Mattie McGrath warns NAS vehicle removals will risk delays

Good morning. I'm going to ask the Minister for Health to review the current situation within the National Amnesty Service where emergency response vehicles have been removed from the off-duty paramedics. Such vehicles are now perceived to be of benefit in kind. This is a very, very extreme situation and will have a huge impact on response times. I have been informed over the last number of weeks that a benefit in kind liability was identified by the HSE for staff using the NAS response vehicles when travelling from home to work. A review is underway in the National Amnesty Service and it is not hoped to be concluded in April. The National Amnesty Service took the prudent step of informing relevant staff members of a potential benefit in kind liability that may exist in 2025. The Deputy will appreciate, of course, that the HSE, like everybody else, must comply with revenue commissioner regulations in relation to what may be considered a potential personal use of a publicly owned vehicle. The National Amnesty Service is also preparing to seek a ruling from the revenue commissioners in the matter. It is important to clarify that response vehicles highlighted by the Deputy are not patient-carrying vehicles and that is a really important distinction. The vehicles in question are rapid response vehicles for authorised NAS staff to respond to an incident in support of an emergency ambulance while on duty, but they are not patient-carrying ambulances, not patient-carrying vehicles. That decision taken by the National Amnesty Service pending a ruling by the revenue commissioners that has been sought does not impact on the National Amnesty Service emergency ambulance provision. I would like to emphasise the Government's commitment to investing in our National Amnesty Service with an allocation of €285 million in 2025. That includes €8 million new service development funding with a full-year investment of €16 million in 2026 to deliver up to 180 additional posts this year. The National Amnesty Service is badly broken and the government must intervene here with the National Amnesty Service to try and ameliorate this situation. Because they have been in a wonderful job and the paramedics that are there, just as you said, they are not an ambulance carrier, we know that, but they are normally the first person to arrive to an accident or an incident. And in many cases now when they are driving their cars, they have to pass the scene of the accident and the emergency and then go and pick up the ambulance and come back. So that valuable time, often there are only minutes to spare, seconds in some cases to revive a patient or to stabilise the patient. So this is a fascinating situation. We know there are huge issues with the ambulance and the burnout of the staff, but this was something that came in a few years ago in a blaze of glory. It has been successful. And how come it wasn't a benefit in kind up to now? In my own area, the National Amnesty Service, I know areas where they have them at home, not that they are of a huge benefit, but they are there then, they don't have to go to the hospital or the ambulance base to pick them up maybe 20 miles away. It makes no sense whatsoever. Surely it can be dealt with in some other way, that they have the fastest response time. That's what I meant to be, a lead response before the other ambulances will come in. And of course, I clarify for the benefit of others watching, not for yourself in relation to the patient carrying vehicle. I know you do know that, but perhaps others haven't been as involved in this issue as your good self. I think it is important to say that, you know, this review was prompted by the National Ambulance Service themselves, undertaking a review in September 2024 of the procedures governing the out-of-hours use of official response vehicles. And they identified a potential benefit in client liability. I think it is much better and more prudent to have taken that approach rather than to find out after the fact that it had been done wrongly and that a liability had accrued. And I think it is a precautionary measure. And they have sought a ruling from the revenue commissioners. We all have to comply with the rulings of the revenue commissioners. They have sought such a ruling and that the review of the scale of the use of response vehicles for out-of-hour incidents is being examined. And we will have the results of that review presented to the HSE in April 2025. But I do agree about the good work done, but it has to comply with the rules as well. Minister, I would accept this by some other group of employees, but these are dedicated, vital, fast responders. And indeed they work with, and I want to salute the first responder groups who are in my own community, who are doing excellent work here and doing the work in the HSE. And in some cases they are supported by these particular paramedics who have these cars. They do training with them and support them every which way. And there is also reassurance that they are in an area. They have the blue lights so they can travel fast to an incident or an accident. If they don't have to go in their own car, they have to observe the rules of the road and no blue lights. So it's delay, delay, delay. We are already crucified with delays. Some people are waiting three and four and five and six hours for ambulances. And ambulances come from Sligo to Clonmel and from Clonmel up to Roscommon. The whole thing is broken. Badly broke. This is one area that wasn't. So they are doing great work and working. Why change it? Because revenue may be an issue. Why don't we wait and see if they have an issue? But we take these so vital paramedics off the road literally and take pity pension on such a vital service. There are plenty of areas that start to waste and issues in HSE. But not for these angels of mercy who can come so swiftly to an accident or incident. I don't disagree with you one bit about the value of the service that they are providing. What has happened is that the National Ambulance Service is seeking a ruling prudently on whether or not there is a benefit and kind liability and has informed people that there may be a liability to put them on notice of that. And we await a determination. But I think the review is useful more broadly because, of course, it will look at the scale, as I said, of use of response vehicles for out of hours. But it will also determine the benefit and the balance of the use of those vehicles out of hours compared to other existing out of hours or voluntary responses, including, as we all know, the community first responder schemes. And we have 300 of those schemes and 4,000 community first responders volunteers nationwide, which is just extraordinary. And we also have the NAS off-duty responder scheme, where we have 682 National Ambulance Service staff involved. So I think pending the results of the review, the National Ambulance Service took it upon themselves to inform people that there may be a benefit and kind liability. I think, had they not done that, they would have been rightly criticised for being aware that there may be a liability that would accrue to people and not having informed them. And we await a ruling of the Revenue Commissioners on it.