Ambulances left to gather dust

The DA in the City of Ekurhuleni (CoE) has learnt that R47m worth of ambulances are gathering dust while residents suffer because of extended response times and healthcare failures.

The party alluded that these life-saving assets have been standing idle for over three years at the city’s fire stations, adding that 36 of these ambulances are brand new.

Amid that, it said the CoE continues to have the lowest ambulance response time in the province.

“The ambulances in question were supposed to be transferred to the Gauteng provincial government following the provincialisation of the service by the ANC-led government in 2020. Although the ambulance function was transferred in paper, that is where it stayed,” stated DA spokesperson for health and social development in Ekurhuleni, Stefanie Ueckermann.

She said millions of rands of equipment meant to be transferred with the provincial takeover have been left to rot for over three years in Ekurhuleni fire stations.

Ueckermann said these ambulances are in the Brakpan, Benoni, Leon Ferreira, Rynfield, Edenvale, and Wadeville fire stations.

“More worryingly, a report by the DA Gauteng Shadow MEC for Health, Jack Bloom, in August revealed Ekurhuleni had the lowest ambulance response time in the province. It is now clear why that is the case,” she explained.

According to the report she said, “Emergency ambulances respond to only 56% of calls for priority one patients within 30 minutes in Gauteng’s urban areas, which means unnecessary lives are lost daily.

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“According to Bloom, the most dismal response rate is observed in Ekurhuleni, where merely 46% of life-threatening emergency calls receive a response within 30 minutes.

“Residents, especially those residing in township areas, had to withstand the worst of an ambulance service that is now more unresponsive than ever,” Ueckermann said.

She reiterated reports of residents having to use their private cars to transport the sick and injured to hospitals and clinics after waiting between three or four hours for an ambulance are commonplace.

Provincial move

The Gauteng Executive Council decided to provincialise Emergency Medical Services (EMS) in line with the National Health Act, which placed an imperative to separate Fire and Rescue Services (municipal competency) and Emergency Medical Services (provincial competency).

The Gauteng Department of Health (GDoH) is, according to the Constitution of the Republic of South Africa, Act 108 of 1996, schedule 4 and the National Health Act, the competent authority for the provision of emergency medical services to the community of the province.

CoE spokesperson Zweli Dlamini stated the ambulance service is now in the hands of the Gauteng Provincial Government and that it was proper that questions be directed to the health department, which is the custodian department.

Speaking for the GDoH, Motalatale Modiba said the process of provincialising started with the Metsweding District Municipality in April 2007.

“Sedibeng District Municipality followed in September 2012, West Rand District Municipality in November 2015, the City of Tshwane in July 2018, City of Johannesburg in January 2020, and the CoE in July 2020 as per Gauteng Provincial Government EXCO resolution of 2016,” he said.

He pointed out that the City of Tshwane, City of Joburg and the CoE all opted to retain their emergency medical services personnel.

“Gauteng was the last province to provincialise; all other provinces did this long ago. For example, in the Free State, they did this in 1999.

“The ambulances procured by the Gauteng Department of Health EMS were returned to the province, as part of the surrender agreement in the memorandum of agreement,” Modiba said.

He said the metropolitan municipalities are in a better position to indicate how they use the ambulances they have directly procured.

“In terms of licensing to run ambulance services, municipalities may, like other service providers, apply to be licensed to render such services in accordance with the National Health Act 61 of 2003: Emergency Medical Services (EMS) Regulations, promulgated in 2017,” he added.

CoE’s Dlamini said, “We were rendering the service on behalf of the province; it was never a municipal function. We surrendered the ambulances as per the requirements. We met the obligation and the province can confirm that.”

Licensing issues

• The National Health Act 61 of 2003: EMS Regulations requires that any person or organisation who wants to render an emergency medical service, aeromedical service, events medical service, volunteer medical service and educational institution of emergency medical care must apply for an EMS operating license that is renewable every year.

• Licensed EMS providers are issued with an official operating license and license tokens for each compliant vehicle in line with the EMS regulations.

Dlamini said there has since been a notable improvement in the provision of quality service and seamless operation of EMS.

• The usage of one emergency number (112), as compared to many numbers used by the local authority. All emergency calls are now received through one emergency communication centre and there is no combination of fire and other utility services calls. This means calls are now routed to a dedicated Gauteng EMS emergency communication centre instead of a general service communication centre, thus improving response time.

• All complaint delays and adverse events are managed through GDoH emergency medical services by qualified professionals.

• Gauteng EMS has no boundaries between metros and districts and resources can be activated from any metropolitan municipality or district.

• The quality of emergency medical care and treatment is at an intermediate life support and/or higher as compared to the previous arrangement where the city’s emergency management services were reliant mainly on the basic life support staff, with fire qualifications.

• The Gauteng Department of Health staff has a bigger scope of practice for patient care as compared to those in municipalities who have less scope of practice as per Health Professionals Council of South Africa guidelines.

The GDoH cannot confirm or deny allegations.

Modiba continues, “The City of Ekurhuleni Fire and Emergency Services can give context on procurement. The GDoH cannot confirm nor deny the allegation of the 75 ambulances as stated in the allegation, because we did not procure any of the alleged ambulances,” Modiba explained.

When asked whether this move which has been strongly criticised in the CoE could be violating residents’ constitutional rights to health. He said the Gauteng Emergency Medical Services is fulfilling its constitutional obligation by responding to all emergencies reported.

“As the Constitution states that no one should be denied emergency care, it should be noted that in line with the Constitution of South Africa, ‘no one should be denied emergency care’, this statement applies to any health services provider,” said Modiba.

“As much as government is the custodian of health services, the government implemented measures that allow private health providers to be approved for rendering medical services as they are also obligated to render medical services to the citizens of the country.”

He said this was part of a strategy to alleviate service gaps.

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