We're being ignored

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Frontline staff across the National Ambulance Service (NAS) say they are once again being sidelined and misrepresented—this time in the lead-up to a critical ballot on sweeping changes to pay, allowances, and working conditions.

From Emergency Medical Technicians (EMTs) to Paramedics, Advanced Paramedics, and Supervisors, staff are expressing frustration at the lack of consultation and transparency surrounding the latest Workplace Relations Commission (WRC) proposal, now being put to a ballot by trade unions SIPTU and UNITE.

Adding fuel to the fire is the exclusion of clinically active supervisors from the vote, despite their vital role in keeping the ambulance service running day and night. Many of these supervisors maintain PHECC registration, respond to emergency calls, and handle essential tasks like medication bag management and fleet readiness.

From Rejection in 2023 to Exclusion in 2025

This is not the first time ambulance staff have rejected a modernisation proposal. In 2023, a similar package was voted down by staff due to vague commitments and fears of deteriorating work-life balance.

Now, in 2025, the process feels disturbingly familiar. The current proposal, endorsed by both SIPTU and the Irish Ambulance Representative Council (IARC), is being rushed to ballot without what staff say is any meaningful consultation with frontline workers.

“There’s a recurring pattern here,” said one Advanced Paramedic from the Midlands. “The unions present something, the frontline push back, and we're told we just don't understand the bigger picture. But we do—we’re living it.”

No Vote for Supervisors, No Representation for Many

Among the most contentious issues is the exclusion of Paramedic and Advanced Paramedic Supervisors from the ballot. These staff are clinically active, integral to operations, and yet have been denied a voice in a vote that may redefine their conditions of employment.

“It’s an insult,” said one supervisor. “We’re expected to support the system from the inside, keep the vehicles moving, respond to emergencies, and hold clinical responsibility—yet we’re not given a vote. How is that fair?”

Survey Results Highlight Deep Union Discontent

A recent Union Satisfaction Survey, conducted by the Irish Society of Paramedicine (ISP) between July 1st and 17th, gathered responses from 550 staff members, including 511 union members. The results reveal a widespread lack of confidence in current union representation, particularly in SIPTU.

Key findings included:

• Low satisfaction in advocacy and negotiation

• Poor responsiveness to member concerns

• Minimal confidence that member interests are being prioritised

These results have underscored what many already felt: that the voice of frontline ambulance professionals is being diluted, overlooked, or ignored at the highest levels of union and political decision-making.

No Confidence – And No Response

Earlier this year, in a landmark move, the Irish Society of Paramedicine conducted a vote of no confidence in the Director of the National Ambulance Service. The motion was supported by a significant majority of participants from all clinical grades.

The Society subsequently submitted a formal letter to the Minister for Health and all 173 sitting TDs, outlining the concerns raised by frontline staff. Yet no response has been received from the Minister, and no acknowledgement from the majority government.

Staff are now asking a fundamental question: “Is our voice only valid when it’s filtered through a union? If we speak through a professional representative body, are we just ignored?”

One Advanced Paramedic summed up the feeling: “We’ve served through pandemics, staff shortages, and system failures. We’ve held this service together. And now we’re being told we don’t count—not by patients, but by the people who are supposed to represent and lead us.”

A Call for Representation, Not Rhetoric

Ambulance service staff are not opposed to reform. They want progress—but not at the cost of fairness, consultation, and dignity. “This is about more than a pay scale,” said a Paramedic from the West. “It’s about being seen, heard, and respected. That starts by giving every clinical grade, including supervisors, a voice. And listening when we use it.”