THE health ministry and the fire brigade are expected to wrap up a series of meetings this week, aimed at finding a way to move the island’s nine year-old Emergency Medical Services (EMS) from the pilot stage and expand it to cover other parishes across the country.

Nearly 2,000 persons in western Jamaica use the EMS every year, according to Assistant Superintendent Gifford Blagrove. He is in charge of the service now offered in St James, Hanover and Westmoreland and is among those who think it is time for the EMS to be offered in more locations. The original plan had been for the service to be expanded after two years.

“Sometimes it’s pressuring for us, because of the volume of calls we have to answer, and as you know we only have one ambulance for each station; the need is great,” Blagrove said.

But acting fire chief Frederick Whyte has warned that it may not be a good idea to expand the services now being offered in Ironshore, St James; Lucea in Hanover; along with Negril and Savanna-la-Mar in Westmoreland.

The current EMS service, he intimated, has challenges that need to be addressed.

“To have an effective EMS, we would need more ambulances; we cannot respond to an emergency if that one unit is out of service for repairs or maintenance,” Whyte said.

His predecessor, Major George Benson, had also been against plans to expand the service when the issue was mooted last year. The former fire chief had raised the issue of inadequate medical supplies as one of the many problems plaguing the EMS.

“Phase one still has many problems; why should we then think of going on to phase two without getting phase one up and running?” Benson had argued during a Public Accounts Committee (PAC) meeting in Parliament.

“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,” he complained then. “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.”

But last week, Blagrove said conditions had improved since then and their operations have been running fairly smoothly – except for the beating the ambulances are taking on the pothole-riddled roads.

“Even though these ambulances are fairly new, because of potholes and wear and tear we had to take them out over a period of time to get them serviced,” he said.

“Sometimes we have to send them into the garage before the regular maintenance schedule, because of the (poor condition of the) roads. Right now, maybe they’re not a hundred per cent, maybe 90 per cent.”

The EMS, which operates as a pre-hospital service in emergencies, caters to the needs of the general public and even though housed at fire stations does not restrict its service to fire victims. The response from the public, Blagrove explained, has been overwhelming.

“Whatever the emergency is, they call us because that’s what we are trained to do.

Basically, we respond to every form of medical emergency. They call us for everything and we go, we assess and we treat and transport the best way we can,” he added.

The fire brigade is responsible for staffing, providing EMS bases, maintenance and upkeep of ambulances. The health ministry is responsible for providing the ambulances, equipment and medical supplies.

During the 2004/2005 financial year, the fire brigade spent $38 million on the EMS. But with cuts in this year’s budgets of both the fire brigade and the health ministry, questions are being raised about the wisdom of trying to expand the service at this time.

Last week, Whyte also raised the issue of staffing, saying each EMS site would need 13 persons, broken down into a three-man four-shift crew, plus a supervisor.

In June 2003, the first batch of 27 police officers graduated from the University of the West Indies’ Pre-Hospital Emergency Medical Services after being trained as emergency medical technicians. They were trained with the expectation that the EMS service would have been available in other sections of the island by now.

Two other EMS sites have been identified – Linstead and Portmore, both in St Catherine – but these are yet to become functional because of financial constraints, the acting fire chief said.

“Some amount of work was carried out on both the Linstead and Waterford fire stations to accommodate these sites, the ambulances have been procured and the required staff have been trained for these two sites, but to date these two sites are yet to come on stream,” Whyte said.

To solve the problem of financing the EMS, there had been suggestions that user fees could be charged once the service was expanded.

Whyte believes that is an avenue worth pursuing.

“The suggestion in regards to paying for the service has not materialised and we in the brigade would agree to a cost for those who can afford to pay, depending on the circumstances,” he said.

Patients who use the EMS during accidents, he suggested, could be exempt from user fees, but payment should be made if the services were used by hotels and other institutions that needed to have someone taken to the hospital.

The issue of user fees was among the topics expected to be discussed during the meetings between the health ministry and the fire brigade over the past week.