Dublin City Council wants to transfer the call and dispatch function of the Dublin Fire Brigade (DFB) ambulance service to the National Ambulance Service (NAS). However, opponents of the plan say that this will fundamentally change the way DFB is run and will result in the ambulance service being taken away.
Fire and ambulance services are unique in Dublin because they are both offered by DFB. This system is known as fire-based emergency medical service (EMS) and is recognised as international best practice, particularly in large metropolitan areas. At present, when a member of the DFB goes to work, they could be put on a fire truck or on an ambulance for their shift, because they are dual-trained as paramedics as well as firefighters. When it comes to responding to emergencies, this means that all of the responders to a scene are both trained as firefighters and paramedics.
This has huge benefits when it comes to things like road traffic collisions, or major emergencies such as the fire in the Metro Hotel in Ballymun last month. It means a paramedic can be sent in to help treat a casualty because they have the training to operate the breathing apparatus, or a firefighter knows how to safely extract a casualty. This is crucial because when it comes to saving lives, minutes and seconds count.
To bystanders and onlookers, it is unclear as to why Dublin City Council want to implement this change. Green Party Councillor for Rathgar-Rathmines Patrick Costello says the change of the call and dispatch function would require a “fundamental change to the service” and how it is currently run. “If you look at the numbers, fire-based EMS produces better results in terms of survival rates for people who have the misfortune of needing the service. Fire based EMS is the gold standard.” On why he thinks Dublin City Council want to push the change through, Costello said “there have been a couple of difficulties identified in terms of funding streams… there’s an element, a perceived element of duplication in terms of the two ambulance services.”
SIPTU DFB Convener Shane McGill said that there is “better co-operation” because DFB currently has control over ambulance and fire brigade dispatching. Dublin Fire Brigade are constantly in contact with the appliances that have responded to emergencies and “they’re adjusting to the information they’re getting” he said. McGill said he thought the main reason behind Dublin City Council’s push to bring the control centre over to the NAS is “not enough funding. The cost overrun is met by Dublin City Council” he says, which inevitably takes money out of their budget for other projects.
The story starts in early 2014 when a Prime Time Investigates report was released about the delays in answering calls in the ambulance service. On foot of this, the Health Information Quality Authority (HIQA) commissioned a report into pre-hospital care in Ireland. This report was released in late 2014 and recommended that there be better co-operation between the NAS and the DFB ambulance service. After this report, Dublin City Council unilaterally announced they would be moving the call and dispatch function of the DFB ambulance over to the NAS.
However, in the face of opposition to this plan, Dublin City Council set up a forum for stakeholders to discuss the future of the DFB ambulance service. This forum ultimately never made any public recommendations because Dublin City Council withdrew from the forum in early 2016 and resumed their plans to merge the call and dispatch function of the DFB and the NAS.
According to Costello, the forum fell apart when it reached the module looking at the dispatch function because Dublin City Council were unwilling to look at anything other than moving the call and dispatch function from DFB. However, before the forum fell apart some of its recommendations were leaked to the public. These recommendations included that the call and dispatch function stay with DFB, but a technical solution be found to bring the DFB and NAS control centres together.
Since then, DFB has been negotiating with Dublin City Council over the proposed changes but these went nowhere and in March 2017, SIPTU and IMPACT union members served strike notice. A crisis was averted when Kieran Mulvey, former head of the Workplace Relations Commission, took all of the concerned parties into mediation, which is still ongoing. McGill says that there is progress being made in some areas and not in other, but that mediation has entered its final stages.
Independent Councillor for Dublin’s North Inner City Christy Burke says that the council management wants to “wash its hands” of the ambulance service and that it will be “one less headache” for them to deal with. “Why fix something that’s not broken?” argues Burke. “Dublin Fire Brigade are experienced, qualified, effective, reassuring and highly skilled in this job.”
Costello says “Fire based EMS is shown globally to be the way forward … (and) produces an excellent standard of care. It really needs to be protected. I think given the complication of the funding streams and things like that, it would appear that Dublin City Council management do not want to continue the fire-based EMS and want to lose the ambulance service.”
What would be the cost of moving the call centre to the NAS? “There would be drastic infrastructural costs. It would make it more difficult to continue the fire-based EMS and then you’re looking at breaking up the fire-based EMS,” says Costello. “Ultimately I think it would lead to cuts to the Dublin Fire Brigade that I don’t think would be beneficial to the people of Dublin.”
When approached on the matter, Dublin City Council refused to comment, saying that the matter was subject of union-management discussions at the present time and commenting would not be appropriate.