Two paramedics have been suspended and four others issued with warnings after they expressed health and safety concerns about being asked to drive a young patient from Cork to Dublin towards the end of their third night-shift in a row.

Paramedics based at the Cork city ambulance base are now refusing to plug the gap caused by the suspension of the two-person crew, with ambulances and crews being drafted in from county areas to help provide cover in the city in recent days.

Paramedics have now written to National Ambulance Service (NAS) management calling for the immediate reinstatement of their suspended colleagues.

In a statement last night, the HSE said the NAS is “investigating an issue that occurred locally” and is not in a position to comment further. It added: “The HSE is satisfied that there has been no impact regarding continuity of service”.

The suspensions and warnings follow an incident in the early hours of last Monday as the three two-person ambulance crews providing overnight cover in Cork City were coming to the end of their third night-shift in a row — working 8pm to 8am on Friday, Saturday and Sunday.

They became aware around 11pm on Sunday that an intra-hospital transfer involving a stable paediatric patient from Cork to Dublin may be required. It is understood that a nurse, due on duty at CUH on Monday morning, was asked to report earlier than rostered, to accompany the patient on the transfer. The hospital requested the transfer, which prompted ambulance control in Dublin to contact the first paramedic crew in Cork City with a ‘Protocol 37’ or emergency transfer request around 5am.

The crew, which had dealt with eight calls that night and who were two hours from the end of their third 10-hour shift, expressed concerns about crew fatigue. In that context, they pointed out to dispatchers the health and safety risks.

Ambulance control passed the call to a second city crew, who were dealing with a patient in a hospital at the time. They expressed similar health and safety concerns. The call was then passed to a third crew who expressed similar concerns.

A source said despite the Protocol 37 request, the patient was stable, and at no stage did any of the crews refuse to take the transfer. The source also insisted that crews would have responded if it was an emergency case.

A crew from Macroom was subsequently tasked to transfer the young patient, leaving CUH for Crumlin just after 6.30am on Monday and arriving back at their base at 3pm, a 20-hour shift.

The source pointed out that the hospital protected its staff by calling a day-shift nurse in early but that the NAS has no system in place for its staff in such scenarios: “If a surgeon had come into an operating room 10 hours into the last night of a three-night shift and expressed concerns about fatigue, would you let the surgeon operate? You’d wait for a fresh surgeon.

“This is a long-standing issue that has come to a head. It’s not the hospital’s fault, because they looked after their staff by not sending a night nurse. It’s a failure of the ambulance service to not have a system in place for such calls.”