SINGAPORE CIVIL DEFENCE FORCE AMBULANCES (Raising of charges in non-emergency cases)

Assoc. Prof. Chin Tet Yung asked the Minister for Home Affairs what are the reasons for raising the charges for the use of Singapore Civil Defence Force (SCDF) ambulances in non-emergency cases, given that there will be a concerted publicity campaign to encourage people to use the service provided by Commercial and Industrial Security Corporation (CISCO); and whether the SCDF can, as an alternative measure, re-route calls to CISCO when non-emergency cases are involved.

The Minister of State for Home Affairs (Assoc. Prof. Ho Peng Kee) (for the Minister for Home Affairs): Mr Speaker, Sir, the Singapore Civil Defence Force's Emergency Ambulance Service (EAS) is primarily intended for response to life-threatening emergencies. SCDF ambulances are thus equipped with state-of-the-art equipment such as defibrillators and other resuscitative devices, and ambulance crews are specially trained to give basic life support to the seriously injured or sick. SCDF currently charges only $50 for each non-emergency call, although the full cost is $110 each time one of our ambulances is called out. Most private ambulance operators currently charge $50 to $70 per trip, but their ambulances are not similarly equipped.

The EAS is increasingly being misused by the public, despite SCDF's sustained public education efforts. Although emergency calls have hovered around 40,000 per year over the last five years, non-emergency calls have nearly doubled - 11,000 in 1992 to 20,000 calls last year. Another way of looking at this is that roughly 1 out of every 3 ambulance calls was unnecessarily handled by the SCDF, when a private ambulance or even a taxi would have served the purpose.

Each time the EAS attends to a non-emergency call, it is less able to respond in time to a real emergency. We must take decisive steps to stop this abuse. Our approach is two-pronged. First, SCDF has helped to set up a private non-emergency ambulance hotline, 777-0000, currently operated by CISCO. SCDF has widely publicised it, using the mass media as well as distributing brochures to every household. We have achieved modest results so far. But we need to do more to encourage the public to switch over and call for private ambulances when they do not have an emergency on hand.

Secondly, from October 1997, every non-emergency EAS user will be billed $75, which barely recovers three quarters of the cost. From October 1998, non-emergency users will have to bear the full cost, which will be at least $110. Many countries such as the United States, Canada and Australia are charging full cost for their non-emergency ambulance services so that critical resources are properly allocated. Indeed, users even have to pay for emergency ambulance services in these countries.

SCDF already re-routes an average of 10 to 15 calls a day to the CISCO hotline. But this still unnecessarily involves the SCDF and is only a small fraction of the number of non-emergency calls received by it. The measures we are introducing will have greater impact. They are designed to relieve the SCDF of unnecessarily taking calls or attending to non-emergency cases, so that it can be more effective in its core responsibility of attending to real emergencies.

Assoc. Prof. Chin Tet Yung (Sembawang): Sir, can the Minister of State explain how a decision is made between non-emergency cases and emergency cases? Who decides?

Assoc. Prof. Ho Peng Kee: Sir, in a large percentage of cases it is not possible to ascertain on the telephone whether it is an emergency or non-emergency case. Indeed, when a person calls the SCDF he will say that it is something that requires attention straightaway. In these cases, SCDF will not take the risk and they will go to the ground. There is a staff nurse who is well trained and there are guidelines. In instances when it is non-life threatening, for example, a headache or backache or sometimes a bad toothache, and so forth, the user will be told that it is a non-emergency situation. If the person insists that it is an emergency and he must get to the hospital straightaway, SCDF nevertheless will take him to the hospital. After which, SCDF will check with the hospital and the doctor, having treated the person, will tell us the situation. If it is a non-emergency case, we will treat it as such.