Plans to expand the much-needed Emergency Medical Services (EMS) will go ahead, despite a heated argument between the two partners – the health ministry and the Jamaica Fire Brigade – almost a decade after the EMS was launched as a pilot project in western Jamaica.

The health ministry believes it is time to expand the service, but the Fire Brigade disagrees, saying it is not yet ready to move on.

inistry of Health, phase one still has so many problems, why should we then think of going on to phase two, without getting phase one up and running,” said fire chief, Major George Benson, when the issue surfaced at last Tuesday’s meeting of the Public Accounts Committee (PAC) of Parliament.

PAC Chairman Audley Shaw questioned Benson about the problems facing the Fire Brigade, which has led to its $416 million indebtedness to the Government for statutory deductions not paid over from the salaries of its employees.

Benson listed the EMS as one of the areas the Brigade had taken. He explained the role of the two partners, saying that the Fire Brigade handled the day-to-day operations of the service, while the health ministry was involved in training, setting standards and monitoring the health care that was provided.

He said that the EMS was still in a pilot stage, even though it was launched on April 1, 1996 and is still centred in the western end of the island – Savanna-la-Mar and Negril in Westmoreland and Ironshore near Montego Bay.

“Last week, two stations, Negril and Sav, had to be closed down temporarily for want of oxygen, for want of other health equipment that we just didn’t have,” Benson complained. “We couldn’t respond without the oxygen, because it would be pointless to. They don’t have ‘Savlon’, they don’t have bleach, they don’t have bandages, they don’t have gloves. These are supplies which, under the present arrangements, are provided by the Ministry of Health and these supplies are not forthcoming.”

Firing back, Marion Bullock-DuCasse, director of the ministry’s emergency and disaster management and special services, argued that eight years was a long time for the pilot to continue and that, in fact, that phase had only been expected to last about two years. However, she added, her department had used the opportunity to assess the problems and better prepare itself for an expanded programme.

Despite the differences, the representatives of the Fire Brigade, including Major Benson, and the health ministry, led by Bullock-Ducasse, met last Wednesday and decided to go ahead with the next phase. This new phase will expand into Waterford and Linstead in St Catherine and May Pen, Clarendon and St Ann’s Bay, St Ann.

Bullock-Ducasse pointed out that the new, expanded phase would, for the first time, include the use of hospitals in May Pen and St Ann’s Bay.

Up to now, the EMS has been operated from fire stations in the various towns. For example, Benson told South Central St Catherine MP Sharon Hay-Webster that Waterford and Linstead were chosen over St Catherine’s capital town of Spanish Town, because their fire stations stations were better suited.

Explaining how the EMS works, Bullock-DuCasse said the service – fashioned off similar ones overseas – provided an ambulance and medical crew in cases of emergencies, such as road traffic accidents, life-threatening trauma, cardiovascular emergencies, acute respiratory distress, severe bleeding and even for women in labour.

Users call the emergency number 110. The call is forwarded to the nearest EMS station. An emergency medical dispatcher answers and sends out a crew, which will go to the scene and do an assessment. Treatment commences after the crew gets in touch with a hospital and is advised what to do.

Admitting that there were problems with the project, linked mainly to the current cash crunch in the public sector, Bullock-DuCasse said that she had advised the ministry to strengthen its Inventory and Re-ordering System, which should improve the procurement process.

She said that in many cases, suppliers demanded payment in advance or credit time and that the credit system was “not working perfectly”. However, she said, the ministry’s Emergency Care Programme, of which the EMS was a part, was a priority and something had to be done quickly to rectify the situation.

The next level of the programme would not only include hospitals, as EMS centres, but for the first time trained Emergency Medical Technicians (EMTs) at the intermediate level, a step above the firefighters who have only basic EMT training.

She said that the training, which was done at the University of the West Indies, was funded by the Inter-American Development Bank (IDB). The IDB had also financed the purchase of nine new ambulances which were already in the island for the new phase.

Bullock-DuCasse admitted that the programme would take some time to enter the Corporate Area, and it was not yet capable of taking on the level of use expected from such a heavily populated area.

However, she noted that while the programme was now free to users, it would not remain so for much longer.

“We are looking at introducing cost recovery with the implementation of the new sites,” she said, adding that users would have to pay at the hospital.