Emergency case

Finally, the government is serious about introducing a new, three-tier ambulance dispatch system and has launched a four-month-long consultation after years of dithering. Officials know it will save lives, so why it took so long for a relatively simple initiative to get to the top of the policy queue is part of the mind-boggling mystery of Hong Kong's bureaucracy.

The current system provides a target response time of 12 minutes, and aims for a 92.5 per cent success rate on a next-in-queue basis. However, the system is based on a 'first-come, first served' basis that ignores those requiring priority. In the case of a stroke or heart attack, for example, getting medical help within the first 10 minutes dramatically increases the chance of survival or recovery, but the current system does not take this urgency into account. Thus, the system is a 'dumb' one that cannot recognise serious cases.

There is an alternative: 'smart' systems, such as those employed in about 20 jurisdictions around the world. This requires the person who receives the emergency call to ask a set series of simply framed questions, the answers to which enable the operator to categorise the degree of urgency. The questions are designed by medical professionals and the whole protocol is internationally recognised to enable a trained person to determine whether it is a top-priority case. If there is any doubt, an urgent dispatch call-out is implemented, to be on the safe side.

For instance, Toronto's response-time target for life-threatening emergencies is nine minutes in 90 per cent of cases. In London, the standard for the most critical emergency calls is 8 minutes in 75 per cent of cases. For non-acute calls, Toronto sets a target of 21 minutes for 90 per cent of these cases. London has not set a target for serious or life-threatening cases.

Here in Hong Kong, some legislators have expressed doubts about whether the protocol works or not. Evidence elsewhere is quite conclusive - it does work; it saves lives.

Under Hong Kong's proposed medical priority dispatch system, all emergency ambulance calls would be divided into three response modes: nine minutes for life-threatening cases, 12 minutes for urgent ones and 20 minutes for less-serious cases.