Pros and Cons of Amalgamation.....

crackcrack30

In the current prolonged climate of austerity and future proposed cutbacks, productivity and budget agreements what would be the cons and pros of an amalgation of the Fire and Ambulance Services nationwide...:eek:, from the point of view of the workforce and the public services...

Is this nettle too big????... & how would it work? i.e. transform to new body over a given timeframe?

Since I started this thread its only fair that i give examples.....

Cons - Big,Big shake up.... probably early/forced redundancys:o
..

Pros - A more cohesive body, befitting of the 21th century
..

MugMugs

Are a large degree of ambulances not private?

crackcrack30

There are many private ambulance companies but these are not state owned or dedicated to frontline emergency calls, rather private hospital transfers and events, gigs ect.

crackcrack30

crackcrack30 wrote: »

Cons - Big,Big shake up.... probably early/forced redundancys:o
..

Pros - A more cohesive body, befitting of the 21th century
..

Gee, I wonder which side you're on? :rolleyes:

In all seriousness, It'd be an interesting idea, but would it mean the end of retained services in smaller towns?

im invisible

They'd probably just stick an extra few layers of bearuocracy on top of whats already there, while cutting the numbers on the front lines

flazio

The main con is that you would have plenty of well capable paramedics who would know the human body nearly better then the local GP, but wouldn't have a clue one side of a hosepipe from another. On the other side you would have lads who could have a flood control pump up in record time but would be useless if they were required to put in an IV line into a person.
Firefighting and pre hospital care are two different skill sets and it seems a bit unfair to the kid who had dreams of being a firefighter but no interest in 'doctors and nurses' to be denied his or her dream.
I have much respect for Dublin Fire Brigade and the great role they play in both fields, but advanced pre hospital care is too specialised a skill to just integrate into a role of every firefighter in the country.

Having said that, I wouldn't be against local firefighting agencies taking on a 'rapid response' role in medical, particularly cardiac and respiratory arrest emergency situations in support to the mainline ambulance services. I appreciate that many retained fire crews are trained up to EFR and EMT these days, and that a defib is now situated in nearly every fire station across the country, so I do feel that in the event of an arrest that the HSE dispatch should factor in whether or not a local fire crew is closer then the ambulance and consider dispatching said fire crew.
Take my own county, Galway, for example. Ambulances are based in Ballinasloe, Loughrea, Clifden and Galway city , a station should be open in Tuam soon, compare that to how many fire stations are in the county, Galway city, Clifden, Gort, Athenry, Loughrea, Tuam, Mountbellew, Portumna and Ballinasloe. Say someone had a collapse in Portumna forest park, an ambulance from Loughrea or Ballinasloe could take 10 - 20 minutes to arrive on scene by which time the person could be lost, however you could set off the Portumna fire crews pagers let them bring their defib into the park, get to the casualty, administer early shocks and the casualty might still stand a chance by the time the ambulance crew arrives.

The only barrier I can see to getting a system like that to work is trying to agree re-numeration for providing such a service, no doubt unions representing both services would be arguing over 'Croke Park' this and 'Bench mark' that that the service would probably be caught up in Red Tape for ages.

So in summary:Amalgamation, No. Better cross service cooperation, Yes.

crackcrack30

This would be a big nettle but

Firstly I am on no side in this debate, thats why i suggested both cons and pros, but having said that I would like to be a part of a modern, efficient patient oreintated service that would be mimiced or envied accross the world,
Am i going to do this for free or at a cost to my family/social life....certainly not but hand on heart, I think there are many shorfalls in the current set-up and rolling out repeditive/ rehearsed US sytyle fly on the fall docs is almost see- thru at this stage.....

Flasio I wouldn't be inclined to take person 'A ' who is great at one task and swaping him/her with person 'b' tommorow to do his task, thats counter productive an a simplafied view of the proposed task and would spiral this chat within a few posts.......but I think you are being a little elitest to suggest that most fire/emt level guys couldn't adequately carry out 50/60% of daily calls that you deal with every day with all the supports in place such as ALS and refersher training/ upskilling, accurate dispatching ect.

There would be probably more sucess with this in large towns and cities at first.....

This would free up and spacially allow a faster responce time regardless of area, and allow the advanced programme to grow nationwide....

With regard to renumeration I would think it would have to be a stand alone service without the constraints of politics with its own budget which is already allocated & (mis)spent by both the HSE & councils.....

Another Pro --Larger more focused & centralised training school.

Another Con -- A few accountants needed to budget and deal with gov/ VHI/Aviva ect. ( prob already there)

flazio

So what you're saying is, if a person isn't capable of mastering a paramedic course, which is a very intense course. Then perhaps there is no place for them in frontline rescue?

crackcrack30

Where did I say that?.....feel free to outline all the cons you can think up...

irishrgr

New Zealand has a National Fire service, one agency for the whole country. Given the relative small size of Iralnd, I think this would allow more economies of scale when purchasing equipment, consolidated maintenance, training, etc. NZ also has the retained fire services, they are part of the national service, but function as retained similar to what the retained services do in Ireland. They are retained members who work for the national service.

I think same could be offered for the EMS system, a national model for the reasons above.

This would also allow greater career mobility by members having the ability to promote nationally as opposed to within a single county. Granted, then there would be less need for senior officers and that generally causes problems.

Using the fire service as EMS first responders though is a no brainer. With dwindling fire calls (safer houses, fire alarms, sprinklers, etc) many fire services have embraced the first reponder role. Most jurisdictions have more fire stations than EMS ones, so it reduces response times and increases survivability. In the US, most FF's are also trained to EMT level as part of training and most appliances carry a AED & medical kit.

In watching the CPR video on the other thread, a noticable difference between the UK and US model was the UK crew had another ambulance back them up, whereas the US call was a fire/EMS response. I don't want to start a "we are better than them" debate....but the UK model puts two ambulances out of service. I have run many a call where I've transported my patient with two FF's performing CPR (or otehr care). Yes, an engine is out of service, but that has less service impact than taking another ambulance out of service.

Regards and Happy New Year,

flazio

Still doesn't answer the question about what to do with the person who excels at pre hospital patient care but isn't cut out to be a firefighter. You can't train anyone anything. Would there be scope to let people join the fire service on an ambulance only?

crackcrack30

Yeah, I suppose from a certain date any new entrants would be expected to reach a certain degree of skills or ability in both areas.
Then progress in what derection they are best suited to or what ever operational requirments desire without leaving behind either profession completly i.e minimum amount of hours required served in both inside a rolling 12-24 month period???

sjb25

irishrgr wrote: »

New Zealand has a National Fire service, one agency for the whole country. Given the relative small size of Iralnd, I think this would allow more economies of scale when purchasing equipment, consolidated maintenance, training, etc. NZ also has the retained fire services, they are part of the national service, but function as retained similar to what the retained services do in Ireland. They are retained members who work for the national service.

I think same could be offered for the EMS system, a national model for the reasons above.

This would also allow greater career mobility by members having the ability to promote nationally as opposed to within a single county. Granted, then there would be less need for senior officers and that generally causes problems.

Using the fire service as EMS first responders though is a no brainer. With dwindling fire calls (safer houses, fire alarms, sprinklers, etc) many fire services have embraced the first reponder role. Most jurisdictions have more fire stations than EMS ones, so it reduces response times and increases survivability. In the US, most FF's are also trained to EMT level as part of training and most appliances carry a AED & medical kit.

In watching the CPR video on the other thread, a noticable difference between the UK and US model was the UK crew had another ambulance back them up, whereas the US call was a fire/EMS response. I don't want to start a "we are better than them" debate....but the UK model puts two ambulances out of service. I have run many a call where I've transported my patient with two FF's performing CPR (or otehr care). Yes, an engine is out of service, but that has less service impact than taking another ambulance out of service.

Regards and Happy New Year,

Agree with all this amalgamation of all fire services to a national fire service cut back on all officers etc and a national ambulance service with fire service being used as first responders/back up when required by ambulance control

irishrgr

My opinion is that the fire and EMS professions are two connected but seperate career fields. I know there are many excellent professionals who can combine both careers, however I think the specilization gives you a better product as it were.

In the FF/Paramedic role, once he/she promotes from the fank of FF/Paramedic, then the medical skills begin to decline and effectively you have the medical portion of the career as an additional skill for the front line crews but begins to fade in as one moves up the career ladder (no pun intended).

FF/EMT is reasonable in the role of first responder, but the advanced skills it is a career in of itself. Different skill sets, different type of personality, different career desires.

However, I really am a firm beliver of using the fire service as first repsonders. Patient mortality decreases, an EMS crew has several more hands to assist with moving, lifting, extrication and so on. At the end of the day, the taxpayers get a better, more efficient service.

My thoughts anyhow....

resus

http://airrescue24.org.uk/

crackcrack30

irishrgr wrote: »

My opinion is that the fire and EMS professions are two connected but seperate career fields. I know there are many excellent professionals who can combine both careers, however I think the specilization gives you a better product as it were.

In the FF/Paramedic role, once he/she promotes from the fank of FF/Paramedic, then the medical skills begin to decline and effectively you have the medical portion of the career as an additional skill for the front line crews but begins to fade in as one moves up the career ladder (no pun intended).

FF/EMT is reasonable in the role of first responder, but the advanced skills it is a career in of itself. Different skill sets, different type of personality, different career desires.


However, I really am a firm beliver of using the fire service as first repsonders. Patient mortality decreases, an EMS crew has several more hands to assist with moving, lifting, extrication and so on. At the end of the day, the taxpayers get a better, more efficient service.

My thoughts anyhow....

Both organizations work hand in hand daily on several scenes accross the country,.... both professions rely on each other, and every member finds him/herself in positions where patients/members of the public require immediate & sometimes life saving treatment to bridge the gap between illness or trauma & difinitive care ........
How can two professions like that find themselves in the position (as it stands today) where ambulances are driving past modern empty firestations to medical emergencies in the middle of the night, while at the same time the very same stations are under threat of closure????