Thin end of the privatisation wedge

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Worrying news has broken that a private ambulance company has won a contract for a "medical taxi service" in the Greater Dublin Area. The service, described as Non-Emergency Transport for Service Users in the Greater Dublin Area, is intended to transport very low acuity patients to hospital. The service is expected to be staffed by one emergency medical technician and one driver. The ISP committee is deeply concerned about this initiative. We feel that it is the thin end of a wedge, opening the door to privatisation of an emergency service that exists for the public good. There follows an open letter to the government outlining our concerns.

Dear Ministers,

We, the Irish Society of Paramedicine (ISP), write to you on behalf of our members to express our deep concern at the recent decision to award a contract for non-emergency patient transport in the Greater Dublin Area to a private ambulance provider.

The National Ambulance Service (NAS) already operates a well-established and fully staffed Intermediate Care Vehicle (ICV) service. This service is more than capable of carrying out the functions now being outsourced. The decision to divert this work away from NAS staff raises fundamental questions about the direction of pre-hospital care in Ireland and represents a significant step towards the privatisation of core public health services.

This move has far-reaching consequences:

• Erosion of Profession: Outsourcing undermines the role of paramedics and EMTs within NAS, stripping away responsibilities that form an essential part of our scope of practice.

• Undermining Public Services: Publicly funded and resourced services are being side-lined in favour of private operators, despite existing public capacity.

• Lack of Transparency: This decision appears to have been taken without meaningful consultation with staff or their representatives, leaving frontline professionals blindsided and disillusioned.

• Public Accountability: Patient transport is a matter of public health and safety. Delegating this responsibility to private entities risks creating a fragmented system where profit, not patients, drives decisions.

We must ask directly:

• Why was a private operator chosen when NAS ICV resources are already available?

• What safeguards are in place to ensure this is not the beginning of a wider privatisation agenda within pre-hospital emergency care?

• How will government protect the future of the ICV service and ensure the professional integrity of paramedics, EMTs, and advanced practitioners within NAS?

Our members feel strongly that this decision erodes the profession they have worked tirelessly to build, while simultaneously weakening the foundations of a publicly accountable ambulance service.

We call on you, as Ministers, to:

1. Immediately review the decision to outsource this contract.

2. Commit to strengthening and investing in NAS resources rather than diverting public funds into private services.

3. Engage in meaningful consultation with staff representatives to safeguard the future of our profession and protect the public interest.

Ireland deserves a fully funded, fully public, and professionally respected ambulance service. Anything less undermines both patient care and the profession of paramedicine itself.

We urge you to act decisively in the interest of patients, staff, and the future of pre-hospital care in this country.

In solidarity,

James Mullen - Chair
Jim Kelly - Vice chair
The Irish Society of Paramedicine