A priority case

PUBLISHED : Friday, 26 March, 2010, 12:00am
UPDATED : Friday, 26 March, 2010, 12:00am

Legislators must stop dithering and approve the new system for prioritising the use of ambulances - the Medical Priority Dispatch System (MPDS). They can take the first step at the security panel meeting on April 13. Once they endorse the plan, the government can seek funding from lawmakers and implementation can begin.

What problem does the MPDS address? Say someone in your family is taken suddenly ill - perhaps the problem is even life-threatening. You call 999 for an ambulance. The government's current policy is to provide a free, first-call, first-serve service within 12 minutes in 92.5 per cent of the cases - no matter what condition the patient is in. Say someone calls one second before you with just a twisted ankle; that caller gets the ambulance first.

It has taken some years for the government to adopt a new policy - the MPDS, which prioritises ambulance responses, sending them to the most critical cases first in a reduced time of nine minutes. These include stroke and heart attacks, where the earlier the patient gets to hospital, the better the chance of survival.

Serious but non-life-threatening cases will continue to be met in 12 minutes; non-serious cases, like a twisted ankle, will be served within 20 minutes. These three-tier targets compare well to best practices around the world.

Not surprisingly, the result of the government's four-month consultation conducted last year showed overwhelming public support for prioritising ambulance responses in accordance with the degree of urgency of the calls. Ordinary folk understand the common sense of this system and the MPDS has the endorsement of doctors and hospitals as well.

The new MPDS would focus on retraining the dispatch staff working in the Fire Services Department's central call centre in Tsim Sha Tsui. They would operate under the new, medically approved protocol designed to increase the chances of saving lives. The current staff at the dispatch centre does a good job; there is no reason to think they cannot be trained to operate the MPDS well. The government's new policy is thus the critical chain in improving the effectiveness of the ambulance dispatch service. The faster an ambulance is sent out on a call, the earlier it will arrive, and the sooner the patient can reach a hospital - resulting in a better chance of effective medical help.

The next chain is the ambulance service itself. Ambulance officers are trained to give pre-hospital care to prevent the deterioration of a patient's condition. The MPDS will affect them minimally: an ambulance heading to a non-acute case may be asked to go to a different destination instead, to pick up a critical case. The ambulance staff unions' view of the MPDS has been fascinating. They have no objection to the MPDS in principle, and they have understandably called for more ambulances and staff to be hired - which is a part of the government's plan in any case. But they have also called for a two-tier dispatch system with a six-minute response time in critical cases and 11 minutes in non-critical cases.

This sounds attractive: why not have the fastest dispatch response time in the world? To do this, Hong Kong just needs to throw more money at the problem, buying more ambulances and hiring more ambulance staff. To go from the current 12-minute response time to six minutes and 11 minutes, in a two-tiered system, would shift the issue away from implementing the dispatch system at the central call centre to beefing up ambulance crews. Perhaps this is what the unions want because it increases their staff strength - but it would be in their interest and not that of either the public or the administration as a whole.

Legislators should not let their attention be diverted. They should stay focused on what is in the community's best interest. The government's proposal is a meaningful step forward, and Hongkongers should not have to wait longer to have it implemented. Further improvements can come later. Let's focus on helping to save lives.

Christine Loh Kung-wai is chief executive of the think tank Civic Exchange