What does one look for in an efficient ambulance emergency service? Three factors stand out. First, there should be a speedy response to an emergency call. Secondly, the ambulance personnel must be capable of administering immediate first aid and life-saving medical treatment to the patient on his/her way to hospital. Thirdly, on arrival at the hospital, there must be efficient reception arrangements to provide correct medical treatment to the patient as speedily as possible.
The Minister for Health has just announced that there will be an increase in the provision of ambulances in order to cut response times on call-out. The number of ambulances at Mater Dei Hospital will go up from seven to 11 by the end of the year. Moreover, the ambulance drivers and porters, who will henceforth be known as ‘ambulance responders’, will be doubled from 44 to 88.
The minister was not clear about the significance of the change of nomenclature, except to indicate that the agreement he had reached with the unions would provide better conditions of work – including more pay, presumably – and more flexibility.
What the minister left unsaid was whether the conversion of ‘ambulance drivers and porters’ into ‘ambulance responders’ would lead to more qualified individuals being employed in this field. This is crucially important because the quality of care and treatment provided by the ambulance service could make all the difference between life and death in an emergency. It is to be hoped, therefore, that ambulance responders will be better trained to assist nurses and be more responsive to calls for help.
The director of the Mater Dei emergency services said that, on average, ambulances took about 10 minutes to reach localities in the central region. However, it could take up to 25 minutes to go to the fringes of the island and localities in the south of Malta posed a challenge due to the heavy traffic on the roads at peak hours.
It was therefore proposed that, in future, ambulances would be deployed on stand-by to the Paola and Mosta health centres during peak times to reduce response time in emergencies.
Although these response times are relatively poor compared with those demanded of other ambulance emergency services – in London, for example, the target is eight minutes – the reality is that Malta’s roads are both inadequate and overcrowded. However, Malta’s response of 10 to 30 minutes underlines the need for those in the ambulance attending to the emergency call-out to be well trained and also to be equipped with the latest medical kit.
As to the reception facilities on arrival of the ambulance at Mater Dei, the organisation and response facilities at the accident and emergency department are also vitally important.
It was therefore encouraging to hear the minister declare that the objectives that he had set out in the ‘smart plan’ for the emergency department last July were being met.
The plan called essentially for a bigger complement of doctors and nurses to cope with demand during peak times and the introduction of a patients’ tracking system to alert the emergency department whenever standard best practice was not being observed.
Dealing with accidents or other medical emergencies efficiently and speedily is an essential part of a modern and effective health service. Although clearly capable of further improvement, the steps the Health Minister has set in hand are heading in the right direction.