Tensions over funding of Dublin ambulance service
Emails show city council accused HSE of ‘short-changing’ Dublin Fire Brigade over €10m arrears
Although short of ambulances, Dublin Fire Brigade has 22 fully crewed fire appliances which respond to a significant proportion of ambulance call-outs. Photograph: Cyril Byrne/The Irish Times
An increasingly fractious relationship between Dublin City Council and the HSE over who should pay for the State’s busiest ambulance service is revealed in correspondence dating from July 2010, released to The Irish Times under the Freedom of Information Act.
In emails between senior council officials, the HSE is accused of “short-changing” the local authority in relation to alleged arrears of more than €10 million accrued since 2005 for the ambulance service, which is provided by Dublin Fire Brigade (DFB) on behalf of the council.
The correspondence culminates in a letter from city manager Owen Keegan to the director general of the HSE, Tony O’Brien, dated November 22nd, 2013, in which Mr Keegan accuses the HSE of “refusing to abide by the terms” of an agreement reached 16 years ago as to how the ambulance service would be paid for.
The letter was sent three months before the announcement on February 27th by the HSE and the council of a joint review of ambulance services in Dublin city.
Charged with looking at patient-care and value for money, it is being conducted by former Dublin deputy city manager Derek Brady and former interim director of the National Ambulance Service (NAS) Martin Flaherty. It is is due to be completed by May.
Mr Keegan said in the November letter that while DFB had “a long tradition of service to the population of Dublin”, having provided the ambulance service since 1898, the council could not continue to provide it where “DFB’s capacity to meet Hiqa [Health Information and Quality Authority] standards is being undermined by factors outside its control”.
He claimed the HSE was refusing to abide by long-standing agreements on payment, the current funding formula did not provide for reimbursement of significant costs incurred by DFB and agreement had “proved impossible” on a new service-level agreement.
Asked by The Irish Times last week about the alleged arrears with the city council, NAS director Martin Dunne said: “There are no arrears.”
The emergency ambulance service in Dublin costs about €12 million a year, to which the HSE contributes €9.2 million out of a national ambulance budget of €134 million.
DFB takes about 40 per cent of all emergency calls in the State.
Although DFB has 12 ambulances stationed across its 11 fire stations (with two in Tara Street), it also has 22 fire appliances, each capable of carrying up to six paramedics.
Chief fire officer Pat Fleming says that up to 60 per cent of the most serious life-threatening calls in the city are responded to initially by a fire tender. He says this underlines the brigade’s need for three more ambulances, which it cannot afford to buy.