HSE spending on private ambulances doubles

Health Service Executive (HSE) spending on private ambulance providers has doubled in a four-year period, new figures show.

Last year the HSE spent €7.8 million on private ambulance operators, mainly to provide patient transport in rural areas.

A new framework contract for private ambulance providers that is being prepared by the HSE has an annual estimated value of €13.7million.

The figures, obtained under the Freedom of Information Act, show rural hospitals have the largest spend on private ambulance services. Letterkenny General Hospital spent €738,981 last year, Mayo University Hospital €770,943, and Sligo Regional Hospital €634,347.

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In 2012, the HSE spent €3.7 million hiring private ambulance companies, according to related data obtained by Sinn Féin TD Louise O'Reilly from a parliamentary question. Spending on the private firms rose to €4.4 million in 2014, and up to €6.1 million in 2015. In total the Health Service has paid €26 million to private ambulance operators since 2012.

Private ambulance operators are mainly used to transfer patients to and from hospitals for scheduled appointments, or between hospitals, and they do not respond to emergency calls.

The use of the private companies by the HSE has increased steadily since 2012. Letterkenny Hospital spent €82,694 on private ambulance services in that year, while its spending for 2015 stood at €835,615.

Reliance

Ms O’Reilly said the “failure to properly resource the National Ambulance Service has led to an increasing reliance on private ambulances”. The current “supply of public ambulance services is not delivering for communities”.

In documentation, HSE explained “there is a significant requirement for transfers of non-urgent public patients” to and from hospitals, and private operators were used to help meet this demand.

Four private ambulance companies are part of the current approved framework of service providers for the HSE: Lifeline, Medicall Ambulance, Beaumont Private Ambulance and Murray Ambulance.

The HSE also uses a small number of private companies not on the approved framework when the four firms are unavailable.

Last May the HSE began the process of accepting bids from companies to be included in a new framework agreement. The estimated cost of the contract is €55 million over four years.

Clinical standards

The Pre-Hospital Emergency Care Council (PHECC) is responsible for licensing private ambulance operators, and certifying clinical standards. There is no legal requirement for a private ambulance company to be certified by the PHECC.

David Hall, owner of Lifeline Ambulance Services, one of the largest private providers, said the sector needed stronger regulation to ensure quality standards for patients. “It is completely unacceptable that the sector is not regulated. There are no statutory licences, there is no inspections of providers.”

The HSE only employs private ambulance services that have been certified to the standards of the PHECC, and National Ambulance Service vehicles are required by law to be certified by PHECC.