A SHAKE-UP in who provides the ambulance service in Dublin could see the HSE taking control of the city's fleet.
The HSE currently provides the ambulance service outside Dublin, while Dublin Fire Brigade (DFB) has served the capital since 1898.
But tensions are now emerging as plans are unveiled to change the system.
The HSE provides DFB with €10m of the €11m cost of running the ambulance service in Dublin, while the total national ambulance budget is €134m.
With DFB responding to 40pc of the country's ambulance calls, unions representing the ambulance personnel in the capital say it represents value for money.
But an internal HSE plan that was recently drawn up claims that its aims to develop an integrated National Ambulance Service are being "constrained" in its "inadequate control" over both the €10m transferred annually to DFB towards the ambulance service and the quality of services.
DFB operates the ambulance and firefighting services in Dublin under the control of Dublin City Council (DCC).
However, a document signed by HSE national director Laverne McGuinness and the then director of the National Ambulance Service Robert Morton states that the "revised arrangements would be phased in with a target of being fully operational by the end of 2015", according to the Irish Times this morning.
It also says that the HSE should withdraw funding from DFB on a phased basis because "this approach is best placed to reduce public and political anxiety" about the change.
The latest moves will heighten concerns that the HSE and city council review of Dublin ambulance services is a precursor to the removal of the service from the fire brigade.
The Herald reported last week that the Irish Fire and Emergency Services Association (IFESA) fears that the removal of ambulance services provided by DFB could result in people dying.
IFESA national secretary John Kidd said the services review by DCC is of huge concern to them, as City Manager Owen Keegan has a "reputation" for privatising public services.
He also said he was concerned that no fire service members were on the HSE review panel.
Last year, the HSE was reported to be considering the phasing-out of fire brigade ambulances in order to save money, as firefighters are paid more than HSE ambulance staff.
In response to IFESA's remarks, a spokesman for Dublin City Council told the Herald: "It is entirely premature to pre-empt the outcome of the review at this stage."