Private ambulance services inadequate, unregulated and erratic even in the national capital

A senior citizen living in South Delhi was dismayed last month when he made enquiries about emergency ambulance services. With most hospitals having outsourced the service, private ambulance services have mushroomed. But the four services he called up informed that they had no ambulance to spare. One of them said it would take two hours before one would be available.

More shock was in store for him when he enquired about the rates. All four services informed that the rates would be settled and negotiated by the drivers. Weren’t there standard rates for hiring, for the driver, for oxygen, helpers and for every extra hour? If there were, they were not forthcoming.

Senior citizens living alone in the city and elderly couples with no help and no access to private vehicles are especially vulnerable. But barring a Senior Citizens’ Helpline Number (14567) which works ironically between 8 am and 6 pm, there was little to reassure them. Even in a city like Delhi they are left to themselves and good Samaritans.

“I sold off my car before the lockdown, thinking that with the Metro and app-based cabs, my limited needs for transportation could be met by public transport. But while the lockdown was a nightmare—when we read stories of ambulances charging exorbitant amounts—the situation does not seem to have improved,” says R.K. Paul, a former marketing manager.

Even a journalist who never bothered to get a PIB accreditation now rues his decision. “I now realise that the accreditation provides access to the Central Government Health Service (CGHS); without that in a city like Delhi you are doomed,” he admits with regret.

An elderly couple living on a first floor in CR Park worry what if one of them has to be hospitalised at night? It will be tough for one of us to carry the other down the stairs, if it comes to that. Ambulances with attendants and stretchers are what we would bank on. But we are being advised by well meaning friends not to wait for the ambulance in an emergency, explained K. Sengupta.

One suspects at least a part of the government’s fleet of ambulances are kept on stand-by for VIP service.

With Delhi having more than its share of VIPs, most public services are geared to satisfy their needs. And ambulances are no exception. But would it help if every police station in Delhi gets to keep two ambulances each? “Police stations during the pandemic would call up senior citizens regularly to find out if they had been infected. They surely can respond more quickly since they already have a computerized database of residents in the locality?” asks Paul.

Sengupta thinks it is a brilliant idea to attach ambulances to police stations. “They do break some heads as part of duty,” she wryly quips, “ambulances attached to them will indeed save time and hassle. And they can charge a fees for the use of ambulances since Mohalla clinics seem to be of little use in emergencies.”

Ambulances on highways, in the states and in rural areas are of course even more scarce; which is why people carry the sick on their shoulder, on hand carts, on make shift cots and stretchers and even on bicycles. In the absence of adequate number of ambulances, drivers and attendants, more victims of road accidents die in India than anywhere else.

Health ministers do make grand announcements from time to time. The Bihar health minister had promised that ambulances would reach the victim in 20 minutes in rural areas and 30 minutes in the cities. And while the state has embarked on an ambitious plan to revamp its ambulance service, people will be lucky to get the service when they need it.

Delhi Chief Minister Arvind Kejriwal had announced that Delhi Government had fixed the rates for use of its 259 ambulances at Rs.1500 up to a distance of 10 Kms. Dr. Anil Bansal, head of the anti-quackery cell of IMA says, “I have heard of the cap on charges for ambulance services during the lockdown. But I have not heard what action they have taken when users were over-charged.”

An added problem in smaller towns is the appointment of just one driver for each ambulance. If the driver is on leave, sick or intoxicated, there is no one to take his place.

Anoop Nautiyal ran the ‘108’ ambulance service in Uttarakhand for three years during 2000 to 2003 and made it a success.

“With my experience I can only say that we have to deal with the problem in totality. Roads, hospitals, accessibility of staff and sensitivity are required for the system to work. It’s all about management. It’s either there or not there. No piecemeal solution would work.”

(This was first published in National Herald on Sunday)