Ambulance came 45 miles despite there being a station just a mile away

HIQA report highlights ambulance crisis in country

A local TD recently endured a harrowing wait in which he feared for his mother’s life, as an ambulance was dispatched from 45 miles away to respond to his emergency call; despite there being an ambulance station in his hometown. This was a third time within a year ambulance delays had impacted on his family, explained Sinn Féin health spokesperson, Caoimhghín Ó Caoláin at last week’s the Dáil Health Committee. 

Deputy Ó Caoláin stunned his colleagues with his moving account of how he and his family had been affected by the ongoing gaps experienced in the regional service. Addressing the committee hearing on the recently released Ambulance Service Review the Cavan-Monaghan deputy claimed in the year since his brother-in-law died in circumstances where there was a delay in the arrival of an ambulance, both he and his mother had suffered in similar situations.
His comments followed admissions in the Health Information and Quality Authority (HIQA) review that geographical challenges in rural areas continue to present difficulties in striving to achieve a “timely and appropriate” responses to emergency calls.
“I live in an area within a mile of which there is an ambulance station. There is another one 15 miles away from that, and another 30 miles away. In each of the three incidents, one of which resulted in a death as a result of a heart attack, another of which was my heart attack, I am sitting here before Mr Quinn (chief executive HIQA) and the details are all verifiable where it took place in a GP’s surgery and the other, last Saturday week, where I had to kneel before my mother, who had collapsed, and was unable to lift her.”
In all three incidents Deputy Ó Caoláin says, despite three nearer ambulance stations, including one in his hometown of Castleblayney, an ambulance was instead dispatched from Virginia, 45 miles away.
“I am just one citizen sitting here today. I should be very thankful that I am,” he said.
While accepting his wife’s brother may not have lived, had an ambulance come from any of the three closer stations, of his own situation he said those in the GP office, including the doctor were “incredulous” at the length of time it took for emergency services to arrive at the scene.
To make matters worse, when the ambulance did arrive in Monaghan from Virginia “they could not even find” the GP office in which Deputy Ó Caoláin had collapsed.
“It is no reflection on the ambulance crews, who are wonderful people, as I can attest to,” he continued. “My mother is a hospital patient as we speak. Again, only in the past fortnight, I was on my knees because I could not move for a full hour waiting for that ambulance to come.
“That experience is replicated for many families throughout the country. We need to get serious about the issue,” he said.

Response time
Deputy Ó Caoláin pointed to a recommendation in the review that seven minutes and 59 second should be the first response time for patients in cardiac or respiratory arrest. He said if this was to be applied in his own circumstance, the standard would be “off the Richter scale”.
“Two of those were cardiac arrests, including mine. I was transported from Cavan initially and then on to St James’s and operated on that evening. Seven minutes and 59 seconds sounds all fine and good. It was achievable if the ambulance had been dispatched from the station closest to each of the three stations I have cited. However, the ambulance passed that station and passed two others also closer than the station from which the ambulance was dispatched. I find that intolerable.”
The HIQA report also found that 18% of the current fleet is almost a decade old, contrary to National Ambulance Service replacement policy that clearly says vehicles should be replaced after seven years or once mileage has exceeded 500,000 kilometers.
In June of this year, a Mercedes Sprinter 515 travelling from Cavan General Hospital to Beaumont burst into flames. The crew managed to get out of the vehicle after noticing smoke coming from the bonnet. The HSE subsequently confirmed four vehicles out of a total fleet of 266 were damaged by fire between 2007 and early 2009.
The National Ambulance Service has only recently started to review adverse clinical incidents. A new policy, which is aligned with best practice, was introduced in 2011.
According to the report, 2014 saw a 10% increase in the number of people calling an ambulance, with patients transported to the nearest main emergency department.

No longer sustainable
HIQA has stated this model is no longer sustainable, nor is it in line with other jurisdictions.
In the Republic, there are 266 ambulances and 57 response vehicles. By comparison, Northern Ireland with a population of 1.7 million, has 60 ambulances and 40 emergency response vehicles, with the emphasis across the border more on the emergency response. Deputy Ó Caoláin feels this is worth considering.
Ultimately, Deputy Ó Caoláin was frustrated by the fact the HIQA review did not include the opinions of service users, instead focusing on the thoughts of over 200 members of the national ambulance service staff and a portion of the Dublin fire brigade staff.
Deputy Ó Caoláin concluded by highlighting the loss of acute services at Monaghan County Hospital, citing that the area was promised to be compensated by a fully staffed state of the art ambulance service to cater for all emergency needs.
“We have not got within an ass’s roar of it. I say that with great vexation,” he stated.