will have a position that we absolutely need them to have and that they can be placed as close to home as possible. I believe that is absolutely necessary. My understanding is that the staffing number for the NAS is around 2,500, with about 1,800 front-line staff. I am also told that we need about 1,000 more personnel. When I look at the National Service Plan 2026, I do not see answers in relation to the needs that Louth has at this point in time. We are all talking about community paramedics, and that is something we all welcome, but it is also about seeing movement regarding the recognition of those who have advanced paramedic training and seeing more privileging courses. We need all of those issues to be dealt with. It is very important that people are close to home. We can see the issues that would arise if somebody had a very long commute at the moment. I accept it is not the Minister of State's fault in relation to Donald Trump and Benjamin Netanyahu's illegal war, but the fact is that for three weeks now we have been looking at a cost-of-fuel crisis on top of a cost-of-living crisis and we really need to see action taken. I would have thought that what is going on at the minute might bring sufficient focus for the Government, but it looks like it was probably necessary for Sinn Féin to bring forward this evening's Private Members' business to place an absolute focus on it. Like many others, I have community nurses sending me letters and emails and making correspondence on the basis of that high cost. I will give those to the Minister of State afterwards. They are worried that they may not be able to provide the service required because of the cost-of-living crisis.

I thank Deputy Ó Murchú. These are really important points. As the Deputy said, all of us have been working with our ambulance paramedics over the years and we see the value of their work. Tonight I want to compliment them for their outstanding work in the community and the work they do for all of us. That is the main thing. There are three main points. First, full-time permanent contracts will be offered to all year 3 paramedic graduates in 2026. Agreement has now been reached on those posts and they will be assigned. Second, there is no recruitment embargo in the NAS. On the contrary, 263 additional posts and, as we said, €20 million in new funding have been approved this year, alongside continued and significant investment in the service. Third, graduates are not facing unemployment. They have been granted a 16-week extension to their existing contracts to ensure continuity while permanent assignments are finalised under the agreed process. The main thing is that these graduates are valued. They are needed and they are part of a service that is expanding significantly to meet growing demand. Our responsibility is to ensure those posts are all allocated fairly, transparently and in a way that meets operational needs across all communities while assigning graduates as close as possible to their homes. I welcome the resolution that has been reached. I remain committed, as does the Minister for Health, to supporting these graduates and to continuing the expansion of the NAS so that patients across the country receive timely, high-quality emergency care.