SINGAPORE CIVIL DEFENCE FORCE (Competence of paramedic and ambulance attendants)

Mr Low Thia Khiang asked the Minister for Home Affairs how his Ministry ensures that paramedic and ambulance attendants of the Singapore Civil Defence Force are competent and exercise due diligence in deciding whether a person is in need of emergency help.

The Minister of State for Home Affairs (Assoc. Prof. Ho Peng Kee) (for the Minister for Home Affairs): Sir, the Emergency Ambulance Service of the Singapore Civil Defence Force (SCDF) is currently operated by SCDF paramedics as well as Ambulance Officers (AOs) seconded from the Ministry of Health (MOH).

Sir, to ensure that they are competent, SCDF paramedics and AOs undergo rigorous training before becoming fully operational.

SCDF paramedics are trained at SAF's School of Military Medicine. The paramedic training syllabus is recognised by the Paramedic Academy of Justice Institute, British Columbia (Canada), and endorsed by MOH. The training lasts 18 months and includes attachments to hospital Accidents and Emergency (A&E) departments and fire stations. After completing their training, the paramedics undergo a programme of assessment and testing by senior doctors from MOH before being certified operational.

Sir, the AOs are registered nurses seconded from MOH. In addition to their nursing training, they undergo pre-operational training and the protocol conversion course similar to that of the paramedics. The AOs undergo stringent assessment by the Singapore General Hospital before being allowed to operate independently.

Both the paramedics and AOs are regularly re-certified to ensure that their knowledge and skills are up to standard and updated.

Sir, do they exercise due diligence? The paramedics and AOs are guided by a set of protocols and procedures drawn up by SCDF's Medical Advisory Committee which comprises a group of specialists from various medical institutions. Ambulance crew use essentially the same emergency/non-emergency verification system adopted by the hospital A&E departments. Nevertheless, the guiding principle for the paramedics and AOs is that, when in doubt, the patients are to be conveyed to the hospitals.

Sir, besides rigorous training and operational guidelines, the SCDF also has an internal audit system to review cases where death occurs (eg, death on arrival). There are also frequent and regular spot checks on the professional care provided by the ambulance officers and paramedics. SCDF also monitors their performance through feedback from the hospitals.

Sir, I would like to assure the House that our ambulance crew are competent and do exercise due diligence in deciding whether a person is in need of emergency help.

Mr Low Thia Khiang: Sir, I would like to ask whether the Minister of State is aware of the recent case in which a student was attended to by a paramedic and who was certified to be all right but died later in hospital. If so, would he like to tell this House what had happened to the case?

Assoc. Prof. Ho Peng Kee: Sir, certainly all of us are aware of the case. It is an unfortunate case. But as there may be a coroner's inquiry, I cannot say very much now in this House. But what I can say is that when the ambulance was called the Ambulance Officer who attended to the boy had properly carried out the assessment on him, according to the set of medical procedures approved by SCDF's Medical Advisory Committee. Her assessment was that it was a non-emergency situation.

Mr Low Thia Khiang: After this case, does the Minister of State see the need to revise the guidelines because it may apparently be a wrong assessment resulting in the death of a person?

Assoc. Prof. Ho Peng Kee: Sir, I think the question is premature. Like I said, there may be a coroner's inquiry. He is assuming that it is a wrong assessment. What I have said before is that the procedures are very clear and the instructions are that if in doubt, the patient will be conveyed to hospital.