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Preference: Administration and Health Services

2

Latest figures released on overseas travel emergencies

Foreign Minister Julie Bishop has urged all Australians who travel overseas to ensure they are fully insured for medical emergencies and sickness when abroad.

In 2016-17, Australia’s consular officers around the world helped more than 12,000 nationals in trouble overseas, in cases that included 1,701 hospitalisations and 1,653 deaths.

There were also 1,642 arrests overseas, 2,546 whereabouts inquiries, 3,081 welfare cases, and 1,090 victims of crime.

More than 10 million departures from Australia were recorded in 2016-17. 

“With so many Australians travelling, things can go wrong including robbery, injury, assault and arrest,” Ms Bishop said.

“However, there are limits to the assistance the Government can provide.

“Australians who choose to travel overseas should be as prepared and self-reliant as possible. Appropriate insurance is essential. If you can’t afford travel insurance, you can’t afford to travel.

“Uninsured travellers who are hospitalised overseas or need medical evacuation can face crippling medical bills. Medicare and the Government will not cover those expenses.”

Early in October, the Minister launched the 2016-17 Consular State of Play – a statistical snapshot of consular assistance provided to Australians abroad by the Department of Foreign Affairs and Trade (DFAT).

It showed that Australian residents took 10,039,700 trips during that financial year, having grown about five per cent annually over the past five years.

While only one in one thousand Australians who are overseas at any given time during a year need the Australian Government’s assistance with problems, priority is given to cases involving particularly vulnerable Australians such as children, the mentally impaired, and victims of assault (including sexual assault).

The destinations where Australian travellers have received consular help the most are New Zealand, Indonesia, USA, the UK, Thailand, China, Singapore, Japan, Fiji and India.

The 30-39 year-old age group received the most help (18 per cent of cases), followed by 40-49 year-olds and 50-59 year-olds (17 per cent each), 20-29 year-olds (15 per cent), 60-69 year-olds (12 per cent), and 10-19 year-olds (8 per cent).

Children up to nine years old who received help accounted for eight per cent of cases, while the 70+ age group accounted for five per cent.

According to the 2017 Australian Travel Insurance Behaviour survey (commissioned by DFAT and Understand Insurance and released at the same time as the Consular State of Play), 48 per cent of recent cruise ship travellers bought the wrong kind of insurance for their travel.

“Travellers need to choose the right insurance for their trip. Many travellers mistakenly believe their insurance provides appropriate cover,” Ms Bishop said.

“I urge all Australians planning overseas travel to visit the Smartraveller website for advice and to read the Consular Services Charter, which explains what services the Government can provide if assistance is required while overseas.”

The Consular State of Play 2016-17 can be found at: http://dfat.gov.au/about-us/our-services/consular-services/Pages/consular-state-of-play-2016-17.aspx . 

CHRIS JOHNSON 

[Editorial] Decisions only she should make

From a teenager seeking safe abortion in the USA, to the multiple actresses with sexual harassment allegations against the film producer Harvey Weinstein, recent media reports concerning the rights of women and girls share the familiar sense of objectification of female bodies by men in power and lost agency in sexual and reproductive rights. The latest draft of the 2018–22 strategic plan of the the US Department of Health and Human Services (HHS) defined the HHS mission as “serving and protecting Americans at every stage of life, beginning at conception”.

PHI reforms in right direction, but more work needed

The AMA has welcomed the Government’s reforms to private health insurance as a “start in the right direction”, but says much more needs to be done to make the sector more transparent and affordable.

On October 13, the Federal Government announced a raft of changes to the private health insurance (PHI) sector, following lengthy consultation and an ongoing consumer backlash against the industry.

The changes include encouraging younger Australians to take up PHI by allowing insurers to discount premiums up to two per cent for each year as an adult before turning 30, to a maximum of 10 per cent. This will be phased out by the time they turn 40.

Regional patients will benefit from policies that will for the first time include travel and accommodation subsidies for some hospital services.

A hierarchy of Gold, Silver, Bronze and Basic policy categories will be introduced to help consumers compare what is on offer.

But even policies under the Basic classification will provide mental health services, which are not currently covered under many polices.

Existing policy holders will be able to upgrade their cover in order to access in-hospital mental health services without having to endure a waiting period. And insurers will not be allowed to limit the number of in-hospital mental health sessions a patient can access.

Insurers will be able to keep premiums down by offering higher excess levels.

From April 2019, unproven therapies such as Pilates, yoga, homeopathy, aromatherapy, iridology and herbalism (among others) will not attract rebates.  

A prosthetics deal between the Government and manufacturers aims to reduce the cost to private insurers for the devices, and subsequently pass on savings to consumers.

In announcing the changes, Health Minister Greg Hunt said reform in the sector would continue, with the Private Health Ministerial Advisory Committee still examining issues such as risk equalisation.

“And we will work with the medical profession on options to improve the transparency of medical out-of-pocket costs,” Mr Hunt said. 

“The Turnbull Government is committed to private health insurance and we’re committed to supporting the more than 13 million Australians that have taken out cover.

“We are investing around $6 billion every year in the private health insurance rebate to help keep premiums affordable.”

The Opposition, however, has described the reforms as “too little, too late” and criticised the Government for not addressing the so-called “junk policies” that are hardly worth the paper they are written on.

Shadow Health Minister Catherine King said junk policies should be banned.

“The fact that the Government has broken its election promise and retained junk policies remains concerning to me,” Ms King said.

Consumer group CHOICE has also criticised the failure to ban junk policies.

AMA President Dr Michael Gannon said the announced changes to PHI would not solve the problem of a perceived lack of value in the services provided by the PHI sector.

Health fund membership has been falling by 10,000 a month, as premiums increase an annual average of 5.6 per cent.

Dr Gannon said Australia needs a strong and viable private health sector to maintain the reputation of the Australian health system as one of the world’s best.

But the reforms will need the genuine commitment and cooperation from all stakeholders to deliver real value and quality to policyholders.

“The framework for positive reform of the private health insurance industry is now in place,” Dr Gannon said.

“The challenge now is to clearly define and describe the insurance products on offer so that families and individuals – many of whom are facing considerable cost-of-living and housing affordability pressures – have the confidence that their investment in private health delivers the cover they are promised and expect when they are sick or injured.”

Dr Gannon welcomed the decision to introduce Gold, Silver, and Bronze categories for PHI policies and that standard clinical definitions will be applied.

“Importantly, the changes will provide better coverage for mental health services and for people in rural and regional Australia,” he said.

“The AMA advocated strongly for standard clinical definitions on behalf of our patients. What we need to see now is meaningful and consistent levels of cover in each category.

“While we had called for the banning of so-called junk policies, we will watch closely to ensure that any junk policies that remain on the market are clearly described so that people know exactly what they are buying and are not subject to unexpected shocks of non-coverage for certain events or conditions.

“Basic cannot mean worthless.

“We will continue to call out any misleading products in our yearly report card.

“Other areas that will need further investigation include the fine detail of the new prostheses arrangements, how and at what level pregnancy will be covered, and the review of low value care for things like mental health and rehabilitation.

“We welcome the removal of coverage for a range of natural therapies such as homeopathy, iridology, kinesiology, naturopathy, and reflexology, which the Chief Medical Officer has rightly declared as lacking evidence or efficacy.”

Dr Gannon said the AMA has concerns about the possible direction of ongoing work on out-of-pocket costs and the review of privately insured patients being treated in public hospitals.

“We will be pushing for the expert committee considering out-of-pocket costs to broaden its review beyond doctors’ fees.

“Doctors’ fees are not the problem – 95 per cent of services in Australia are currently provided at a no-gap or a known gap of less than $500,” he said.

“The out-of-pockets committee must instead focus on the issues that leave patients with less support such as the caveats, carve-outs, and exclusions; hospital costs; and inconsistent and tricky product definitions.

“We will of course support efforts to rein in unacceptably high fees in the small number of cases where they occur.

“And we will be vigilant on any moves to deny private patients access to care in a public hospital. This is a critical and complex area that needs careful consideration. It is especially critical if the Government is going to promote basic and public hospital only cover.”

Dr Gannon told ABC Radio that the changes were “perhaps” a start in the right direction, but that ongoing work was required.

“The one thing the Minister is up against, one thing that future Governments will be up against is the inevitable increase in the cost of health care,” he said.

“Health CPI runs at four, five, six per cent per year. We’re interested in some of the one-off savings that the Minister is going to be able to achieve, but it’s going to require ongoing work.

“The different players in the industry, the hospitals, the doctors, the insurers, need to continue to try and work with Minister Hunt on savings in the system. He’s come up with some good ideas here.

“So, for example, he has managed to negotiate some savings with the people who manufacture prostheses. That’s how he intends to deliver on cheaper hip replacements.

“But he’s got cost control when it comes to doctors’ fees. They’ve been in many ways frozen for nearly five years now. That’s not the problem in the system. The biggest problem in the affordability of private health insurance is the amount that’s going into the pockets of the for-profit insurers.

“Now I’ve spoken to the Minister about this. The genie is not going back in the bottle…

“There are too many tricks in the current system, too many carve-outs, and too many caveats. Too many people who find out they’re not covered for the first time when they’re actually sick.

“We went to the Minister and said we want to get rid of junk policies. We’re not overly excited about the idea of maintaining Basic, but he came back to us and other stakeholders and said ‘look we need to do something about affordability’. So I think, at least for now, we’re stuck with Basic.

“But as long as people know what they’re getting, as long as there’s no tricks on clinical definitions. People shouldn’t need to be six months into a medical degree to know what they’re actually covered for.”

CHRIS JOHNSON

 

Tensions reach boiling point over codeine changes

 

The row between the Pharmacy Guild and the medical community over the coming upscheduling of codeine products has well and truly boiled over this week, with the Guild accusing doctor groups of “hurling abuse and playing political games”.

Over-the-counter codeine products will become prescription-only as of February next year, in a move by the Therapeutic Goods Administration that has received the support of all main medical associations, including the AMA, RACGP, RACP and Pain Australia.

In its decision, the TGA cited the issue of opioid misuse and addiction as well as the poor additional pain relief offered by codeine compared with other common over-the-counter painkillers.

Over 6 million codeine-containing products, such as Panadeine and Nurofen Plus, are sold every year by pharmacists, who stand to lose up to $120 million in sales once these painkillers are upscheduled.

But the Guild has lobbied hard for a softening of the upscheduling decision. It wants pharmacists to continue to be able to continue supplying over-the-counter codeine products for the temporary treatment of acute pain, with a mandatory requirement for real-time monitoring to identify non-legitimate misuse.

Their argument is that upscheduling of codeine will merely overburden GP surgeries and ER departments, and that in rural and regional areas people will find it hard to see a doctor to get their medication.

The Guild’s intense lobbying efforts appear to be paying off. This month, health ministers from all state and territories, with the exception of South Australia, wrote to federal Health Minister Greg Hunt to express their concern about the new rules.

“Some people managing chronic conditions with codeine medications will deteriorate as they abandon medication due to the out-of-pocket expenses associated with accessing GPs for their prescription,” they wrote.

AMA President Michael Gannon hit back at the “irresponsible and unprincipled lobbying of state and territory governments”, while RACGP President Dr Bastian Seidel pointed to the $340,000 the Guild has donated to the major political parties in the past two years alone.

“They are trying to introduce policy by chequebook by donating large amounts to state and federal parties to gain open access to decision makers,” he said.

But on Wednesday the Guild said it rejected “the outrageous and baseless claim that it is putting the commercial interests of pharmacies ahead of patients in relations to the upscheduling of codeine”.

It said its arguments had been motivated solely by “the need to maintain convenient access for patients who use these products legitimately, and the safeguard of real-time monitoring for at-risk patients with addiction issues”.

It said that “rather than throwing mud”, doctor groups should be taking responsibility for the “very real patient issues that doctors will need to manage” once codeine is upscheduled.

It questioned how overstretched doctors will manage the increase in demand in areas where patients already have to wait long periods before seeing their GP.

At the same time the presidents of five high-profile medical and health consumer associations, including the RACGP and Pain Australia, have written an open letter to all state and territory health ministers, warning that any changes to the TGA’s plan to upschedule codeine will put health and lives at risk.

“The Guild’s proposed alternative model carries a serious risk of increased harms and potentially preventable deaths and cannot be supported by the medical community and consumer advocates,” the letter says.

It also notes the “serious and far-reaching implications” of any state or territory creating exemptions, as it would be “tantamount to walking away from nationally consistent regulation of medicines in this country”.

The European Union, Japan and Canada all require a prescription for codeine-containing products.

Australia deepens its ties to World Health Organisation

 

A new era in relations between Australia and the World Health Organisation (WHO) is being ushered in with an agreement that will further deepen Australia’s involvement in the health of its region.

Signed last week at a WHO regional meeting in Brisbane, the agreement puts in place Australia’s first country cooperation strategy with the WHO. The plan is also the first of its type signed with a high-income country in the Western Pacific region.

It’s designed to leverage Australia’s expertise in healthcare to the benefit of less well developed countries in the region, while at the same time strengthening Australia’s own health security.

Health Minister Greg Hunt said the new partnership puts Australia at the forefront of international best practice in health policy.

“This strategy strengthens our systems to guard against emerging diseases at home and abroad, boosts our public health capacities and improves our already robust regulations to ensure we have safe and effective medicines and treatments,” he said.

The agreement outlines three strategic priorities:

  • Improving health security, with a focus on infectious diseases and emerging disease outbreaks;
  • Exchanging expertise and information in health systems policy;
  • Strengthening health regulations across the region.

Also at the Brisbane meeting of the WHO Regional Committee for the Western Pacific, Foreign Minister Julie Bishop launched a $300 million Indo-Pacific Health Security Initiative.

“In an interconnected world, diseases such as Ebola, MERS and the Zika Virus do not respect borders. A major epidemic could potentially disrupt tourism, trade, investment and people movement, setting back regional economic growth and development,” Minister Bishop said.

The $300 million will go to supporting efforts to prevent and contain disease outbreaks that could impact significantly on national, regional and global economies. The initial focus will be on drug-resistant tuberculosis and malaria in the Indo-Pacific region. These efforts will be led by the newly formed Indo-Pacific Centre for Health Security, a unit within the Department of Foreign Affairs and Trade.

As part of the fight against pandemics in the region, Greg Hunt has also announced that hospitals across the country will open their doors to a WHO-led team of auditors, who will look at local policies and plans for public health emergencies and antimicrobial resistance.

“I’m confident that our investments in pandemic preparedness, the national medical stockpile, biosecurity and vaccination supported by our people, systems and processes, will prove worthy,” he commented.

“We know there are gaps in our defences against global pandemics or potential epidemics, and antimicrobial resistance, and we need more, and better research to plug those gaps.”

Mr Hunt said the Pacific region is a known hotspot for emerging disease and increased resistance to conventional tuberculosis and malaria treatments.

“We are not alone in facing these health threats which have potentially disastrous social and economic impacts. While Australia recognises its privileged position in the world, we are not complacent about the risk that pandemics and other health threats pose to us.”

Patients’ ability to use private cover in public hospitals must not be curtailed

The AMA is advising the Federal Government to reject any policy proposals that limit patients’ ability to use their private health insurance for treatment in a public hospital, warning that such a move would restrict patient choice and further disadvantage public hospitals.

In its submission to the Government’s paper, Options to reduce pressure on private health insurance premiums by addressing the growth in private patients in public hospitals, the AMA strongly rejects all of the options proposed.

AMA President Dr Michael Gannon said the options would have a negative impact on the health system and should be dismissed out of hand.

“The options raised in this paper would simply reduce the level of funding available to public hospitals in favour of private health insurers, and significantly reduce the health care choices available to privately insured patients,” Dr Gannon said.

“Patient choice is a fundamental feature of our health system, which includes the option for patients to use their private health insurance in a public hospital.

“There are very good reasons why a patient may choose to use their private health insurance for treatment in a public hospital.

“In regional and rural areas, there may be no other option available due to the lack of private sector services.

“Public hospitals are also equipped to handle the most complex of cases and, in many cases, may represent the most appropriate clinical setting for treatment.

“It may also be the most cost effective option for a patient, particularly in light of the growing number of private health insurance policies with exclusionary features or excesses and co-payments.

“A patient may also wish to be able choose to be treated by a doctor who they have previously seen or know.

“There are also significant benefits that flow to public hospitals.

“In a constrained funding environment, the supplementary revenue generated from private patients makes an important contribution towards the recruitment and retention of medical practitioners, improved staffing, teaching, training, and research, and the purchase of modern new equipment.

“All these resources support and enhance the delivery of high quality care to public and private patients alike.”

Dr Gannon said the private health insurance lobby was guilty of blatant hypocrisy.

“On the one hand, the industry is offering and promoting public hospital-only private insurance policies, but at the same time objecting to more and more of their members opting to use their insurance in a public hospital,” he said.

“Insurers and governments only have themselves to blame for patients increasingly choosing to be treated as a private patient in a public hospital.

“The private health insurers offer a bewildering array of products, with varying levels of cover and many exclusions, which often leave patients confused and shocked when they find out that common medical procedures are not covered by their expensive insurance policy.

“This is compounded by the stagnation of the indexation of the Commonwealth Medicare Benefits Schedule (MBS) and medical fee schedules offered by the private health insurers.

“On top of this, public hospital funding has failed to keep up with community demand for services, with the Commonwealth and the States and Territories guilty of under-delivering in this area for many years.

“If the Government and the private health insurers want to see fewer patients opt to use their private health insurance in a public hospital, we will need to see significantly improved long-term funding for public hospitals, private health insurance policies that meet the common medical needs of consumers, and clear articulation of the different levels of coverage so that they are easily understood by consumers.

“If there is evidence of cost shifting, or concerns that private patients are jumping the queue in public hospitals, this needs to be addressed through stronger provisions and improved compliance arrangements in future COAG Hospital Funding Agreements.

“The development of a durable solution to this issue needs to be proportionate, and considered in the context of broader private health insurance reforms and future public hospital funding arrangements.

“This will require extensive consultation, including with the States and Territories which, in relation to private patients in public hospitals, appear to have had very limited input to date.”

The AMA submission is as submission/private-patients-public-hospitals

MARIA HAWTHORNE

Medical Students call for clearer pathways for reporting sexual assault

The Australian Medical Students’ Association (AMSA) has raised serious concerns about recent incidents of two medical students falling victim to alleged sexual assaults at Royal Darwin Hospital. 

AMSA, the peak representative body for Australia’s 17,000 medical students, believes that both the historical institutional culture of dominance in medicine and lack of clear reporting pathways are to blame for the ongoing problem of sexual harassment and assault. 

While two doctors have been stood down over the separate incidents at Royal Darwin Hospital and clinical placements have been suspended in the department, AMSA says there is a desperate need for wider action to see an end to this behaviour. 

“Unfortunately we continue to hear of stories of sexual harassment and assault of students on clinical placements. It is not uncommon; however, more often than not, it goes unreported. The stories we see in the news are only scraping the surface of a much larger systemic problem,” AMSA President Rob Thomas said.

Rob Thomas believes that there are many reasons that students feel they are better off not reporting experiences of sexual harassment and stems from: a lack of satisfactory mechanisms of addressing inappropriate behavior; fear of reprisal; and a negative impact on their studies.

Recently at the request of Australia’s 39 universities, the Australian Human Rights Commission has conducted a national, independent survey of university students to gain greater insight into the nature, prevalence and reporting of sexual assault and sexual harassment at Australian universities.

The Australian Human Rights Commission found that across all university settings, the Commission found that women were three times as likely as men to be sexually assaulted in 2015 or 2016 and almost twice as likely to have been sexually harassed in a university setting in 2016.

The Commission’s research also revealed that most students who were sexually assaulted or sexually harassed at university in 2015 and 2016 did not make a formal report or complaint to their university.

Rob Thomas says the problems associated with medical students reporting sexual assault is exacerbated because they: “exist in an awkward interim space between the university where their degrees are accredited and hospitals where they undertake their clinical placements.”

The result is that the dual reporting structures of each institution’s sexual harassment policies are often either inaccessible or difficult to enforce.  AMSA believes that the solution requires a cooperative and independent process between Universities and health services.  

An important part of changing this side to the culture of medicine will be improved knowledge, access and effect of incident reporting structures and mechanisms for dealing with inappropriate behaviour.

According to current statistics, one in three Australian women over the age of 15 will experience physical violence, and almost one in five will experience sexual violence. Living safe and free from violence is everyone’s right; reducing violence is everyone’s responsibility.

The National Sexual Assault, Family & Domestic Violence Counselling Line for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault is: 1800RESPECT (1800 737 732).

MEREDITH HORNE

Nation-first pill testing trial at Canberra music festival

Australia’s first pill testing trial will be held at a music festival in Canberra later this year, prompting applause from drug reform advocates but concern from the Federal Government.

Revellers at the Spilt Milk festival in November will be able to have their illicit substances tested for purity and authenticity, and will have the option of safely disposing of the pills if they turn out to be not what they thought they had purchased.

ACT Health Minister Meegan Fitzharris said the testing would be provided free by the Safety Testing and Advisory Service at Festivals and Events (STA-SAFE), which is led by Harm Reduction Australia, Australian Drug Observatory, Noffs Foundation, DanceWize and Students for Sensible Drug Policy.

A similar proposal for another festival in May was denied.

Ms Fitzharris said the decision had been made after careful assessment of the STA-SAFE proposal, and of pill testing schemes in New Zealand and Canada.

“We need to find the right balance between letting young people know it’s illegal to take drugs, they can be very harmful, but also being realistic because we’ve seen deaths at festivals, five in 2015 alone, so if that helps to keep people safe, it’s worth doing,” Ms Fitzharris said.

“Pill testing means young people who are considering taking drugs can be informed about what’s really in their pills, and how potent they are, and it creates an opportunity to remind them of the risks before they make the final decision to take a drug.”

While the AMA has always supported a range of drug harm minimisation measures, AMA President Dr Michael Gannon raised concerns that the trial might send the wrong message.

“We do need to do better but we also need real evidence that something works,” Dr Gannon told The Project.

“And the last thing we would want to do is give people a false sense of security about taking illegal drugs cooked up in someone’s bath tub.”

The AMA is concerned that pill testing does not entirely remove the risks associated with taking illicit drugs, as people react to drugs differently, and may also be influenced by the amount of drug consumed, gender, age, weight and other substances consumed such as alcohol.

The announcement coincided with the launch of a new national TV and online advertising campaign cracking down on ice and party drugs, aimed at school leavers who are preparing to celebrate the end of their school education.

Federal Health Minister Greg Hunt said while the pill testing trial was a matter for the ACT Government, the Federal Government did not support it “as a matter of principle”.

“Saying that any drug is okay is not okay,” Mr Hunt told Weekend Sunrise.

“People can have a reaction to any drug. There are no safe illicit drugs, and I think that’s a very important message.”

Festival goers will be able to attend a medical tent and provide a sample of a drug to be tested using laboratory grade equipment for free.

After receiving the results, the person will have the option of keeping the pill or discarding it in an amnesty bin containing bleach.

Regardless of the test outcome, trained drug counsellors will warn festival goers about the health risks of illegal drugs.

Dr David Caldicott, an emergency medicine specialist and advocate for Harm Reduction Australia, said the move would stop people taking drugs and prevent deaths.

Research from overseas programs showed up to 60 per cent of people who had their pills tested went on to throw them away, he said.

ACT Chief Police Officer Justine Saunders said ACT Policing supported the program and had been actively working with ACT Government and stakeholders.

“ACT Policing will be patrolling the festival to ensure patrons enjoy the event in a safe environment,” she said.

“Police will not enter the health facility that contains the pill testing station unless requested to do so by festival organisers, security staff or emergency services or in response to an emergency situation.”

MARIA HAWTHORNE

 

United Hatzalah and the success of the ambucycle

On a hot August night in Jerusalem, a motorcycle with flashing lights sped past our outdoor dining table. It looked like an emergency pizza delivery. The motorcycle was actually a United Hatzalah motorcycle ambulance, or “ambucycle” as they are known. 

The story of this service and how is originated is an example of innovative emergency health care that some other cities around the world are now adopting.

United Hatzalah is a not-for-profit entity that provides emergency medical care to all people regardless of ethnicity or religion. It was founded by Eli Beer, a former Jerusalem ambulance officer.

As a teenager, Eli Beer witnessed a terrorist attack on a domestic bus and saw traditional ambulances stuck in urban traffic, arriving too late to save some victims. Anyone who has been to a major city, especially in the Middle-East, Asia and the sub-continent which were not designed for the influx of millions of motor vehicles, buses and trucks, would be familiar with the type of traffic chaos that can leave ambulances stuck in ‘jams’.    

At a young age, Eli Beer began what is now United Hatzalah, a community-based medical responder model. He didn’t invent this concept, but he was the first person to turn it into a free national model. United Hatzalah services includes a fleet of specially equipped “ambucycles” that are fitted with almost everything a traditional ambulance carries except for a backboard, stretcher, chair, and bed. Ambucycles have an average response time of three minutes. The 3000 plus medics operating these motorcycles are now Israel’s primary first responders for most medical emergencies.  The medics are all volunteers and comprise Jews, non-Jews, Muslims and Christians.

The ambucycles can easily maneuver through Jerusalem’s maze of streets and crowded pedestrian walkways, and even use non-traditional paths to reach emergencies.  They use an advanced GPS tracking technology – Moskowitz Lifecompass – that is now the basis for an app that alerts security forces when a person is in distress or kidnapped.

The advanced GPS tracking is vital because Jerusalem has a new light rail system that prevents motor vehicles from easily accessing sections of the city. Traditional ambulances are forced to negotiate narrow streets, illegally parked vehicles and cannot get into small thoroughfares and the like.   

The free services doesn’t just use ambucycles, they now have ambutractors, first responder push bicycles, an ambuboat and even jet skis that enable medics to reach patients, regardless of the environment, location or terrain.

From what I’ve read, the United Hatzalah community-based responder model is now being used in 10 countries, and there are plans to set up an operation in India soon. They say that their services, including their applications and technologies, can be downloaded by anyone for free. They also provide free transport to hospitals.

Since their inception, United Hatzalah claim to have treated over two million patients “and never once did any of them receive a bill for services” said their founder.

SIMON TATZ
AMA DIRECTOR PUBLIC HEALTH