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The HSE has drawn up a comprehensive plan to take control of Dublin's ambulance service away from Dublin Fire Brigade (DFB), which has provided the services since 1898.
The plan, seen by The Irish Times , was drawn up ahead of last month's announcement of a HSE/city council review of Dublin's ambulance services.
The confidential internal HSE plan says that, in the absence of a formal service-level agreement between the HSE and the council for the capital’s ambulances, the HSE “is constrained in its plans to develop an integrated National Ambulance Service” and has “inadequate control” over both the €10 million transferred to DFB/city council towards the ambulance service annually and the quality of services.
“Given the above deficits [Dublin’s ambulances]... should now be provided directly by the HSE,” it says.
"The revised arrangements would be phased in with a target of being fully operational by the end of 2015," says the document, signed by HSE national director Laverne McGuinness and the then director of the National Ambulance Service, Robert Morton.
Incremental withdrawal
The document says the HSE should "incrementally withdraw funding" from DFB and "this approach is best placed to reduce public and political anxiety" about the change.
The revelations will heighten concerns the HSE/city council review of Dublin ambulance services is a precursor to the removal of the service from the fire brigade. It is due to be finished by May.
Dublin’s emergency ambulances are provided mainly by DFB while outside the capital ambulances are provided by the HSE which contributes €9.4 million a year towards the estimated €11 million cost of Dublin’s ambulances, from a national ambulance budget of €134 million. DFB responds to 28 per cent of emergency ambulance calls nationally.*
Documents released by the council to The Irish Times indicate the plans were taking shape at implementation level.
In a letter to the then assistant city manager, Séamus Lyons, in 2012, Mr Morton said “the HSE is now actively considering the funding provision to DCC...”
* This article was edited on March 19th.