R28 million spent on private ambulance contractors

The Western Cape Department of Health has paid R28.9 million to five private ambulance companies after Covid-19 placed a strain on the provincial government’s resources.

This emerged in a response to a written question to MEC for Health Nomafrench Mbombo on whether the department had entered into any contracts for the transportation of patients since last year. While the contract is due to expire on Wednesday, work is underway to try and source money to fund the project again for the coming year as the country prepares for a possible third wave of Covid-19 infections.

To date, more than 21 000 patients have been transported on this service. With staff of nearly 2 000 spread out across 49 Emergency Medical Service (EMS) stations in the province, the sector was reportedly placed under severe strain as staff contracted Covid-19and were placed on leave. Emergency response has also been impacted by ambulance crews relying on police escort in high crime or red zone areas.

“Since the outbreak of the Covid-19 pandemic, our staff resources have been under severe strain on account of isolation and quarantine processes. This made the provision of patient transfers (between facilities) incredibly difficult with unfortunately prolonged delays,” said Mbombo in her response.

“EMS subsequently entered into a contract with private vendors to assist with patient transfers, at a negotiated rate. This contract proved to be extremely successful in alleviating the workload in the Metropole and have been a large part of the Department’s response to absorb patient pressures.”

While the project began in the Cape metro, by the time the second wave hit, it was expanded to the Eden district which covers the Garden Route Municipality. Mbombo said given its impact on operational budgets, the project was curtailed as the second wave receded. “Since inception, private EMS contractors have (transported) 21 500 patients at a cost of R28.9 million,” she said.

Emergency services were allocated R24.4million more for the coming financial year when compared to the revised estimates of the 2020/21 budget. EMS spokesperson Deanna Bessick said like all Covid-19 initiatives, no funding allocation was made available for the coming year as it would come from the department’s larger planning.

“We are looking at ways of funding a similar initiative in the 2021/2022 financial year to deal with a potential third and possibly fourth wave of Covid-19 infections. This contract provides relief to EMS covering full-time staff who are either sick or redeployed from the front line due to vulnerable status. This initiative is not part of our usual operations and is thus not funded within our normal allocation,” she said.

In the province’s budget vote, the department also noted how safety protocols have affected operations, she said. Provincial Chairperson of the Health and Other Services Personnel Trade Union of South Africa (Hospersa), Gerald Lotriet, said while their members welcomed the assistance which alleviated the pressure, underlying issues around staffing in EMS remained a concern.

“Prior to this contract and with our members going into quarantine, passing away and others placed on long term leave, the service pressure became so severe that our members were crying out for extra staffing. They were already dealing with having to wait for a police escort to go into red zones and this was impacting on service delivery,” he said.

“But the bigger issue remains the need to fill all funded posts. We are sitting with Hospersa members who have been acting in some positions within EMS for long periods, some two years and others longer.

“The question is if they can contract this service why not finalise the issues of people in acting positions. They chose to go with the route of those private companies where they don’t have to take any accountability or liability in line with the Labour Relations Act in terms of what happens to the people staffing those ambulances. Our concern is we don’t know the people on those ambulances, how qualified they are to render those services.

“But these contractors are only doing hospital transfers while our guys still sit with the burden of going to patients' homes and collecting them which continues to be a dangerous exercise because of the attacks they suffer.”

Last year, EMS recorded as many as 68 attacks on paramedics. Lotriet said they plan to challenge this contract at the upcoming meeting of the public health and social development sector bargaining council on April 21.

Bessick said EMS has no vacancies and that staffing issues around pressure brought on by absenteeism were being dealt with by bringing in contract staff.