Just one in four ambulances reach a life threatening emergency within the target time of 19 minutes in rural parts of the west of Ireland – by far the worst performing service in the country.
The first major review into the National Ambulance service (NAS) has found that it is not possible to achieve the current 80% response time target of eight minutes set by the Health Information and Quality Authority (HIQA) even with substantial investment due to the rural spread of the population.
Just under a quarter of ambulances meet patients within 19 minutes in rural west of Ireland and 5% are within eight-minute target for life-threatening and potentially life threatening cases. This is far behind the second worst service in the country – in the south west nearly 40% meet the 19-minute target – and the best performing services – the north east and the mid west had half of their vehicles reaching the standard.
However, with a significant increase in staffing levels and vehicles, as well as an upgrade in technology, that number of ambulances meeting the target in the west could jump to nearly one in two – or 47.3%.
Newly appointed Minister for Communications and Climate Change Denis Naughten said the report commissioned by the Health Service Executive (HSE) clearly acknowledged the scale of the problem across Galway, Mayo and Roscommon.
“These response times are by far the worst in the country and clearly show that urgent investment is now needed in both ambulances and staff in the West of Ireland,” he told the Connacht Tribune.
“While the response time figures prove what I have been pointing out for some years, the positive aspect of the report is that with investment we can see response times improve by 100%”
“I see this is a stepping stone – it’s not the full solution. It’s important we improve the service – even if we continue to lag behind the rest of the country.”
He would be working with the new Health Minister Simon Harris to implement the long list of recommendations in the report.
“I understand an additional 461 staff would be required to improve the service over and above the 148 staff positions which have been funded and trained – that’s in EMTs [emergency medical technicians], paramedics and advanced paramedics.
“The Department estimates that’s going to cost €25m which will take time as staff get trained up. Also required will be 71 additional vehicles at a cost of €10m. There will be additional resources provided in the forthcoming budget and HSE service plan. How many of those will come west I don’t know at the moment.”
The consultants found that the Irish ambulance services serve a much greater rural population than their counterparts in England and Scotland. Some 40% of incidents are in a rural location compared to 12% in a typical UK service.
However, there are 40% less calls per head of population within Ireland compared with the UK.
Martin Dunne, director of the HSE National Ambulance Service said the recommendations, once implemented, will improve pre-hospital emergency care services for patients which will in turn have a positive impact on the wider health services.
The report recommends setting up a clinical support desk to offer improved medical advice and services to patients.
Ambulances in the UK are now responding to about 7% of calls with telephone advice on self-care or guidance on alternative care pathways.
It also recommends an improved model for rural and remote locations with an extensive rollout of community first responder schemes, co-locations of paramedics with primary care professionals and continued use of the aeromedical services.
The consultants believe some ambulances should not to be maintained at specified static bases but “used in a more flexible manner that reflects the population needs”.
“Even on the assumption that the NAS is fully resourced and operating to international good practice standards in all of its operational processes, the theoretical best achievable performance would be 64% [meeting the eight-minute performance target],” the report states.
“Our analysis indicates that it could only achieve an 8-minute performance of 60.6% across Ireland – compared to around 79% for a typical English service – because of the immense difficulties with rurality in Ireland. This means that NAS cannot possibly achieve the HIQA prescribed target of 80% in 8 minutes.”
Nationally 26% of ambulances are responding within eight minutes, while 67% are within 19 minutes – instead of 95% set by HIQA.
Over 1,500 additional hours are required to improve the response times for Echo [life-threatening] and Delta [potentially life-threatening] calls to improve performance from 35.7% to 51.2% in eight minutes and from 70.9% to 81.5% in 19 minutes.
The report found that the 18 ambulances in the west – with three more due to be commissioned – were responding to an average of 68 incidents per day – with four more regions of the country dealing with a greater number of medical emergencies.
Galway City Council turns down Mad Yolk Farm site
An application to retain farming-related development on a site in Roscam has been turned down by Galway City Council.
The local authority has refused to grant retention permission to applicant Brian Dilleen for subsurface piping to be used for agricultural irrigation at ‘Mad Yolk Farm’ on Rosshill Road.
It also refused permission for the retention of a bore-hole well, water pump and concrete plinth; and two water holding tanks for 6,500 litres; and other associated site works.
In its written decision, the Planning Department at City Hall said: “The proposed development, would if permitted, facilitate the use of the site for the provision of sixty 15.5m high seed beds, which have been deemed by the planning authority not to be exempted development.
“Therefore a grant of permission for the proposed development would facilitate the unauthorised development and usage on the site, contrary to the proper planning and sustainable development of the area.”
The site has been the subject of enforcement action by the local authority.
A lengthy Appropriate Assessment Screening report, submitted with the planning application, concluded “beyond reasonable scientific doubt, in view of the best scientific knowledge, on the basis of objective information and in light of the conservation objectives of the relevant European sites, that the proposed retention and development, individually or in combination with other plans and projects, has not and will not have a significant effect on any European site”.
A borehole Impact Assessment Report concluded that the proposed retention development “on the hydraulic properties of the aquifer is considered negligible”.
It said that there was “no potential for significant effects on water quality, groundwater dependent habitats or species associated with any European site”.
Six objections were lodged by neighbours, including one from the Roshill/Roscam Residents Association, which argued the Further Information submitted by the applicant did “little to allay our concerns” about the impact of the development on an “extremely sensitive site”.
The applicant has until June 29 to appeal the decision to An Bórd Pleanála.
NUIG student accommodation firm records loss
The property company which operates student accommodation on behalf of NUI Galway recorded a €3.4 million increase in turnover in 2019.
However, Atalia Student Residences DAC (Designated Activity Company), which is owned by the university, recorded a loss for the year of €6,300.
Accounts for the company for the year ended August 31, 2019, show that while there was a loss, retained profits are at more than €1.6 million. The accounts are the most up to date available from the Companies Registration Office.
The previous year, the company made a profit of more than €460,000.
Atalia Student Residences operates the 764-bed Corrib Village apartment complex and the 429-bed Goldcrest Village.
The figures show that the company’s overall turnover jumped by 52% – from €6.4m to €9.8m.
Turnover for accommodation services was up from €5.2m to €8.4m; and from conferences and events was up from €850,000 to €1.1m. Turnover from shops was down from almost €328,000 to €290,000.
Outside of the academic year, both complexes are used as accommodation for conference delegates, while Corrib Village is also used for short-term holiday lets.
The accounts show fixed assets – including fixtures and fittings, plant and machinery and office equipment – valued at €1.5m. Its current assets were valued at more than €7m, including ‘cash at bank and in hand’ of almost €6.9m (up from €5.6m last year).
The company owed creditors €6.9m, including €5.2m in deferred income.
It employed 38 people (which includes its five directors) last year, up from 31 the previous year.
As well as operating the student accommodation complexes, the company also markets conference facilities and services on behalf of the university.
It pays rent to NUIG but the figure is not included in the company accounts. In 2018, the rent figure was just over €2.25m.
In Corrib Village, a single bedroom with a private en suite for the academic year costs €5,950. For Goldcrest Village, the figure is €6,760.
Call for two-way cycling under Galway City outdoor dining plan
Bike users want the local authority to examine the introduction of two-way cycling on one-way city centre streets.
Galway Cycling Campaign has again called for cycling to be allowed both ways. It comes as Galway City Council prepares to cordon-off parts of city centre streets to traffic, and make Dominick Street Lower one-way, to facilitate outdoor dining.
The cycling organisation said that the proposed pedestrianisation plan at the Small Crane, and the one-way system on Dominick Street, will result in lengthy diversions for people on bikes.
It has pointed out that school children and their guardians who cycle along Raleigh Row, and turn right towards Sea Road, will probably continue to do so even when the Small Crane is cordoned off to traffic, because the alternative route – via Henry Street – is too long a detour.
Similarly, it has been suggested that food-delivery services on bikes are unlikely to go the ‘long way round’ via Mill Street and New Road to get from Bridge Mills to restaurants on Dominick Street and would be tempted to cycle the ‘wrong way’ down the proposed one-way street or on the footpath.
Shane Foran, committee member of Galway Cycling Campaign, said now would be an ideal time to introduce two-way cycling on some one-way streets.
“It’s not controversial,” insisted Mr Foran. “It’s a general principle in other countries, if you are putting in new traffic arrangements, you would try and keep access for people on bikes.”
The regulation is contained in the National Cycle Policy Framework 2009; and a specific objective was contained in two of the most recent previous City Development Plans.
He said a former minister and Galway West TD, the late Bobby Molloy, had the vision to change the legislation in the late 1990s – but it hasn’t yet been embraced here.
“Bobby Molloy, who couldn’t be classed as an eco warrior, changed the law in 1998, so that it is available to local authorities to put up a sign granting an exemption from restrictions for people cycling on one-way streets.
“The road stays one-way for cars, and two ways for bicycles. Clearly that’s not going to be a sensible to do everywhere, like Merchants’ Road. In those situations, you might need a cycle track or lane to segregate people from traffic.
“But if it’s a low traffic street, with low speeds or relatively lower volumes of cars, then it should be possible for people on bicycles to cycle in both directions and still have it one-way for cars, without it being a major safety issue. It works in other countries,” said Mr Foran.