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In Ireland, serious incidents are attended by paramedics and advanced paramedics. Damien Storan
Emergency Services

Taoiseach to meet Irish flying doctors who have raised concerns over ambulance service

The Taoiseach has been warned of ‘profound and systemic’ failures in pre-hospital care.

Taoiseach Simon Harris has said he will “listen very carefully” to pre-hospital emergency medicine consultants who have raised concerns about deficiencies in Ireland’s ambulance service.

The Taoiseach said he hopes to meet with consultants who have warned that the survival and long-term health of victims of road traffic collisions and other serious medical emergencies are being put at risk by limited pre-hospital medical treatment.

Ireland is an outlier in not sending specialist doctors to the scene of serious accidents to work with paramedics.

Potentially life-saving interventions that can be provided on the roadside in other jurisdictions, including the UK and Northern Ireland, cannot be performed by Irish ambulance crews, which comprise paramedics and advanced paramedics whose scope of practice is more limited than that of doctors.

As reported by The Journal, the Taoiseach has been warned in recent weeks of “profound and systemic” failures in such pre-hospital care, and that Irish people have potentially been “misled” about the quality of care delivered to critically ill and dying trauma patients before they reach hospital.

Asked this afternoon whether he shared the doctors’ concerns and what action he planned to take, the Taoiseach said: “The first thing I intend to do is meet with that group.”

“It would be the height of arrogance for someone like me to dismiss the views of people on the frontline,” Harris said.

He said the government had taken steps that he was proud of to improve the paramedic and ambulance services but he was “very eager and open-eared” to listen to the doctors’ concerns.

Dr William Passmore, an NHS consultant in emergency medicine and pre-hospital emergency medicine, has sent the Taoiseach data setting out the case for an upskilled helicopter emergency medicine service (HEMS) for the thousands of people seriously injured each year in Ireland.

Physician-staffed HEMS services are in place across the UK and Northern Ireland.

Writing in The Journal yesterday, Dr Brian Burns, an Irish pre-hospital consultant based in Australia, urged the government to work with Northern Ireland to establish an all-island HEMS.

“There are time-critical interventions and decision making that must occur early in that initial golden hour [after traumatic injury] that makes the difference between life or death; the difference between return to family, friends and work versus severe long-term disability and lifetime care,” Burns wrote.

Other consultants have warned that patients are dying at the scene of accidents or before they reach Irish emergency departments who could be saved with critical care at the scene, and that time-critical interventions such as emergency general anaesthetic and intubation – to prevent brain damage from lack of oxygen – are being delayed until hospital admission when they could be carried out on the roadside.

The issue has come to the the fore amid a startling increase in road deaths over the past two years, with 79 lives lost so far this year, up 14% in a year, despite concerted effort by agencies such as the Road Safety Authority to reverse the trend.

The Taoiseach has said reducing the number of people killed or seriously injured on the road is one of his top priorities.

In a written statement provided in recent days, the National Ambulance Service (NAS) said it collaborates closely with the Northern Ireland Ambulance Service where required, providing mutual support by responding on each side of the border.

The NAS has declined a request for interview on the subject of pre-hospital medicine, pre-hospital and inter-hospital retrieval and cross-border cooperation.

The HSE has previously said that the NAS tasked helicopters to 904 incidents last year. These incidents were attended by advanced paramedics and paramedics.

Doctors sometimes attend the scene of incidents in Ireland but only on an ad hoc and voluntary basis.

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