The National Ambulance Service needs 750 extra staff to enable it to meet official emergency response times.
A report by the HSE claims an additional 250 ambulances are also needed.
But it says the Irish system is "too rural" to be compared to performance in countries like England.
David Hall, the CEO of Lifeline Ambulance says the report shows that lives are being put at risk due to the inadequacies of the system
Donegal Councillor Martin Mc Dermott has suggested the Fire Service could, in certain instances, become first responders.
That was also advocated at a conference in Dublin last week.
Cllr mc Dermott says the most important thing now is that the various agencies talk to each other.......