Office of the Comptroller and Auditor General - Press release VFM examination report on The Emergency Ambulance Services

Press release issued on 31 March 1998

The Emergency Ambulance Services

The Comptroller and Auditor General, Mr. John Purcell, has undertaken an examination to establish the extent to which the emergency ambulance services operated by the health boards are provided efficiently and economically. The services cost an estimated ?28 million a year to run.

A report on the examination was presented to Dáil ?reann on 31 March 1998. The main findings of the examination are summarised below.

Efficiency Issues

In early 1997, an estimated 87% of emergency calls made nationally were responded to by the ambulance services within 20 minutes. The fastest response times were achieved in the Eastern Health Board area, where the service is provided by the Health Board’s own fleet and by the Dublin Fire Brigade’s ambulance fleet. In three health board areas, less than 60% of the calls received were responded to within 20 minutes. The response times achieved are influenced by population and geographical circumstances in the health board regions and by the level of resources provided.

Performance mechanisms and targets in relation to response times should be drawn up as a matter of urgency at national and regional levels.

Efficiency gains can be achieved by centralising command and control units in each health board region.

Initiatives to improve the service should be subjected to rigorous cost-benefit analysis before implementation.

Economy Issues

In most of the health board areas, the cost of the emergency ambulance service in 1996 was in the range ?6.09 to ?7.32 per head of population served. The cost was significantly higher in the North Western Health Board, which spent ?11.29 per head.

The average cost per rostered hour (i.e. each hour that an ambulance crew is planned to be on duty) ranged from ?16 in the Midland Health Board to ?44 for the Dublin Fire Brigade. The cost per rostered hour was between ?19 and ?24 in most health boards.

Non-emergency journeys averaged 40 per thousand of population. The highest rates of non-emergency journeys were in the Western and Mid-Western Health Board areas — 63 and 73 journeys per thousand, respectively. In considering options to improve response times, the use of less expensive transport for non-emergency journeys should be taken into account.

Strategic Issues

Progress in implementing the recommendations of a 1993 expert group has been slow, partly due to industrial relations difficulties which were resolved only in April 1997.

The Department of Health and Children is working with the health boards to introduce clinical audit of the emergency ambulance services which should facilitate the setting of national standards for the quality of pre-hospital medical treatment.

For further information about the report contents, please contact:

Fergus O’Brien at +353 (0)1 679 3122 or fergus obrien@audgen.irlgov.ie

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The contents of this page were last updated on 26/09/03