Executive says the cover is adequate, but GPs say taxis are being sent out in place of ambulances, writes LORNA SIGGINS
THE HEALTH Service Executive West has confirmed that it is using taxis instead of ambulances for “non-acute” hospital transport. However, it has denied that there is a shortage of ambulance cover in Galway city and county, or that emergency cases are being jeopardised by this arrangement.
Several general practitioners in the Co Galway area who requested ambulances for patients recently were asked whether a taxi might suffice.
One practice in Galway city told The Irish Times this occurred less than a month after new arrangements were announced for ambulance cover in Roscommon. He questioned whether ambulance services had been given sufficient resources to cover the region, following the closure of that county hospital’s emergency department.
However, HSE West, which is responsible for Galway, Mayo and Roscommon, said the National Ambulance Service West was maintaining “normal levels of ambulance cover in Galway”. The ambulance regional base is controlled from Castlebar, Co Mayo.
“HSE vehicles and their staff are prioritised for front line, emergency work and therefore a much more effective service is provided for patients or clients who are not acutely ill through the use of taxis,” it said in a statement.
Dr Mary Rogan, a GP at Annaghdown Medical Centre, said it was “not an ideal or an appropriate situation”, and raised questions about the suitability of taxis and about liability.
“A taxi is appropriate for bringing patients to a routine outpatient visit, but if a GP calls for an ambulance, it is because an ambulance is needed. Taxi drivers are not trained in paramedic skills,” Dr Rogan said.
“One can understand that HSE management wishes to address situations where there may have been inappropriate requests for ambulances, perhaps by members of the public, but we now have a situation where there are critical shortages in the system.
“Trained paramedics in ambulances are equipped and skilled in giving oxygen, ECGs (electro-cardiographs), drugs, and they can resuscitate patients and administer airways into lungs. They update their skills all the time . . . Taxi drivers do not have such equipment or training.”
There are also insurance implications, according to Dr Rogan. “At a time when our medical indemnity fees are going up, who is responsible if a patient has an arrest in a taxicab en route to hospital?” she said. “Is it the GP who agreed to accept the taxi in the first place, perhaps because there was no other option?”
Transport to hospital by ambulance also ensures that a critically-ill patient would receive priority attention in an emergency department, she pointed out, whereas delivery by taxi could not guarantee this.
The HSE spent €55 million on taxis last year, as reported in last week’s ‘HEALTHplus’. However, the figure cited in a reply to a Dáil question tabled by Fianna Fáil did not specify whether this related to taxis used by patients, by staff or by both – and whether it related to emergency cases in any of the HSE regions.
The health authority is not required to provide transport for non-critical patients to and from hospital, but does so on a “discretionary basis”, it said. HSE senior management has acknowledged that the €55 million spend has reached “unsustainable levels”.