Editor's Viewpoint: Ambulance crisis is a life and death matter
Once again the Northern Ireland Ambulance Service is making the headlines, and over the past 48 hours we have been given a grim insight into the current worrying situation.
Last night was expected to witness the third successive night of staff shortages, with some 20% of the crews unavailable, and emergency measures in place to mitigate the challenges.
Over the weekend in general these measures included two ambulance crews from the Republic offering assistance, and demonstrating cross-border co-operation at its best. There was also support from private and voluntary ambulances.
The ambulance staff have responded to this latest emergency with typical professionalism, with many delivering the best possible care in extremely difficult, gruelling circumstances.
Some responded to appeals to turn up for work at the weekend due to the difficulties of filling staff rotas. They are to be commended for their sense of duty and dedication to their jobs.
Nevertheless, many members of the public will rightly ask how on Earth has it come to this? When people dial 999 for emergency help they have a justified expectation that the health service they have paid for will actually be there for them.
In a life-threatening emergency every minute counts, and the very idea that the service is under such pressure will not allay the fears of people who are already apprehensive about having to call an ambulance in the first place.
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The paramedics face intense pressure at the best of times. As a first responder to a crisis call, the paramedic is often hurrying to a situation most of us would do our best to avoid.
They are so often in the front line of trauma, and they experience all the emotions that go with it. Sadly, they are also vulnerable to physical assault, even from those they are trying to help.
No doubt a complex myriad of issues have contributed to the present crisis in the service. These include staff holiday leave, illness or not enough staff available to begin with.
It is clear from the comments of Dr Nigel Ruddell, the Ambulance Service medical director, that for far too long its staff have been expected routinely to go the extra mile, and often working shifts of up to 15 hours.
The good news is that more staff are being recruited and trained, and it is hoped that these measures will help to offset the worst of the current intolerable pressures.
As for the bigger picture of the many other pressure points in Northern Ireland, including education, it would be helpful if these were tackled by an Executive and ministers at Stormont. Sadly, however, there is little prospect of that poorly patient's health picking up any time soon.