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You’re lying critically injured after a car crash when you hear the sound of a siren. You see the flashing red lights of an ambulance and think help has arrived.
There’s just one problem - ambulance services operating in KwaZulu-Natal’s private sector are not regulated. You could be transported in a vehicle that is not properly equipped to deal with your injury or treated by someone who is not properly qualified.
Medical aids will only pay ambulance companies that have been certified by their industry body, the Board of Healthcare Funders (BHF). However, once a private ambulance provider has been certified there is no mechanism in place to monitor their operations. As a result, unscrupulous operators have rushed to the scene.
According to the BHF, there are 65 active ambulance services operating in KZN. Of these, only one is operated by the provincial health department - the rest are private. Five of these provide basic life support, 32 provide intermediate life support and 27 advanced life support.
It’s a lucrative business, with service providers charging between R2 000 and R3 000 for a short trip to hospital. Consequently there is growing interest in the sector. In 2012 the BHF received 15 applications, last year they got 22, and this year they’ve already received six.
Some of the more established players have now voiced concern. They have pointed out that some private ambulance companies:
- Work in cahoots with tow truck drivers, waiting for accidents to happen or, in some cases, causing them.
- Pay a spotter’s fee of between R250 to R500 to tow truck operators for patients.
- Borrow equipment to get certified by the BHF.
- Hire trained paramedics to get certified by the BHF and thereafter use less skilled personnel.
Garith Jamieson, director of Rescuecare, has 15 years’ experience in running private ambulances. He said these days, anyone with money can run a private ambulance service, often with little or no interest in the well-being of patients.
“I know of cases where the critically injured are left behind because the staff are unable to treat them, while those who are not injured… are being transported to hospital.”
Jamieson said he was also aware of instances where equipment and staff were borrowed to ensure BHF certification. However, there was no follow-up inspection from the BHF or the state.
Viky Januk, owner of Accimed, started his business 13 years ago. He said the industry has become oversaturated in the last three years.
“Our aim is to save lives, but for some it has turned into a money-making business. It has gone from servicing a need to becoming greedy,” said Januk.
George Ilive described the industry as “cut-throat”. He worked as a paramedic for 20 years before starting a service called Medix.
“It’s very worrying that some are only interested in making money, but this comes at the risk of patients. I know of instances where crews from different private ambulance services got involved in fist fights over who should treat and transport injured patients.”
Sthembiso Ngubo, owner of Afromed, said there was a need for the industry to be regulated. Ngubo started his business two years ago and works mainly in the townships around Durban.
Oliver Wright, chief executive of the South African Private Ambulance and Emergency Services Association (SAPAESA), said there is a perception that the private ambulance industry is highly profitable.
“However, in a number of instances this is not true and a number of services close and leave the market within their first 24 months of operation.”
Heidi Kruger, head of corporate communications at BHF, said they have engaged with SAPAESA regarding conducting inspections of their members. However, nothing concrete has been put in place.
Sam Mkhwanazi, spokesman for the Department of Health in KZN, said the department currently does not have the competency to regulate private ambulance services.