the politics of health

The Limerick Leader posted an interesting article online this week.

University Hospital Limerick’s ‘colossal spend’ on hiring ambulances

Limerick Leader 6 July 2017

The growth in spend quoted in this article makes for good politics but it doesn’t get to the bottom of the story. What kind of private ambulances were hired? Staffed by what level of clinical qualification?

TD Quinlivan says four fully equipped ambulances could have been bought with the spend since 2012 – I assume he means emergency ambulances with fully qualified paramedics or EMTs on board.

But it’s far more likely than non-emergency patient transport is needed in Limerick far more than emergency ambulances. Managed well, this is a good clinical decision and good business too. And this is very likely what this private ambulance spend was used on.

Non-emergency patient transport is staffed by people with lower clinical qualifications using a vehicle with far fewer pieces of expensive equipment and little or no drugs on board. The majority of people requiring ambulance transport in any country need it not because they are a critical emergency case requiring high-speed transport by highly qualified (and relatively expensive) paramedics. They are the chronically ill or injured who cannot make their own way to hospital for regular appointments – chemotherapy, dialysis, rehab – because of the nature of their illness. They need a certain level of assistance and perhaps monitoring en route. And there are far, far more of these journeys needed every day in every city than people needing an emergency ambulance.

Funding four new emergency ambulances will not get these people to their hospital appointments on time and safely, but it would make a good political headline.

Investigating the need for this spend – the real people behind the headline – would have been a good piece of investigative journalism for writer Fintan Walsh, but I suppose that takes time and he probably doesn’t have the luxury of delivering that kind of good journalism these days.


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