A feature article published in Monday's editions of this newspaper on the subject of ambulance services had a familiar ring to it and, sure enough, a trawl through the past quarter century of Irish newspaper cuttings revealed a long string of similar articles citing various complaints and unfulfilled promises to improve and develop those services for the benefit of the personnel providing them and, more importantly, for the critically ill and injured people whose very lives depend on them. The various recommendations from advisory councils and review groups appear to have been ignored by successive ministers for health, and squabbles between different agencies have been recurrent. Any coherence between the training curriculum for ambulance personnel and the regulations which govern what they may or may not do for patients, is difficult to find.
The last statement from the present Minister for Health in the cuttings files was published on April 1st last year and it reports Mr Cowan saying (in response to a report from the Comptroller and Auditor General) that there was an obvious need for improvement in the response times of Irish ambulances to emergency calls - a problem which he would be urgently addressing.
It would be instructive now to hear what improvements have been achieved as a result of his urgent address 15 months ago, just as it was instructive to read in Monday's article about how the defunct National Ambulance Advisory Council recommendations on a training syllabus for ambulance personnel had never received a positive response from the Department of Health. Or how the further recommendation of the Review Group on the Ambulance Service that there be a pilot project set up to assess the use of paramedical life-saving skills on Irish ambulances, had never been implemented.
Officially, most ambulance services are run by the health boards, except where emergency calls may be met by the fire services (and there has been conflict in that situation on several occasions over the years). The health boards are, for the most part, answerable to the Department of Health which seems largely to have ignored the advice of such councils and review groups as it has established to examine the ambulance services. Indeed, it is difficult to avoid the impression that the Department scarcely pays any heed to the basic needs for the development of the ambulance services if it is to be judged by its record over the past 25 years. There would seem to be a strong case for the establishment of a national ambulance authority, with real power and some degree of autonomy from local and national government, to ensure that this aspect of emergency medical services can develop and improve for the benefit of both its providers and its necessitous users.
The present Minister and his Department have dozed indifferently through the still imminent crisis in Irish nursing. The Department and successive ministers seem to have dozed through the crisis that has been afflicting non-consultant hospital doctors for decades and remains unresolved. There is much to be said for freeing the ambulance services from this dozing indifference to allow those services to achieve at least late 20th century standards of emergency care for the millennium.