The Ministers for Health and ACC have announced a significant increase to ambulance funding today (Thursday, 30 October 2008, 3:22 pm)

Minister of Health, David Cunliffe and Minister for ACC Maryan Street today announced a $47 million funding injection for the ambulance sector over the next five years.

"Earlier this year I directed the Ministry of Health to develop a strategic plan for the ambulance sector," Mr Cunliffe said.
"I am pleased to allocate this funding to advance the ambulance services provided to all New Zealanders."

Mr Cunliffe said the sector had some urgent needs and this funding would go some way in addressing those.
"I expect this funding to be used to reduce part charges by the ambulance sector and to address in part the issue of single crewing." Mr Cunliffe said where the funding would be invested would be further reviewed once consultation had been completed on the draft ambulance strategy.

The Government released a draft New Zealand Ambulance Service Strategy in September, and comments from the public are welcome until 12 December 2008. ACC and the Ministry of Health recently created a joint venture organisation, the National Ambulance Sector Office (NASO), to coordinate crown funding for emergency ambulance services and to provide a national view for the sector. NASO is soliciting comments on the draft strategy through http://www.naso.govt.nz. "I hope that all concerned parties will provide comments on the draft strategy," Ms Street said

"The goal of the strategy is a cohesive, safe, sustainable, quality, cost-effective appropriate and efficient ambulance service for New Zealand," said Ms Street. Mr Cunliffe noted that he had directed NASO to implement funding changes on the basis of the findings of the strategy consultation by 31 March 2009.

Press Release: New Zealand Government
From: Hon David Cunliffe - Minister of Health and Hon Maryan Street - Minister for ACC

Initial Union Commentary

• The additional funding announcement is a long overdue and much welcomed increase to boost an emergency service in crisis.
• If the additional funding is spread across the five year period (7 million in the first year and 10 million for each of the subsequent years), and is part of the continued funding (not a one-off payment) and adjusted for inflationary pressure, the additional announcements could provide for over 600 new career Paramedics and would radically transform New Zealand's Ambulance Services. If the funding is a one-off increase its potential impact is far less significant.
• Political ideology on public healthcare provision following Election '08 has the potential to derail the intended funding increases.
• We are pleased that the minister has signaled that this money would in part be used to reduce single crewing of ambulances. The increased safety this will bring career Paramedics and the patients and public they service will be immeasurable.
• Whilst we believe that the provision of emergency ambulance services to the public free of charge where the use is medically or socially justified is appropriate, any reduction or withdrawal of part user charges must be coupled with the adoption of stronger demand controls on the misuse of ambulances. This will require greater communication centre vetting of frivolous calls, probably the registration of Paramedics (including increasing the educational requirements and scope of practice), and effective systems to manage abuse and defer minor cases to alternative health care providers, including the ability to educate the public on the appropriate use of ambulance services and refuse transport where this is not medically justified.
• Consultation is currently occurring on the draft NZ Ambulance Sector Strategy. The NDU will be making a submission and is encouraging all its members to take a proactive role in the forthcoming consultative meetings. We do however note that the very lofty goals of this newly established group will require prioritisation of action. Effective disbursement of additional funding is best achieved where a robust model for applying funding increases based on a complete review of the ambulance network has occurred. At present, no effective model exists and it is unlikely to in the short term. We want to see a robust model based on not only workload and population, but on other factors including access to tertiary hospitals, helicopters, community demographics, geographic risk etc.

Craig Page, Ambulance Sector Coordinator for the National Distribution Union says Wairarapa ambulance services are chronically short staffed, under resourced and at risk of failing.

"This is partly because they pay their paramedics $10,000 a year less than their St John counterparts.

"We are trying to negotiate a multi employer collective agreement to bring all the paramedics in the district on to the same conditions but the DHB refuses to come to the table.

"An improved agreement would provide a platform for ensuring paramedics could be retained and recruited and be the first step towards establishing a safe and sustainable service for the area."

Mr Page says the base ambulance coverage during normal working hours is two ambulances for a population of nearly 40,000.

"This is critically low and because of the isolation of the area there is a real risk that if the workload were above normal, or there was a serious event, the service would not cope."

Ambulance Sector Coordinator Craig Page says the union is pleased that paramedics will be recognised as frontline health care providers and welcomes a move towards national consistency in service delivery. He is not so happy with other aspects of the strategy.

"The draft fails to comment on the critical safety issue of single crewing in ambulances," he says. "There has been widespread public concern about this and it should not be ignored. "We are also disappointed there is no specific model for service delivery to rural and provincial communities. Population based models don't work well in these areas."

Mr Page says the report should have looked at whether ambulance services should continue to be run by individual District Health Boards.

"These services are increasingly complex and expensive and the NDU has previously recommended that there should be only one national ambulance provider. "We were not consulted prior to the release of the draft strategy. As a representative of paramedics we are a key stakeholder and should have been part of the development committee."