Ambulance service 'failing to improve'

Ambulance emergency services have failed to deliver significant improvement over the past nine years, a new high-level report has found.

The Comptroller and Auditor General (C&AG) found a range of public services have improved - mainly due to new computerised systems - but that the " timeliness of service delivery and the continuation of backlogs have been persistent issues" for the ambulance service.

The C&AG, John Purcell, revisited public sector areas he had examined between 1997 and 2000 to assess the response to adverse comments in the original reports.

"Emergency ambulance services need to improve the level of management information gathered, particularly information on the operational performance of the services," the report found.

The report noted that a series of administrative and technological developments were at varying degrees of implementation. Many of these aimed to improve performance monitoring the setting of response prioritisation.

It also called for consideration of using more less expensive vehicles for non-emergency trips. It noted that motorbikes and rapid response vehicles were being used successfully in some regions.

In a another area of the health service, Mr Purcell found strong efficiency gains where investment was made in new technologies for GP prescribing.

"But there was a need for proper project management and the setting of targets to be incorporated into investment proposals," the report said.

On driver testing, the report said that while there had been investment in information systems, " the development of non-financial performance indicators has lagged behind ".

It also expressed concern that differing standards may be in operation at different test centres.

"There were either a difference in the standard of driving between the regions or there was a difference in the standard of driving test applied," the report said.

It also noted that in 1998, a target of testing 95 per cent of applicants within 15 weeks was set.

By 2002, waiting lists had been reduced to 10 weeks but a number of factors led to increased demand, had led waiting times to rocket to 43.3 weeks by the end of 2003.

It fell gradually and by February of this year was at 27 weeks.

The report said: "The absence of a system to analyse and forecast the demand for driving tests hampered the Department [of Transport's] ability to plan the resources required to administer tests."

Mr Purcell was generally satisfied with Revenue Commissioners' efforts to improve the efficiency and efficacy of Vat collection.

However, he said: "Detection of unregistered liable traders was hindered by a lack of knowledge of the extent of this area within the black economy.

"Several methods for estimating the population of these unregistered traders had been proposed but no reliable approach had emerged and Revenue had not attempted such an exercise."

The report found a €35 million computerised system for processing a range of social welfare payments had improved matters for both recipients and administrators.

But it expressed concern about the amount of money spent on consultants to develop the Integrated Short-Term Schemes (ISTS) system.

However it noted the Department of Social and Family Affairs had "built up considerable expertise over the years in the technologies on which ISTS was developed. As a result of this, the expenditure required on consultancy in maintaining and enhancing the ISTS system since its initial deployment has been minimal."

The C&AG reviewed several other public service areas where concerns had been expressed the last time they were reported on. He graded their response in table below under the headings of "excellent", "reasonable" and "limited".