Ambulance service: Delays in the accident and emergency (A&E) units of Dublin's major hospitals are hampering the ability of Dublin Fire Brigade ambulance crews to respond quickly to other calls, as personnel are caught up in queues for their patients to be seen.
In some cases, crews have to wait several hours to have a patient signed in so that they can free up the ambulance trolley and get back on the road - similar problems were experienced recently at Mayo General Hospital in Castlebar.
Dublin Fire Brigade crews, who are all trained as emergency medical technicians (EMTs) and who operate the service's 11 ambulances, have complained of delays of two to three hours while they wait for a patient to be seen by pressurised A&E staff.
Tony McDonnell, Siptu representative for Dublin Fire Brigade, said the service's 11 ambulances are located at 10 stations around the city. "If you have three or four from the northside tied up in the Mater or Beaumont, it means you have greatly diminished the potential response on that side of the city," he said.
"You are taking ambulances out of commission by virtue of the fact that they're in a queue."
Mr McDonnell, a firefighter and EMT based at North Strand, said three or four ambulances tied up at A&E on the north side could, in effect, mean a vast area of the city from the River Liffey out to Swords did not have an ambulance available for an "immediate response".
Another Dublin Fire Brigade EMT said crews had sometimes waited so long at A&E that colleagues had to relieve them for a meal break.
Dublin Fire Brigade, which holds an ISO quality award for the service, is contracted by the Health Service Executive (HSE) to provide an ambulance service, for which it was paid €8 million last year. The 11 ambulances operate 24 hours a day and cover approximately 365 sq miles.
Mr McDonnell said the number of fire brigade ambulances had not increased since 1985, when there were just over 20,000 calls a year. Last year, the service responded to more than 96,000.
A spokesman for the eastern region of the HSE said there were 61 ambulances in the region, including the 11 fire brigade vehicles. The region's response times were "the best in the State".
"A lot of additional resources have gone into smarter services such as motorbike ambulances," he said. "They have made a difference and they have been recorded as having saved lives."
A spokesman for Dublin Fire Brigade said: "If there are going to be extended delays of even an hour to hand over a patient, then we would have a problem, but that's not necessarily the norm."
Asked whether there were plans to increase the number of ambulances, the spokesman said: "There are times when we are pretty stretched such as busy weekend nights. But you have to balance that against the quieter times. Every additional ambulance will require 10 additional staff - you are talking about a substantial cost."
A spokesman for Beaumont Hospital admitted ambulances were held "on an all-too-frequent basis". "It is a symptom of the overall problem, of which we are well aware. We do attempt to manage as best we can at all times. We do understand the concerns of Dublin Fire Brigade ambulance control and we are in contact with them regularly. We appreciate the efforts they put in. We still have good relations with them and we have a lot of respect for the work they do," he said.
A Mater Hospital spokesman acknowledged that, on occasion, a delay in the transfer of patients from ambulance to the hospital's A&E arises. "The hospital is working in a number of areas to help alleviate the problem."