Industrial action, engagement, and the reality on the ground

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The Irish Society of Paramedicine (ISP) has been engaging closely with members across the National Ambulance Service (NAS) in recent weeks. A consistent and concerning theme has emerged: a growing belief among frontline staff that the current approach to industrial relations has effectively created a situation where meaningful negotiation is increasingly difficult to achieve.

While formal processes remain in place, there is a perception that these mechanisms are being managed rather than utilised to deliver outcomes. Issues are frequently acknowledged but not resolved, discussions are deferred, and disputes move through various forums without clear or timely conclusions. For many staff, this creates a sense that engagement exists in form, but not in substance.

This has led to what many describe as a “checkmate” position — where options appear limited, outcomes uncertain, and progress difficult to secure.

A System Under Sustained Pressure

At the same time, the broader context cannot be ignored. The non-scheduled and acute care elements of the HSE are under continuous and escalating strain. Emergency departments are experiencing persistent overcrowding, patient flow remains challenged, and demand for urgent care continues to rise. Within this environment, the ambulance service plays a critical and often under-recognised role.

Frontline ambulance staff are routinely:

• Managing critically unwell patients in unpredictable settings

• Delivering advanced care in the community

• Absorbing system pressures through extended on-scene care and delayed hospital handovers

• Operating within tight resource constraints while maintaining high clinical standards 

There is a strong and widely held view among staff that the system is operating at its limits, and that it continues to function largely due to the skill, resilience, and professionalism of frontline ambulance personnel.

A Fragile Balance

While this level of commitment is a source of pride within the profession, it is not a sustainable foundation for long-term service delivery.

A system that relies heavily on goodwill and adaptability, without consistent structural support, becomes inherently fragile. Staff are increasingly aware that the margin for error is narrowing, and that ongoing uncertainty around contracts, conditions, and engagement only adds to that strain.

The concern is not solely about industrial action or specific disputes. It is about the cumulative impact of unresolved issues, and what that means for the future of both the workforce and the service.

Industrial Action – A Critical Moment

The ISP is not a trade union and does not organise or direct industrial action. We respect the role of unions and the rights of members to engage through their chosen representation.

However, we do represent a broad and engaged membership across the profession, and there is a clear expectation that any action taken must be:

• Credible and effective

• Grounded in operational reality

• Capable of delivering tangible outcomes 

There is concern among staff that, without a strategic and targeted approach, industrial action risks becoming part of a recurring cycle — one that raises expectations but ultimately fails to deliver meaningful change.

The Need for Genuine Engagement

The current moment presents an opportunity to deliver the clarity, fairness, and stability that frontline staff are seeking. Above all, staff need genuine engagement that leads to real outcomes. The ISP believes that a shift is required away from prolonged processes and towards decisive, transparent, and accountable decision-making.

Looking Forward

The ambulance service remains a cornerstone of Ireland’s emergency care system. Its effectiveness depends not only on resources and planning, but on the people who deliver care every day in challenging and unpredictable environments.Protecting that workforce – through fair treatment, meaningful engagement, and sustainable planning – is essential. Without that, there is a real risk that the system will continue to operate in a state of managed pressure, rather than moving towards a stable and resilient future.

Irish Society of Paramedicine

Advocating for staff. Supporting patient care. Strengthening the profession.