Tallinn challenges planned ambulance allocation

ERR reports that Tallinn says the state is planning too few ambulance crews for Tallinn and Harju County, warning that access to emergency care could worsen during peak demand or a major accident.

The Ministry of Social Affairs says calls in the capital take less time to handle, which is why Tallinn may have fewer ambulance crews per resident than rural areas.

The ministry, together with the Health Insurance Fund and the Health Board, is continuing a reform of the ambulance network. The process will review the location of ambulance crews across Estonia.

In the summer, the ministry proposed adding seven ambulance crews during the day and three at night in Tallinn and Harju County, where the population has grown significantly over the past decade. At the same time, the number of crews in southern Estonia, where the population is smaller than it was 10 years ago, would have been reduced.

Following feedback from southern Estonian stakeholders and the leadership of the Estonian Ambulance Association, the ministry revised its proposal, said Nikita Panjushkin, head of the ministry’s health services department.

Under the new plan, the number of crews in southern Estonia would remain unchanged. Tallinn and Harju County would receive four additional crews during the day instead of seven, and one additional night crew instead of three.

Tallinn officials have criticised the revised plan. Deputy Mayor Riina Solman said it would provide Harju County with half as many ambulance crews per resident as the rest of Estonia.

Solman said this could reduce access to emergency care in the capital, especially during peak demand, crises or major accidents. She noted that Tallinn has many tourists as well as an airport and ports, and therefore needs greater ambulance capacity.

“We are not saying that other regions should somehow be left in trouble. We simply have to take population shifts into account, which means there must be more ambulance crews,” Solman said.

She added that Tallinn and Harju County could end up having to cover the shortfall from their own resources.

Panjushkin said the state has limited resources, including money, staff and equipment. Increasing the number of crews would also require training more paramedics with specialised qualifications, he said.

He confirmed that the plan provides for half as many ambulance crews per resident in the capital, but said calls in Tallinn also take considerably less time to handle.

A crew in Võru County, for example, may spend several hours taking a seriously ill patient to Tartu and returning to its service area. In Tallinn, an ambulance crew can reach North Estonia Regional Hospital with its emergency lights on in 10 to 15 minutes, Panjushkin said.

He said the allocation of ambulance resources must therefore take into account not only the number of residents per crew, but also regional characteristics such as distances and the actual workload of crews.