Dublin council chief rebukes HSE for ambulance underfunding

Chief executive of Dublin City Council (DCC) Owen Keegan has castigated the Health Service Executive (HSE) for what he claims it its failure to adequately fund ambulance services in Dublin.

In a report to councillors ahead of their meeting on Monday to ratify the city’s 2023 budget, Mr Keegan has accused the HSE of re-engaging on a 2021 deal on its contribution to the service provided by Dublin Fire Brigade (DFB), leaving the council with an almost €20 million funding hole.

The HSE has countered that it is meeting its obligations under a 1993 deal with the council and is under no obligation to increase its contribution.

The council and the HSE have been in a long-running dispute over the funding of the ambulance service which in Dublin is provided by the fire brigade. The council has claimed the HSE owed arrears for the provision of the service since 2007, a figure that has accrued annually from €3.5 million in 2007 to more than €116 million this year, according to council figures.

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For more than a decade the HSE has contributed just over €9 million to the service, a sum which Mr Keegan said has not increased despite the increasing costs of running the ambulances.

“Despite continuous engagement by the City Council, the HSE has refused to increase its contribution towards the cost of the DFB emergency ambulance service,” he said.

The ambulance service in Dublin faces major challenges and will require significant additional funding over the coming years

The cost of providing the service was €18.59 million for 2013, of which €9.18 million was recouped from the HSE, he said. “The costs of the service increased to an estimated €28.01 million in 2022,” he said. “The HSE contribution has remained fixed at €9.18 million per annum.”

Last year the HSE agreed to implement the recommendations of a mediation process aimed at resolving the funding issues, Mr Keegan said, but “the HSE subsequently withdrew its agreement”.

The Dublin local authorities “have always had a strong commitment to the provision of the emergency ambulance service by DFB”, Mr Keegan said.

[ Dublin ambulance row between council and HSE dates to 2010 ]

“Every effort will be made to secure a satisfactory resolution of the ongoing funding issues associated with the DFB emergency ambulance service” through resolution with the HSE.

However, he said: “The ambulance service in Dublin faces major challenges and will require significant additional funding over the coming years.”

In response to queries the HSE said it makes a financial contribution to the council towards the costs of the equivalent of 105 full-time staff for the provision of 11 emergency ambulances on a 24/7 basis.

“The current funding support arrangements between the HSE and DCC are grounded in the recommendations of the Review of Ambulance Services in Ireland 1993,” it said.

“There is no Service Level Agreement in place between the HSE and DCC to vary the amount of the contribution made, or accede to, agree with, or accept any alternative costing model.”

It added that in recent years, the HSE has also funded the replacement of DFB emergency ambulances.