Ambulance service in bad state since provincial takeover
While seriously ill and injured patients are forced to wait over an hour for an ambulance to arrive, the City of Ekurhuleni’s fleet of ambulances are standing idle at fire stations
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To improve emergency medical services (EMS), Gauteng’s ambulance services were recently provincialised and are now run by the Gauteng Provincial Health Department.
However, if the scores of complaints about long waits in Ekurhuleni are anything to go by, it seems the demand in the City far outstrips supply, with hundreds of provincial ambulances that out of action due to accidents and repairs.
Residents of Ekurhuleni have been complaining about patients waiting hours for an ambulance to arrive, with others waiting up to five hours. Some complained they called an ambulance but it never arrived, and their seriously ill relatives later died while waiting.
An ambulance was recently called after a diabetic woman collapsed in Witfield. The callers were told the ambulance was on its way, but they waited for about an hour at the side of the road with no sign of an ambulance.
After the long wait and many follow-up calls, the family eventually used a private car to rush the patient to Tambo Hospital where she was immediately certified dead.
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An Ekurhuleni emergency services officials who spoke under anonymity, attested to the residents’ plight – saying since the acquisition of the City’s EMS in June last year, they are also experiencing delayed ambulance response at scenes.
The City’s norms and standards in responding to medical emergencies was 15 minutes’ maximum for Priority One 1 (Critical) patients and 18 minutes for other priorities.
350 Gauteng ambulances out of action due to accidents and repairs
Jack Bloom MPL – DA Gauteng Shadow MEC for Health, said Gauteng residents often complain about poor ambulance response times, but 350 out of 1 244 public ambulances are out of action because of maintenance and repairs.
Bloom said this was revealed by Gauteng Health MEC Nomathemba Mokgethi in a written reply to his questions in the Gauteng Legislature.
“According to Mokgethi, the non-operational ambulances are due to scheduled services, accident repairs and unplanned maintenance due to breakdowns.
Delays occur in repairing ambulances because of quotations from multiple service providers, inspecting the damage and getting authorisations for repairs, and merchant outsourcing of parts,” said Bloom in a statement issued this week.
It was also revealed that last year there were 167 reported accidents of emergency ambulances, compared to 79 cases the year before, with 68 disciplinary cases for misconduct and final warning. And it cost about R5.5-million to repair the accident damage in the past two years.
“I’m concerned by the high number of accidents and the long delays in servicing and repairing ambulances when they are needed to provide an emergency service for the province.“
According to national norms and standards, Gauteng should have 1 600 ambulances to serve its population, but only has 894 available ambulances because nearly 30 per cent of ambulances are stuck in the repair shop.
“The Gauteng Health Department needs to curb the reckless driving of ambulances and streamline repairs and maintenance so that as many ambulances as possible are on the road to serve the public,” said Bloom.
GDoH states the opposite of what has been reported.
This department assures the community of Ekurhuleni that the Gauteng Emergency Medical Services can meet the demand in the area.
“All calls that come through to the Emergency Communication Centre (ECC) are serviced,” said the department’s head of communication, Motalatale Modiba.
Modiba added that in the ECC calls are prioritised in this manner: life-threatening is Priority One, serious but not life-threatening is Priority Two and minor conditions/illness is Priority Three.
According to Modiba, on average 10 -15 per cent of vehicles go into workshops for planned and unplanned maintenance.
“The average time for minor repairs should be +/- three working days and major repairs not more than three working days as per service level agreement annotated on the RT46 contract. Currently, there are 112 in with major and minor repairs.”
Centralised
The Gauteng Department of Health had over the years subcontracted municipalities, including Ekurhuleni, as agents to render emergency medical services.
But the ambulance services in the province are now run entirely by the provincial Department of Health. The City of Ekurhuleni was the last municipality to be provincialised.
For emergency medical services, dial 112 from a cellphone and 10177 from a landline.
What happened to the metro’s CMS resources?
According to metro spokesperson, Zweli Dlamini, currently, the City’s fleet of ambulances and response vehicles are parked at different fire stations, since the City of Ekurhuleni has no authority or licence to render any ambulance services.
The former advanced life support officers have been placed in different positions in fire-fighting services, as most of them were performing dual functions (fire, rescue and medical services). All emergency services personnel within the City were recruited to specialize in both fire and rescue services and medical services domains and to perform dual functions within the department.
“It should be noted that all these resources were procured whilst the ambulance service was rendered by the City before the provincialisation of this service in July 2020. “These ambulances were procured during the period between 2016/17 and 2017/18 financial years. The ambulances were purely procured to assist the high demand from different communities within the City as saving of lives in the objective of the service.”
Dlamini pointed out the resources are still the properties of the city and available to operate as and when required. Only 55 ambulances were operational before the provincialisation of these services.
“It should also be noted that the rendering of ambulance services is the constitutional responsibility of the provincial government,” said Dlamini. “Municipalities were operating ambulance services on behalf of the province prior to July last year. Hence, currently, there are no pre-hospital medical services rendered from local municipalities.”
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When asked whether the metro personnel (paramedics and ambulances) are allowed to assist seriously ill patients waiting in pain while the provincial unit is grappling to keep up with demand, Dlamini reiterated the license to render emergency medical services has been withdrawn from the municipalities and therefore rendering of emergency medical services without the license as required will be considered as a transgression against the law.
“This might lead to unnecessary litigation against the municipality as the employees are still contracted and employed by the municipality. It is however important to note that individuals in their capacity and not acting on behalf of the municipality can assist the patient. “Every individual is trained and registered with the professional council,” explained Dlamini.
The metro added that the metro is not planning to render ambulance services as no municipality can afford to render such a service without the ambulance subsidy from the provincial government.
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