Privatisation of Ambulance Services and the Erosion of NAS Roles

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The Irish Society of Paramedicine wishes to express its serious concern regarding the increasing reliance on private ambulance providers to fill operational gaps within the National Ambulance Service (NAS).

While we acknowledge the challenges posed by NASCAP levels, high demand, and resource pressures, we believe that the solution lies not in outsourcing, but in investing in and supporting the public workforce—our own highly skilled NAS staff across all clinical grades.

The practice of drafting in private providers to cover essential emergency and inter-facility transport risks setting a dangerous precedent that undermines:

• The integrity and sustainability of publicly delivered pre-hospital care

• The terms, conditions, and job security of frontline NAS personnel

• The public’s trust in a nationally accountable, consistent, and regulated ambulance service

Paramedics, Advanced Paramedics, EMTs, and Supervisors within NAS have continued to deliver high-quality care under increasingly difficult conditions—often facing unsustainable rosters, limited downtime, and reduced work-life balance. Instead of supporting these staff with better resourcing, recruitment, and retention initiatives, we are now witnessing the slow outsourcing of a national public health service.

This approach risks creating a two-tier system, erodes morale, and weakens the long-term viability of a national emergency care infrastructure that should remain publicly funded, publicly accountable, and publicly delivered.

The Irish Society of Paramedicine is calling on:

• NAS and HSE management to recommit to permanent recruitment and proper workforce planning

• Government departments to reject creeping privatisation in favour of sustainable, long-term staffing solutions

• All trade unions and representative bodies to stand together in opposing the erosion of public service roles

We strongly believe that privatisation is not a solution—it is a symptom of mismanagement and under-investment. Our communities, and the patients we serve, deserve better.

Having studied the current proposal the committee feel that there are a number of clauses in the proposal that would dilute the NAS workforce and open the service to privatisation.

While the proposal appeals and benefits a small number of NAS staff, the long term outcome would result in many of the current staff working on rest day for flat rate pay with the privates.

This is the current model of service delivery in the UK, EMT with Paramedic with shortfalls provided by private contractors.