Deficiencies mar Ja’s emergency medical services
Sector in desperate need of ambulances, medical technicians
Published:Friday | January 27, 2023 | 12:08 AMMark Titus/Gleaner Writer
Thirteen years after a Pan American Health Organisation (PAHO) review listed Jamaica among regional states that had no legislative framework in place, action is yet to be taken to establish a system that governs the operations of emergency services.
The report noted that only Trinidad and The Bahamas have such mechanisms in place, but added that most of the countries had well-organised emergency medical services.
“There has been no advancement of the 1996 draft EMS Bill to date,” Dunstan Bryan, permanent secretary in the Ministry of Health and Wellness (MOHW), told The Gleaner on Friday. “(but) operational guidelines have been developed by the MOHW that include Standard Operating Procedures for emergency medical technicians, ambulance specifications for vehicles to be registered as ambulances, and an ambulance service provider checklist.”
While there is no specific timeline determined to advance the bill, the MOHW expects to benefit from an external evaluation of the emergency care system sometime this year, including recommendations regarding a prioritisation schedule, it says.
ACT QUICKLY
Opposition Spokesman on Health Dr Morais Guy agrees that successive administrations had the opportunity to put the governance structure in place, but is hoping the Andrew Holness-led government will act quickly. “What this means is that the 1996 draft must be acted on and improved in terms of what needs to happen in the 21st century. That is something successive governments should have done, and the current government needs to fix,” he said.
Up to press time attempts to reach the health minister Dr. Christopher Tufton for comments on the issue were unsuccessful.
Emergency medical services is also known as an ambulance service or paramedic service. It provides out-of-hospital medical care; transport to healthcare facilities and other medical transport to patients.
But an executive member of the Medical Association of Jamaica, who spoke on condition of anonymity, lamented the current shortage of ambulances to respond to emergencies, a core function of the service.
“Jamaica has an ambulance problem, there are not enough to serve the country and it is concerning.”
Detailing the deficiency further, Dr Mindi Fitz Henley, president of the Jamaica Medical Doctors Association (JMDA), said: “More ambulances are desperately needed. Many parishes only have one, especially our rural parishes. You will call for an ambulance and it is just not available. We even have issues transporting patients from the hospital to another or one parish to another. We are struggling to do that,” she said.
Four new ambulances were handed over to the Western Regional Health Authority (WRHA) recently and Fitz Henley is hoping that more units can be acquired to ease the shortfall in the sector, especially the more rural communities.
Dr Guy, the member of parliament for the constituency of Central St Mary and a medical professional, shared the concern. “What I do know based on local experience and what I have seen and heard is that the number of ambulances that are serving us is woefully inadequate,” he said. “In the local hospitals in St Mary, Annotto Bay, and Port Maria, there are times when you need to take patients out for a radiological examination or for transfer to other institutions but there is no ambulance available.Sometimes, the operating ambulance has to go to Kingston for supplies, so you just have to wait. So from that point of view, it is inadequate.”
REGISTRY
The health ministry currently has a fleet of 51 ambulances across the four Regional Health Authorities. Thirteen are out of service.
Eight units are assigned to the MOHW-Jamaica Fire Brigade EMS, while ambulances are also available with the JDF, JCF, and Department of Correctional Services.
According to the health ministry, 32 private firms are registered to provide ambulance services, with a combined fleet of 73 units. But only 18 active, registered, or renewed entities were found in a search of the Companies Office of Jamaica’s registry. The MOHW EMS Unit is responsible for vehicles being registered for the first time to operate as ambulances or that were out of use for a period of time, but the health ministry made no mention of a monitoring mechanism to govern the emergency services community.
Other areas in the service are also under strain.
The health ministry says there are 409 trained emergency medical technicians (EMTs) in Jamaica, with certification valid for two years. But this is also inadequate, and in some cases, nurses are forced to take on tasks that would normally be done by the medical technician, which creates a shortage in other critical areas, Dr Fitz Henley says.
NUMBER OF AMBULANCES PER REGION
• North East Regional Health Authority – (Portland, St ,Mary, and St Ann) – 12
• Western Regional Health Authority – (Westmoreland, Hanover, Trelawny, and St James) – 9
• Southern Regional Health Authority – (Clarendon, Manchester, and St Elizabeth) – 13
• South East Regional Health Authority – (Kingston & St Andrew, St Catherine, and St Thomas) – 17