Replacing ambulance crew members with less qualified staff is a gamble, warn politicians
Major fears have been raised that plans to restructure emergency ambulance crews in Northern Ireland could put lives at risk.
Proposals by the Northern Ireland Ambulance Service – branded a "gamble" by politicians – would result in a trained medical technician being replaced by a lesser-qualified member of staff.
If the plans go ahead, paramedics will no longer be accompanied by emergency medical technicians on 999 calls. Instead, they would be replaced by trained paramedic assistants or an emergency care attendant (ECA).
The concern is that ECAs have fewer skills and are unable to treat or assess patients on their own.
The move, if adopted, is expected to save £1.6m over 15 years and the NIAS – which is under pressure to make savings – has defended the proposals.
The service said it has assessed the risks and believes it will "further enhance the front line model of a paramedic-led service".
But the role of paramedic assistants has been withdrawn by some English trusts having been described as "not fit for purpose".
At a briefing to the Stormont health committee in June, Unison – which represents around 700 ambulance staff – warned the step will endanger lives.
The union's Alistair Long described the role as "inherently flawed" and "entirely unsuitable for the rural geography of Northern Ireland".
Alliance MLA and health committee member Kieran McCarthy praised the NIAS for its work throughout the Troubles but said he had "major concerns".
He added: "The concern is if a paramedic attends an accident scene accompanied by a paramedic assistant. If there are multiple people injured, surely there will be delays in treatment.
"It is a gamble. We must protect and do what we can to support the service. But I have serious concerns about taking a higher trained person off the crew and sending somebody, with fewer skills, to a multiple accident.
"The instant service that is required could save a life."
The NIAS said paramedic assistants will be trained and equipped to support the paramedic to provide "safe, high-quality, effective patient care".
But Richard Dundas, a member of Unison and an emergency medical technician, told the committee: "He (the paramedic assistant) will literally be standing beside the paramedic asking, 'what can I get you? What do you need?' That is the big difference. This is life and death stuff, folks."
Ann Speed, the union's head of bargaining, said: "The NIAS does a fantastic job under great financial pressure. But we believe a joint risk assessment is needed and we do not want these new roles created."
Brian McNeill, director of operations with the Northern Ireland Ambulance Service, defended the new model to the committee.
He said: "We have assessed the risks of introducing the paramedic assistant.
"We believe that the model, the training programme and the competencies that we require of them will mean the provision of a safe service."
The service last night confirmed it is currently exploring options for public consultation as to how to continue to support paramedics, potentially, through the creation of the new assistant role.
Mr McNeill said the NIAS had to operate within budgets, which were reducing annually.
He added: "However, within these constraints, our primary focus remains the provision of high-quality clinical care to our patients.
"Any developments introduced in the delivery of our service will be monitored and reviewed to ensure that our vision is realised and our standards maintained and, where possible, raised."
Health Minister Edwin Poots said: "In considering the potential for any change to impact on the provision of emergency ambulance services I would expect NIAS to reflect on best practice in relation to the workforce and the required skills and scope of practice to ensure safe and effective patient care."