Ambulance bases criticised by HSE 'resisting' change
Auditors found 'obstacles' in the way of recommendations
Ambulance bases have been criticised for lax record- keeping on leave, overtime and expense claims but some are resisting change.
Paramedics in the North Leinster region were found to be "resisting" efforts to change how they used the fuel card, according to an audit report released last week. The report also noted the chief ambulance officer for the region was "aware of the obstacles that were being encountered when implementing" the auditors' recommendations in full.
An ambulance base in Naas was singled out for failing to implement any of eight recommendations on issues such as use of fuel cards and travel and subsistence claims a year after they were issued.
A paramedic at Naas was paid three hours' double time for being called in on a day off to receive a delivery of uniforms, auditors noted. One paramedic received an extra four hours' overtime paid at the wrong rate. Auditors also examined 15 subsistence rate claims at Naas but found half to be inaccurate. Loughlinstown Ambulance Base, in contrast, had implemented all recommendations in full.
The Dublin North Leinster ambulance service, which includes Naas, was first audited in 2016 when 33 high priority areas needed changing. A follow-up audit last year found only a third of their recommendations had been implemented and identified a further 22 new issues that needed to be addressed.
They found 26 of the National Ambulance Service cars assigned a fuel card did not appear on the official register of National Ambulance Service vehicles. Auditors found that of 880 fuel transactions, vehicle registration numbers were not recorded in 14pc of cases, while the odometer reading was not available in almost 30pc of cases. They issued a "high priority" recommendation that ambulance personnel should properly record these details. But auditors were told "resistance was encountered from certain service stations and paramedics when trying to implement this recommendation".
John McCamley, Siptu's industrial organiser for the Eastern Region, which includes North Leinster and Naas, said: "As far as we are aware, there have been no 'obstacles', and management have not come to us with any problems implementing the recommendations."
The Health Service Executive (HSE) did not elaborate on the 'obstacles'. A statement said a national implementation plan was in place at the National Ambulance Service to address "each of the internal audit findings".
The audits were carried out by the HSE last year across eight ambulance bases in Dublin, the west and midlands. Similar issues were found at Kilkenny concerning records on leave, payroll and overtime payments. Auditors found the register of fuel cards was not accurately maintained. Registration numbers and mileage were not accurately recorded and, in some cases, not recorded at all on the monthly fuel card invoice examined.
A review of Cavan/Monaghan found that twice, two different rates were charged by the same ambulance provider for what appeared to be the same trip at Cavan General Hospital. Auditors found "weaknesses in compliance" at Mayo University Hospital over private ambulance bookings.