Ambulance situation is risky business

Hospital administrators were forced to wait eight months for government to release funds for desperately needed new ambulances on Grand Cayman, all the while putting patients in danger.

In the interim, hospital administrators have been forced to take increasingly risky measures to cover for two ambulances (out of a fleet of three) that are tens of thousands of miles beyond their expected life span and keep breaking down.

Grand Cayman is usually served by three ambulances at any one time – one based in George Town, one in West Bay and another based in North Side. A fourth, newer ambulance was written off in a road smash in August 2008 and has yet to be replaced.

For over a month, paramedics based in West Bay have been responding to emergency calls in an old, storm-damaged back-up ambulance that has “non-emergency care” written across the front of the vehicle while their usual ambulance has been getting repairs.

When the vehicle based in North Side broke down recently, paramedics were deployed to the Frank Sound Fire Station, where they responded to emergency calls in a fire response van, providing emergency care until the George Town ambulance could arrive on-scene to transport patients.

The Caymanian Compass understands that while Cabinet agreed to buy three new ambulances for the island in late August or early September, hospital administrators only received the funds – about $300,000 – in the past few weeks after getting Finance Committee approval.

Paramedics and hospital administrators are privately seething about the situation, although none would comment publically about the funding delay.

Questions given to Ministry of Health Deputy Chief Officer Leonard Dilbert about the funding delay had not been responded to by press time Monday.

Three new ambulances, which were finally ordered in recent weeks, are expected to arrive on island in the coming months – one at the end of April followed by two more towards the end of May.

HSA Medical Director Dr. Greg Hoeksema would not comment on the funding delay, but agreed that the situation with ambulances on Grand Cayman has been far from satisfactory for a long time.

“It creates an uncomfortable situation for us,” he said. “The more miles they have, the more they break-down.

“Obviously we want to be able to supply emergency services within internationally accepted standards of response times.

“When we have an ambulance that cannot be on the road, it forces us into a contingency plan which is lower than the nation has come to expect for emergency medical services,” Mr. Hoeksema said.

“It forces us into a position that we don’t want to be in.”

Health Services Authority CEO Lizzette Yearwood told legislators in June 2008 that international safety regulations give ambulances a useful life of 120,000 miles or five years.

At that time North Side MLA Edna Moyle expressed concern that residents in the eastern districts were being put at risk by out of date ambulances.

“I was told that this ambulance has over 142,000 miles on the dash,” she said. The Compass has since learnt that another vehicle has over 178,000 miles on the dash.

“This is an area of growing concern for us at the Health Services Authority,” Ms Yearwood noted during the Legislative Assembly meeting. “The problems that we face with ambulances are similar to that of the other capital equipment. We don’t have the cash up front in order to be able to fund some of these big capital items.”