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New 999 procedures will help save lives
4 July 2009
South China Morning Post

The ambitious response targets that fire chiefs have set for ambulance services have become increasingly hard for medics to meet. That is not their fault. The services are being stretched to the limit, with the number of emergency calls - whether critical or frivolous - rising each year. With the number of ambulances remaining relatively constant at 250-plus, it's a matter of simple arithmetic to work out that more call-outs will not meet a response within the target time of 12 minutes.

The system is clearly unsustainable. Fire chiefs have now put forward a sensible way to revamp the system while offering to shorten the response time for critical or life-threatening cases. It is a much-needed reform and deserves public support.

Under the proposal, calls made to the emergency number 999 will be prioritised. The target response time for critical cases will be shortened to nine minutes, while that for serious, but non-life-threatening ones will remain 12 minutes. All others will have to wait up to 20 minutes for an ambulance to arrive. This will be very different from the current practice, where every call is treated as an emergency and responded to on a first-come, first-served basis.

The existing system, like other free public services, invites abuse. Between 22 and 44 per cent of calls made each year are non-emergency. Lawmakers were told in January that some of the more egregious instances involved no more than a mosquito bite or constipation and that some people just wanted a free ride to a hospital. They not only waste public resources, but threaten lives. Imposing a penalty or a charge in such cases has been proposed, but fire chiefs have concluded public education is more appropriate.

The ageing fleet of ambulances is being replaced. This will help avoid mechanical breakdowns, which, unfortunately, happened a number of times in the past year. But it will not increase significantly the number of emergency vehicles available. All this leaves officials with no choice than to create a new system to filter out non-emergency calls. That is how most advanced economies operate. By adopting it, ambulance services, backed by a new fleet, can be made to operate more efficiently.

An important concern is that those who handle emergency calls must categorise cases accurately. At the moment, emergency receptionists only need to take down addresses and contacts to direct ambulance crews to the right location, though they may ask about a patient's condition. Under the new system, they will ask callers questions and make quick - and potentially life-and-death - decisions. There will inevitably be mistakes, so it is better to err on the safe side. When in doubt, they must assume it is an emergency case. They will also offer first-aid advice to callers before medics arrive. Clearly, the new tasks require much better trained and qualified personnel. But with that proviso, the proposed system can help to streamline ambulance services and save lives.
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