THE Dublin Fire Brigade could lose the emergency ambulance service it has provided in the capital for more than 100 years, under new proposals drafted by the Health Service Executive (HSE).
A draft report proposes that the HSE should withdraw its €10m a year funding towards the fire brigade's 12-strong ambulance fleet and provide the service itself. The report says this would cost the HSE €7.6m, which would save the taxpayer almost €3m a year.
The report examines governance and cost issues at the Dublin Fire Brigade and feeds into the HSE's plan to establish a single, integrated national ambulance service for the entire country.
Its recommendations – which have yet to be communicated to unions and Dublin City Council – are likely to meet strong resistance. City councillors, meanwhile, have warned that any disruptions or funding reductions to the ambulance services in the capital could have serious consequences.
Most of the brigade's 900 firefighters are also trained paramedics and rotate between firefighting and ambulance duties.
It is likely that the Dublin Fire Brigade would have to discontinue its ambulance service if its €10m funding was withdrawn.
There may also be an impact on jobs in the fire service, if it were to lose its ambulance duties. The leaked HSE report says transferring firefighters to the HSE's beefed-up national ambulance service would prove too expensive.
Under the Croke Park agreement, the HSE "would be required to honour current firefighter terms and conditions, which would be a more expensive option than recruiting new staff."
The HSE and Dublin Fire Brigade – via the city council – are the only bodies with statutory powers to deliver ambulance services in the capital. There are also a number of voluntary operators, along with private operators, contracted to the health service.
The HSE currently pays the local authority €10m a year – or €775,000 a month – to fund the firefighters' emergency ambulance service. The report says there is no formal governance arrangement between the health authority and Dublin City Council.
As a result, the HSE has "inadequate control" over the €10m a year it pays towards the Dublin Fire Brigade's ambulance service. It also had "inadequate control" over the quality of that service because Dublin Fire Brigade falls outside the remit of the health watchdog, Hiqa.
"This is a cause of concern both for the HSE and Hiqa," the report said.
The draft report recommended a gradual withdrawal of funding for the fire brigade's ambulance service over the next two years; an investment of €7.6m in its own ambulance service and the recruitment of 104 staff; it set a time frame of 2015.
This approach would "reduce public and political anxiety" and generally be more feasible. It acknowledged, however, that "it will take some time to deliver the national ambulance control centre, and other services" and to identify "deficits" in the emergency ambulance service.
It would also ensure an integrated national ambulance service that would fall within Hiqa's remit, according to the report.
The report ruled out further "outsourcing" of the ambulance service to private operators, citing recent litigation which led to a six-figure settlement with a private operator.
Mary Fitzpatrick, a Fianna Fail city councillor, said she had not been advised of any change in funding arrangements. She said any funding reduction or disruption of services that could impact on response times would be very worrying.
John Kidd, of the Association of Fire and Emergency Services, said: "This will cost people their lives. It will not make savings. What we are looking for is a national fire and ambulance service, as they have in New York."
In a statement, the HSE confirmed that deliberations on appropriate governance and cost effectiveness of the ambulance service are continuing. However, it said "stakeholders" will not be consulted until a decision is reached.