Long waiting time for ambulances and lack of courtesy and care extended to ailing patients by ambulance attendants were just two of several complaints members of the public have been voicing to the Ministry of Health with regard to the country’s ambulance service.
To get to the root cause of the verbal complaints, Chief Medical Officer Dr Colin Furlonge said the ministry may soon audit the Global Medical Response of T&T (GMRTT)—the company contracted by the ministry to provide emergency ambulance services. Furlonge said so when asked if the ministry was satisfied with the level of service provided by GMRTT.
“At the ministry level, we have been extremely disappointed because of the complaints we have had with regard to the ambulance service,” Furlonge said in a telephone interview last week. However, CEO of GMRTT Paul Anderson said the nine years they have been in operation, he was not aware of any complaints by Health Minister Dr Fuad Khan about the service. He said GMRTT also conducts surveys every month on 50 of its clients to gauge its performance and service.
“We question them (clients) about their level of satisfaction and if our attendants acted professionally. And for the nine last years, every month, we received 96 to 98 per cent satisfaction.”
‘One to six hours to remove patients from ambulance stretcher’
Anderson said the delay in service was not caused by its ambulances failing to respond to emergency cases in a timely manner, but to the long wait at the hospitals. Anderson said GMRTT’s biggest challenge was the length of time the hospitals take to get patients out of its stretchers and into the health care system.
“That is a procedure that should take at least 15 to 20 minutes. It takes over an hour and in some cases, it takes sometimes six hours. That delay is caused by the incapacity of the health facility...the staffing, the unavailability of beds and so on. When that starts to backlog, it impairs our ability to respond to the next case.
I know they are sensitive to it because it is something that has reached their attention continuously. They won’t be surprised to hear me speaking about that,” Anderson said in defence of the service they provide.
As the national emergency medical service provider, GMRTT uses a combination of station-based and roving ambulance deployment strategies to ensure people receive safe, reliable, and prompt response to their medical emergency.
Furlonge: Some reports frivolous, unfounded
Furlonge said while some of the complaints may be frivolous and unfounded, others often give the ministry reason to worry. He said because of the high demand for the service, an ambulance may not respond in a timely fashion.
“It is a matter of understanding that when it comes to health, the better service you provide, more people call for it. And then that kind of effect takes place when demand starts to exceed supply. All the hospitals in the world...the best hospitals get the most patients to deal with because people make choices.”
On October 20, a fresh complaint was reported in the print media when mentally ill patient Melville McIntyre, a resident of the Centre for Socially Displaced Persons at Riverside car park, East Dry River, Port-of-Spain, was refused ambulance service. McIntyre, 37, an outpatient of St Ann’s Hospital, jumped to his death from the building’s first floor after facing a relapse.
The centre’s manager, Roger Watson said under normal circumstances an ambulance would be called to pick up mentally ill patients and take them to St Ann’s, but when calls are made no ambulances are sent. Told about ambulances refusing to pick up mentally ill patients, Furlonge said, “We are trying to get information to clarify if that is accurate. If it is, we would investigate that very seriously since it is a serious allegation.”
Furlonge said if information reaches the ministry that ambulances are turning down patients, they would deal with the matter “very strongly.”
Anderson: GMRTT to increase its ambulance fleet in the coming months
In the last few weeks, Anderson said GMRTT has been in discussion with the ministry to help improve its ambulance service through a “resource model.” Anderson said they are trying to hammer out an agreement so GMRTT can increase its ambulances from 38 to at least 60 in the coming months. A few weeks ago, Anderson said, ten new ambulances were added to its fleet of 28.
Instead of the ministry sourcing and supplying the ambulances, Anderson said they are seeking to take on this responsibility. “Considering the size of Trinidad, 38 ambulances does not sound adequate. And we are as busy as TTPS and far busier than the Fire Services.” Anderson said when he compared the T&T Police Service’s 5,000-plus vehicles and the Fire Services’ fleet to what the GMRTT has, there is a disparity.
GMRTT receives on average 180 emergency calls daily, Anderson said. Most of the calls come in before and after work hours. “It is not uncommon to have 40 to 50 cases in one hour.” Anderson said GMRTT has responded to 65,000 emergency medical services cases up to the month of August. By the end of October, an additional 10,000 cases would have to be added to this figure. “So for 2014, we have responded to 65,000 to 75,000 cases. We provide prompt and good service,” Anderson insisted.
Paramedics to administer medical procedures, drugs to patients at home
Anderson said GMRTT also has a long-term strategy—to train paramedics where they can undertake basic medical procedures and administer drugs to the patients at home rather than taking them to the hospitals.
“This is how the industry is moving globally...it is to create a capacity where a person’s medical needs can be taken care of in their home or wherever they may be, than being transported to the hospital. This will help ease the backlog of patients at hospitals and help us. It will be a better outcome for patients.”
Insisting that the demand for health care in T&T has been increasing because of the growth in non-communicable diseases, Anderson said no one has complained to the GMRTT that ambulances are refusing to pick up mentally ill patients. “That is not to say that it is not true. But we have a very strict policy. If someone calls 811 we respond.”
Anderson said employees of GMRTT would have to be very creative to bypass their system.
CAMPAIGN AGAINST DEPLORABLE SERVICE
In an e-mail on Tuesday, UNC social and political activist Phillip Alexander stated that he has begun an unofficial campaign “on our almost non-existent and deplorable ambulance service.” Alexander’s campaign has been based on highlighting the issue and sending messages complete with patient horror stories, including the views of onlookers on social media to the entire Cabinet, including Minister of Health Dr Fuad Khan.
“Sadly, to date, nothing has been done, said or acknowledged on the issue by the Minister of Health or anyone else in Government, despite the cost to life and survival of citizens.” Alexander believes that this is an important national issue and the public should campaign against the poor service until the matter is addressed. Three weeks ago, Alexander said the father of one of his son's friends died after waiting 45 minutes for an ambulance in Diego Martin.
“A Member of Parliament confided that he had to take his mother to the hospital himself as the ambulance they had called seemed to be taking forever and she was in dire need of treatment. This seems to be one of those issues that you do not know how bad it is until you need it and find out to your peril, that the concept of an essential service that you had in your mind simply does not exist.”
Alexander urged citizens to get in touch with him or share their experiences on his Facebook page. “It is time to gather the statistics that we do not now know and add them to the rest of the horror stories.”
