Review for ‘ill-conceived’ air ambulance deal

The KwaZulu-Natal Department of Health is to review its contract with the South African Air Mercy Red Cross Trust that allows department officials to use the only air ambulance in the eThekwini region for “administrative emergencies”. Another air ambulance is based in Richards Bay. Last week, Public Protector Thuli Madonsela released a report into an investigation on whether Health MEC Dr Sibongiseni Dhlomo had violated the Executive Ethics Code when he used the air ambulance to attend a funeral in Hlabisa, in the north of the province, in November, 2012. On the day in question, a young boy, Asheen Maharaj, was involved in an accident and required to be airlifted to hospital, but the air ambulance was not available.

Asheen later died, and in December the same year, DA MPL Sizwe Mchunu lodged a complaint with Madonsela’s office, asking that Dhlomo’s conduct be probed. Madonsela found last week that Dhlomo did not err in using the helicopter, but that the contract binding the department and the Red Cross Trust was flawed. The contract was entered into on April 1, 2003, ran to March 31, 2012, and was later extended to March 31, 2015. It stipulates that the helicopter should provide emergency ambulance services and further allows overflow hours to be used by management for administrative emergencies. The payment for the air ambulance service is R1 million a month, and a direct operating cost payment of R6 008.66 per flight, per hour. The price includes 30 free flying hours per month.

Madonsela said the contract was “ill conceived” because, among other things, while executing an administrative mission, the ambulance would not be readily available for medical emergencies. Regarding whether the utilisation of the helicopter resulted in failure of the emergency services to provide emergency medical care to Asheen, resulting in his death, Madonsela found that the department had responded expeditiously to the accident using ground vehicles. There was no evidence that the helicopter was needed for the boy’s emergency, or any other emergency on the day of the accident, she said. “However, the policy between the department and Red Cross is inappropriate as there is a real risk of a person dying because of the emergency medical ambulance being unavailable while being used for administrative purposes. The arrangement also feeds negative perceptions regarding competing needs of patients and departmental management.

“The MEC accepted that the policy presented uncomfortable, practical and ethical risks, and undertook to have it reviewed as soon as possible,” Madonsela said in the report. She said had Dhlomo travelled to Hlabisa by road, a 268km drive, he would have missed his engagements, and that he had only flown to the area to make the time. On his way back to Durban, he used his vehicle. “An appropriate remedial action to be taken in terms of Section 182(1)(c) of the constitution includes that the department head, Dr (Sibongile) Zungu, take immediate action to review the contract between the department and the Red Cross Trust to make provision for a separate helicopter to cater for non-medical emergencies,” Madonsela said. Dhlomo was reported in Newswatch last week as saying his department would take the recommendations seriously.

The DA’s Mchunu said the use of the air ambulance should be confined to medical emergencies only. “The report may have let MEC Dhlomo off the hook, but it also makes some damning statements in terms of the current contract between his department and the Red Cross Trust,” he said. Dhlomo and Zungu could not be reached for comment by the publication deadline. The publicist for the Red Cross, Vanessa Horn, said the implementation of the Madonsela’s recommendations rested with the health department.