Emergency ambulance

timmywex

SIPTU accuse HSE of ambulance service tenders
Sunday, 13 May 2007 20:41
SIPTU has accused the Health Service Executive of trying to privatise the country's Ambulance Service.

The claim was made after an expression of interest notice was posted on the government's e-tender website on Friday.

Siptu which represents the majority of ambulance personnel has criticised this move, describing it as privitisation by stealth.

Siptu says the decision by the health service executive to seek tenders from private ambulance operators is a breech of the national agreement and the union is demanding an urgent meeting with senior HSE management


The HSE denied the unions claims, saying it was simply formalising existing services around the country.


http://www.rte.ie/news/2007/0513/hse.html

video link:
http://www.rte.ie/news/2007/0513/hse_av.html



imo, if the whole thing goes private, it wont work, paramedics wont be happy and a company cant afford nor cant quickly enough train new paramedics, currently theres 1300+, and it defo needs 300 more just to survive, i think this tender is just for making the contracts to privates official and using the emergency response section for days like major emergencies,

if privates come in, the quality of care will go down as the companies try to save evrey penny they can,


discussion among paramedics here: www.irishambulance.net

tender:
http://www.e-tenders.gov.ie/Search/Search_Show.aspx?id=MAY083772

tallaght01

do you have proper paramedics in Ireland? While I was practising over there, I couldn't believe that we were essentially relying on first-aiders who oculdn't give drugs.
Has that been resolved now? I hope it has.

fasterkitten

actually they're highly trained EMTs. not 'first-aiders' as you so condescendingly put it. and the system works very well

timmywex

tallaght01 wrote:

do you have proper paramedics in Ireland? While I was practising over there, I couldn't believe that we were essentially relying on first-aiders who oculdn't give drugs.
Has that been resolved now? I hope it has.

most are emt's(technician's) but they are called paramedics in ireland, and can give some drugs, there are also some advanced paramedics coming on stream which are higher than nurses but not doctors, check out phecc for further details, a first aider never works on a hse emergency ambulance

timmywex

fasterkitten wrote:

actually they're highly trained EMTs. not 'first-aiders' as you so condescendingly put it. and the system works very well

appears to work well

thats because most paramedics do a lot of overtime and some do 100 hours a week, just to keep an ambulance on the road in a certain area, thats why i said above of the need for 300 more paramedics urgently

tallaght01

fasterkitten wrote:

actually they're highly trained EMTs. not 'first-aiders' as you so condescendingly put it. and the system works very well

I didn't put anything "condescendingly". I've trained first-aiders for many years, and our advanced guys can use all the ambulance equipment pretty well. I still cover a lot of public events with my local first-aid team, and they're superb. They use AEDs, entenox, oxygen, sats monitors, bag+mask ventilation, splints, spinal/scoop stretchers etc. Some of them who've been on the trauma course can even take a BP pretty well. Some are walter mittys, but most of them could use the same stuff as I remember the ambulance guys being able to use when I was in Ireland.

What drugs can the paramedics in Ireland give nowadays?

timmywex

ADVANCED PARAMEDIC:http://www.phecc.ie/BP%20Guidelines%20Medication%20Formulary%20Edition%202.pdf

there is more to be added to that list but not sure what

there training guidelines : http://www.phecc.ie/Edu&TrngStandard2007.htm

the paramedic drug list is defferent from place to place

tallaght01

Cheers Timmywex,
Looks good. Definite step in the right direction. I'd like to see bronchodilators on the list too (might be there, and I just haven't seen them).
Thanks for the info.

Judt

What's wrong with privatization, if it works? Just because it's not a cushy civil service position anymore to be an EMT - remember, you're dealing with vested interests with the unions. At the end of the day business can sometimes do a job better - cheaper, more efficiently, because at the end of the day they're a profit and loss organisation - and where they can, they should. Suggestions that businesses will leave us all to die on the side of the road hardly counts, as they'll lose their contracts. I think that if the HSE thinks that privatization is the way to go - not for me to decide, mind - then I'd say that the unions can shut their gobs and get on with it. EMT's do a good job and deserve good pay, of course, but this natural union knee-jerk anti-business mentality annoys me. Bit French...

timmywex

judt, the hse thinks privatisation because it means less bother for them, they dont have to recruit or buy new ambualnces, if it is a company prviding the care, they will use minimum materials and use the cheapest ambulabnces and equipment, also, the patients will probably get charged for being trasnported as it will be a company


on another note, this could also mean that the dublin fire brigade will lose out on the ambulance service in the dublin area

Wishbone Ash

tallaght01 wrote:

I couldn't believe that we were essentially relying on first-aiders who oculdn't give drugs

Are you confusing emergency ambulance staff with Red Cross/St John's Ambulance/Civil Defence crews which are essentially 'first aiders' (AFAIK)?

Sully

Dont forget the voluntary ambulance service who are often just as good.

I wouldnt agree with privitisation of it tho.

watsgone

Wishbone Ash wrote:

Are you confusing emergency ambulance staff with Red Cross/St John's Ambulance/Civil Defence crews which are essentially 'first aiders' (AFAIK)?

In some parts of the country the OMAC (Order of Malta) provide the full time ambulance cover.

Privation is not the way to go in my opinion though.

lostexpectation

Judt wrote:

What's wrong with privatization, if it works? Just because it's not a cushy civil service position anymore to be an EMT - remember, you're dealing with vested interests with the unions. At the end of the day business can sometimes do a job better - cheaper, more efficiently, because at the end of the day they're a profit and loss organisation - and where they can, they should. Suggestions that businesses will leave us all to die on the side of the road hardly counts, as they'll lose their contracts. I think that if the HSE thinks that privatization is the way to go - not for me to decide, mind - then I'd say that the unions can shut their gobs and get on with it. EMT's do a good job and deserve good pay, of course, but this natural union knee-jerk anti-business mentality annoys me. Bit French...

priviatitison means squeezing every less penny out of profit not giving the service needed I don't know where you get your ideas from?

timmywex

watsgone wrote:

In some parts of the country the OMAC (Order of Malta) provide the full time ambulance cover.

Privation is not the way to go in my opinion though.

no, they cover some events but are paid for the job by the event organisers, they very rarely transport to hospital as they dont have a good enough qualification, in galway city however, emergency service is provided by private companies now and again because of a lack of hse staff

Judt

lostexpectation wrote:

priviatitison means squeezing every less penny out of profit not giving the service needed I don't know where you get your ideas from?

Umm, if you don't provide a good service then you don't get the business and you lose profit, therefore you provide a good service.

Besides, the state is still paying for it, and deciding who gets awarded the contract. They won't swipe your credit card on the way in the doors.

Private business tends to cut fat, but they provide top notch service. Public sector tends to do the opposite.

timmywex

Judt wrote:

Umm, if you don't provide a good service then you don't get the business and you lose profit, therefore you provide a good service.

Besides, the state is still paying for it, and deciding who gets awarded the contract. They won't swipe your credit card on the way in the doors.

Private business tends to cut fat, but they provide top notch service. Public sector tends to do the opposite.

well, there would only be one service so they either get the business or people die because they wont call an ambulance


on another note......the government are trying to reduce costs!! they wont pay as much!! the private companies will either charge the receiving hospittal(who then charge the patient) or charge the patient directly!!so,

Benny-c

watsgone wrote:

In some parts of the country the OMAC (Order of Malta) provide the full time ambulance cover.

Privation is not the way to go in my opinion though.

Really, first I have heard of that!

johnnyrotten

watsgone wrote:

In some parts of the country the OMAC (Order of Malta) provide the full time ambulance cover.

Privation is not the way to go in my opinion though.

Where did you get that from?

delta_bravo

Wishbone Ash wrote:

Are you confusing emergency ambulance staff with Red Cross/St John's Ambulance/Civil Defence crews which are essentially 'first aiders' (AFAIK)?

Im in the St. John Ambulance and the brigade as a whole is currently undergoing a process of upskilling which is probably going on in the other organisations. Most members are trained in aed ( defibrillation) and about growing number of members are trained as emfr ( emergency medical first responder which is a medical grade below emt). Dont forget some members are also doctors,radiographers,nurses,paramedics so we;re not a clueless bunch

watsgone

Achill island I believe and so I have been informed, locals in OMAC provide the service,

Also the OMAC are the first reserve to the HSE in times of large emergency, and OMAC were called upon at the tragic bus crash in meath.

OMAC are also currently upgrading and improving skills such as AED and First Responder .

Also the Tramore Unit are on call in the town, all year round

Elessar

timmywex wrote:

no, they cover some events but are paid for the job by the event organisers, they very rarely transport to hospital as they dont have a good enough qualification, in galway city however, emergency service is provided by private companies now and again because of a lack of hse staff

Excuse me but that is just rubbish. OMAC have essentially the largest ambulance fleet in the country (outside the HSE), extremely well trained volunteers, a growing number of First Responders (incl. myself), paramedics, doctors and we regularly transport people we believe are emergency cases to hospital. Our ambulances are fully equipped for the job. Each time we're out we have at least one, if not more EFRs crewing the vehicle and are fully qualified to transport people to hospital. The HSE even calls on us to help out when there is a major emergency that takes away a good proportion of their own fleet.

Also, next year we will begin training our EFRs up to EMT/Paramedic level.

Think about that next time before you state that the Order of Malta "dont have a good enough qualification".

timmywex

Elessar wrote:

Excuse me but that is just rubbish. OMAC have essentially the largest ambulance fleet in the country (outside the HSE), extremely well trained volunteers, a growing number of First Responders (incl. myself), paramedics, doctors and we regularly transport people we believe are emergency cases to hospital. Our ambulances are fully equipped for the job. Each time we're out we have at least one, if not more EFRs crewing the vehicle and are fully qualified to transport people to hospital. The HSE even calls on us to help out when there is a major emergency that takes away a good proportion of their own fleet.

Also, next year we will begin training our EFRs up to EMT/Paramedic level.

Think about that next time before you state that the Order of Malta "dont have a good enough qualification".

sorry, what i meant is the majuority of are not qualifyed enough to transport (and if they are, they have to ring hse control to get permission firstly)

there are three grades, cfr,efr and emfr. emfr is the only one that allows the transportation of a cauaualty anywhere and to gain this, you need to spend 120 hours learning and more hours doing placements, most people just cant give up the time to do this with other jobs etc,

however, the omac and st john are the reserves of the hse and as said provide great cover for events and help back up the hse on major incidents

btw, efr's cannot transport to my knowledge, only emfr or above can. will confirm this however



EDIT:: http://www.phecc.ie/Edu&TrngStandard2007.htm

outlines all the different training standards for the different grades as outlined by the phecc(pre hospital emergency care council), this is the statuary body for training as laid down by si 109 of 200 ,http://www.irishstatutebook.ie/2000/en/si/0109.html

Elessar

timmywex wrote:

sorry, what i meant is the majuority of are not qualifyed enough to transport (and if they are, they have to ring hse control to get permission firstly)

there are three grades, cfr,efr and emfr. emfr is the only one that allows the transportation of a cauaualty anywhere and to gain this, you need to spend 120 hours learning and more hours doing placements, most people just cant give up the time to do this with other jobs etc,

however, the omac and st john are the reserves of the hse and as said provide great cover for events and help back up the hse on major incidents

btw, efr's cannot transport to my knowledge, only emfr or above can. will confirm this however



EDIT:: http://www.phecc.ie/Edu&TrngStandard2007.htm

outlines all the different training standards for the different grades as outlined by the phecc(pre hospital emergency care council), this is the statuary body for training as laid down by si 109 of 200 ,http://www.irishstatutebook.ie/2000/en/si/0109.html

As far as I am aware, we are all EMFRs because the syllabus is exactly the same, we can transport people in ambulances and are Phecc registered. We don't really use the term though, just "First Responder". In fact there is a lot of confusion over the terminology at the moment, they are re-arranging the titles - afaik, EMFRs will now become EMTs (with a bit more training I think), EMTs are now known as Paramedics, and Paramedics are known as Paramedic-A's. Aparantly, not everyone got the call though, as all the titles are still in use.

Anyway, on topic, I don't think it's a good idea to privatise the ambulance service, as someone else said, they will probably charge you a lot of money for a call out, when it should be state-run and free (or nearly free).

They really need to update the Health Act, because as it stands now - and not many people know this - is that the HSE has absolutely no legal obligation to provide an ambulance service anywhere in the country.

SimpleSam06

Elessar wrote:

Anyway, on topic, I don't think it's a good idea to privatise the ambulance service, as someone else said, they will probably charge you a lot of money for a call out, when it should be state-run and free (or nearly free).

And eh, do I get to pay less taxes if they privatise public services?

Victor

Is it going to tender largely because teh Dublin Fire Brigade provide the ambulance servie in Dublin and control services in other areas without it going to tender?

timmywex

SimpleSam06 wrote:

And eh, do I get to pay less taxes if they privatise public services?

eh, no!! they just dont want the bother, if a loved one is in trouble, you'll still have to pay for an mbulance, at the moment it would be free!!


victor, dfb have controled the ambulance in dublin for years(since 1889 i think) and one private company, which i wont name because another gorum i know was sued for naming them in a similar kind of post to this, but in a case to the EU that the service in dublin should be tendered, dotn know how that case is going, for the rest of the country, the hse are maybe trying a sneeky one to privatise the service or just hoping the same thing like in dublin doesnt happen, in that one private takes a case becasue they are not getting a fair deal in that any patient transport work that privates do for the hse is being done largely by another company while there is no contract (at the moment, it is up to every control to decide who they use)

i think the hse are just formalising existing arrangemnts and the emergency response section for days like major emergencies, on a whole, i cant see this section being economically viable for a private, with staff wages and training, as well as the fleet and equipment and ambulance bases,

timmywex

paramedics calling for a ballot with a view to strike

http://www.rte.ie/news/2007/0516/ambulance.html

the hse dont know how to handle staff!! the nurses maybe winding down their dispute but the consultants about to start and maybe the paramedics too!!


the hse's response to the claims: http://www.hse.ie/en/NewsEvents/News/title,6820,en.html

most of this is indeed quite untrue

sunnyjim

btw, efr's cannot transport to my knowledge, only emfr or above can. will confirm this however

As was pointed out to someone on the IA.net, apparently the EMFR tag is gone, its just called EMT.... and it is them and persons further advanced who can transport.

As far as I am aware, we are all EMFRs because the syllabus is exactly the same, we can transport people in ambulances and are Phecc registered. We don't really use the term though, just "First Responder". In fact there is a lot of confusion over the terminology at the moment, they are re-arranging the titles - afaik, EMFRs will now become EMTs (with a bit more training I think), EMTs are now known as Paramedics, and Paramedics are known as Paramedic-A's. Aparantly, not everyone got the call though, as all the titles are still in use.

If you are an EMFR now (which could mean anything!!! So how were they PHECC registered??), you will become an EFR, not an EMT.

By the way - would all the volunteers on the board stop going on about how you have Doctors etc on yer teams, going on about the HSE calling you out, etc... All have a role to play in an emergency, its not a competition.

jimmycrackcorm

I wonder why Dublin fire brigade operate with 12 Ambulances whereas there are at least more than 12 sitting outside Letterkenny General hospital given that Dublin has more than 10 times the population size...

Barbarossa

Hi, can anyone out there help me, or point me in the right direction.
I’m looking for information on how to become a Paramedic/EMT in Ireland, and also wondering about the average terms and conditions.
I currently live in Co. Galway but work in the North Sea as a Rig Medic. My background is nursing based (RGN and RMN, qualified in Aberdeen in Scotland ), and have been in the oil and gas industry for 6 years as a Medic. I am currently looking at options to enable me to work closer to home and having been “off the wards” for a while and working more at the sharp end I feel that becoming a Paramedic/EMT would suit me better. Unfortunately I have found little detailed information on the internet regarding how to go about becoming one or what the conditions (or pay for that matter) is like.
Any help/pointers on how to start would be appreciated.
Should I forget the whole thing and start selling the Big Issue???

watsgone

Get in contact with http://www.nats.ie/
Thats the national ambulance training centre in Ireland.
If you send them an email they will answer any questions you may have.

Barbarossa

Thanks, I've now emailed them.
What's the unofficial line from the workers though? I've heard scary stories about 50 hour overtime and rubbish pay...and also HSE muttering about a recruitment drive (any evidence of this anywhere?).

watsgone

In that case maybe try this forum lots of views and information there
www.irishambulance.net