Alexander: Covid Can’t be Blamed for Strain on Ambulance Service

 

By Sue-Ann Wayow

THE Ministry of Health cannot blame the spike in Covid-19 cases for putting a strain on ambulance service in the public sector.

And the Government is being called upon to give a complete breakdown of the additional expenditure on Covid-19.

Head of Citizens Union of Trinidad and Tobago (CUTT) Phillip Alexander said the figures were not adding up.

 

“We are 22 months in a pandemic. What did you spend the money on? We have the same number of Intensive Care Unit ICU beds, the same number of ambulances that we had five years ago. There are too many things that are happening that are not making sense at all,” he told AZPNews.com on Wednesday.

In August, Finance Minister Colm Imbert said, “We have crossed the $5 billion mark and we intend to provide as much relief as we can. And certainly, in the next budget, there will be an amount for Covid relief, residual Covid relief going forward into 2022.”

 

A Guardian Media report on Wednesday stated that the steady increase in Covid-19 cases from October into November was causing a strain on the Global Medical Response of T&T (GMRTT) ambulance service that has a fleet of 48 ambulances with a workforce of 350.

In 2016, Health Minister Terrence Deyalsingh had said that GMRTT signed in 2015, a five-year contract valued at $30.8 million per quarter which amounted to over $92 million annually. In November 2016, GMRTT also stated that there would have been 50 ambulances available for public use.

 

Alexander pointed to another newspaper article that reported Deyalsingh saying that according to the contract then with GMRTT, there should have been a fleet of at least 74 ambulances. He said there may be a violation of the contract.

He said, “Before Covid, before there was not any spike, GRMTT supposed to have 74 ambulances operating. The ministry cannot blame the spike for putting a strain on the ambulance service. The Ministry of Health has a responsibility to properly secure the country in a pandemic and this issue was before the pandemic indicating that for all these years, there has been a violation of the contract.

“If we needed 74 then, then we definitely need to have much more operating during the pandemic,” he added.

Alexander is also asking why private ambulance services were not being utilised to ease the strain on GMRTT.

“An ambulance is a stretcher in the back of panel van with lights. Without a pandemic, the ideal fleet for T&T is above 75, 82 if we dedicated just two per 30,000 citizen constituency.”

GMRTT monopolising ambulance service 

Former Member of Parliament for Couva North Ramona Ramdial said she supported Alexander’s call for transparency and accountability.

 

She said GMRTT seems to have monopolised the ambulance service.

“We are spending millions in ambulance service almost $100 million every year. GMRTT has probably monopolised the service but there are a lot of other smaller ambulance-service providers. The Ministry of Health can allow the smaller service providers to expand. This is a very critical and crucial resource that is needed and we need to know exactly how our monies are being spent.”

She also called on the Opposition to ask similar questions in Parliament.

Reduce demand 

Principal Medical Officer Dr Maryam Abdool-Richards at the Ministry of Health’s virtual media conference on Wednesday was asked about the ambulance situation by AZPNews.com.

She responded, “It is a demand issue.”

“The onus is now on the population to reduce this demand for supply of ambulances and other resources,” she added.

Dr Abdool-Richards said the Ministry of Health continued to collaborate and work with the GMRTT service to ensure that the required number of ambulances were deployed on every shift and more ambulances were deployed on peak shifts.

She also mentioned that the ambulances available through the regional health authorities were also available for the transfer of patients between facilities.

Dr Abdool-Richards said the ministry was doing all it can to facilitate healthcare in the best manner possible and again encouraged the population to get vaccinated against Covid-19 in order to assist.

She also stated that ICU beds were being added as needed and as of Wednesday, there were 60 ICU beds in the parallel healthcare system in Trinidad and five in Tobago.

The solution is in vaccination 

And Deyalsingh speaking in Parliament on Wednesday said, “The solution is not in more ambulances, more resources, the solution is in vaccination.” 

He was answering a question asked by Member of Parliament for Fyzabad Dr Lackram Bodoe concerning an increase in ambulance fleet. 

Deyalsingh said, “We have taken decisive action since the start of the pandemic to manage the healthcare system. In the case of the ambulance service where GMRTT has a functioning fleet of 48, we are working with them to bring more of the ambulance fleet in operation.” 

 

He also said of the 50 RHA ambulances, 12 were in use for Covid patients. 

A multifactorial problem was how he described the issue and said at the Accident and Emergency Departments measures were undertaken to have a quicker transfer of patients from an ambulance to the department and the ICU capacity was increased to almost 100% from 35 available beds to 60. 

When further asked how many ambulances may be commissioned, Deyalsingh said at any one time, GMRTT was expected to have between 48 to 50 ambulances in service and there may be about 18 “physical assets” that needed to be maintained and would be down for either routine or unplanned maintenance.  

He repeated, “ We are working with them and that is why we have pressed into service some of our ambulances in the RHAs.”