Health service role is to save lives, not money
Maintaining a balance between costs and efficiency is one of the primary challenges facing the NHS in these times of austerity and that is at the heart of the debate which should take place on proposed changes to the way the Northern Ireland Ambulance Service operates.
Under the restructuring, one of the paramedics in an emergency ambulance crew would be replaced by a lesser trained professional. The move could save the ambulance service £1.6m over 15 years at a time when it is under pressure to reduce costs. This is an issue which requires the most careful consideration. Emergency ambulances are often the first to arrive at the scene of an accident or where someone desperately needs assistance. There is a rule in medicine that the first hour is the most vital time in determining whether someone in crisis survives and that means getting the best possible medical treatment. Cutting the skill set of the crew puts additional pressure on the remaining paramedic. That is bad enough in dealing with one patient, but if there are a number of people requiring immediate high-level care, the unavoidable implication is that lives could be put at peril if this proposal becomes reality.
Northern Ireland is a largely rural community and often medical emergencies occur far from hospital or on poor roads.
In those instances the work of paramedics becomes increasingly vital in stabilising patients sufficiently to enable them to be removed to hospital. It is hard to disagree with those politicians who have branded the restructuring a gamble. That view is reinforced by experience in England where some trusts have described paramedic assistants as not fit for purpose and withdrawn them. Ambulance crews are often unsung heroes of the health service and in Northern Ireland have often been attacked while on duty.
But this attack on their role is even more treacherous and with potentially lethal consequences. It should be remembered that the role of the Health Service is to save lives, not save money, and this proposal should be shelved if it leads to any lessening of the level of assistance provided by ambulance crews.