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Route to health

Last week the Queen Elizabeth Hospital issued a statement informing Barbadians that the fleet of ambulances assigned to the Emergency Ambulance Service had been severely depleted, negatively impacting its ability to respond to calls.

There was really no news in that announcement since media practitioners in just about every media house would have been aware of this situation for some time. In fact, Barbados TODAY reported on the situation soon after John Boyce became minister of health — on a day when the fleet was down to a single working ambulance.

It was on that occasion that the new minister disclosed that the process had already begun for the acquisition of new vehicles, while an official within the EAS reported that the ministry had already put in place an arrangement for them to call on the resources of private ambulance providers to fill the void.

What we do compliment the QEH officials for in making the announcement last week was in taking Barbadians into their confidence, and assuring them that the system of calling on the private providers as well as the resources of the Barbados Defence Force was more than adequate to meet day to day needs.

It was also wise that the QEH also took the opportunity to remind Barbadians that there is a cost attached to prank calls, which becomes immediately apparent when a private ambulance is pressed into service unnecessarily, where a crew from the EAS would ordinarily have responded. Too often we fail to recognise that even though we may not pay for services provided by the Government up front, we nevertheless pay for them — and in the case where a Government agency is not operating as efficiently as it should, we can end up paying far more dearly than if the job had been done by a private sector initiative.

And this brings us to the crux of this article. We sincerely hope that the appropriate persons in the Emergency Ambulance Service, the Queen Elizabeth Hospital, the Ministry of Health and the Ministry of Finance, and perhaps even the Auditor General’s Office, will use the opportunity presented by the use of the private sector ambulances to measure and compare the costs of the two approaches.

We are not necessarily lobbying for the privatisation of the ambulance service, but an examination of the operations to see if as we set out to remake the private sector, if such an approach ought not to be examined. We do not believe that the matter of quality of care by the private providers is an issue, because very often when these brightly painted vehicles respond to emergencies the people manning them look strangely like staff we have seen on public service ambulances.

We are also aware that the Ministry of Health monitors the condition of the private ambulances, including the equipment maintained within each — so that too should not be an issue.

As far as we are concerned, there are some services that are so vital to our daily lives that we are more comfortable having them fall under the direct jurisdiction of the State, but then there are others which the state has traditionally provided, but for which there are no compelling reasons why they have to be.

All over the world ambulance services are privately provided — even though they may be heavily regulated by state authorities. Now that we are faced with financial challenges, and like any entity we look at better managing our expenses, we have to place everything on the table for examination.

And we need to move away from the scare tactic of making people believe that job losses are an automatic consequence of a shift from the public to the private sector. If Barbados needs, for example, a fleet of a dozen or 15 working ambulances and crews then that is what it is. Fewer people will not get sick or hurt because ambulances are not operating from Jemmotts Lane — just like there will not be fewer breakdowns if Government vehicles were served by the private sector as opposed to public servants, or grass will not be more inclined to grow along the highway if the roadsides were maintained by private contractors.

Because we have done it this way for 100 years does not mean we have to do it so for the next 100. Wisdom ought to come with experience!

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