Regulation of Paramedic Services

The following question stood in the name of Dr Lam Pin Min –

To ask the Minister for Health (a) whether there is a need for paramedic services to be regulated; and (b) how is the standard of paramedic training determined and maintained to ensure that patient care is not compromised.

The Emergency Ambulance Services in Singapore are provided by the Singapore Civil Defence Force (SCDF). The emergency ambulance crews are led by paramedics who are trained to handle all medical and trauma emergencies. The service operates round the clock and will respond to any 995 call for medical emergency in Singapore. SCDF also conducts clinical, operational audits and protocol reviews regularly to maintain the high standard of emergency medical care rendered to patients. The paramedics are also subject to oversight by an independent external medical advisory committee under MHA.

In 2009, SCDF embarked on a public-private partnership to engage private ambulance operators to add capacity to SCDF emergency ambulance service. These ambulances have to meet SCDF's standards for ambulance design, equipping and their staff have to meet the requisite medical skills certifications

Page: 46

as part of the contract to operate with the SCDF EAS.

As the ambulance sector develops, there is a need to upgrade the capabilities of ambulance personnel. A key component in the Pre-hospital Emergency Care (PEC) Transformation Plan, jointly developed by MOH and MHA, is the professional development of ambulance personnel, including paramedics, emergency medical technicians (EMTs), and medical transporters/drivers. This plan will cover the development of professional standards, competencies and related training of these personnel.

ITE and the Singapore Armed Forces Medical Training Institute already offer essential training programmes for the paramedic trainees. MOH and MHA are also working on a framework for continuing education to enhance the skills and training of paramedics in the areas of cardiac emergencies, trauma, paediatrics and the management of other time-sensitive emergency conditions. To raise the standards of other ambulance personnel working closely with the paramedics, MOH and MHA have partnered WDA to develop a Pre-Hospital Medical Care Track, administered by SingHealth's Alice Lee Institute of Advanced Nursing, for EMTs and Medical Transporters in Singapore.

One supplementary question, please. Besides working on the skills of these paramedics, are there any guidelines on the charges of these ambulances or paramedic officers, especially those from the private sector?

I thank the Member for the supplementary question and for the opportunity to clarify regarding the ambulance charges. If the call is made to the telephone link 995 Emergency Ambulance Service that is operated by SCDF and it is ascertained by the doctor at the medical institution at the emergency department that it is an emergency case, there is no charge. If it is ascertained that it is non-emergency, there is a charge of $198.

The ambulance service provider is divided into the 995 telephone link service by SCDF and there are also private operators that operate essentially non-emergency patient transport service. There are also some that operate emergency services.

There is a set of guidelines for private ambulance service that MOH has stipulated but these are primarily to ensure or safeguard patients' safety. The charges are not regulated but it is actually listed or put up on the SCDF website. The advice will be that if you want to use private ambulance services, please

Page: 47

check the website so you make an informed decision. The private ambulance operator is supposed to tell you what the charges are before you take up the service.