Defence Forces warn two-person ambulance crews could weaken crisis response

Estonia’s Defence Forces say plans to make some ambulance crews two-person teams could undermine the service’s ability to respond in a crisis or wartime, ERR reported. The Social Affairs Ministry’s planned reform would also reduce the number of ambulance crews.

In a response to an information request from Tartu Ambulance, the Defence Forces said an effective ambulance service was essential for national defence in a crisis or war. They noted that the minister’s approved ambulance development plans through 2035 identify three-person crews as a source of reserve staff in emergencies. The existing ambulance training model, developed in cooperation with the Defence Forces, is also based on three-person crews.

Exercises and real-life incidents have shown that a three-person crew is the minimum needed to treat a seriously injured patient or begin the initial response to an incident involving multiple casualties, the Defence Forces said. They added that a summoned crew increases the number of medics at an incident by three when both crews have three members, compared with an increase of two when both have two. That difference could leave too few staff at the scene and affect patient care.

Three-person crews also provide a staffing reserve that can be converted into two-person crews when needed, the Defence Forces said. If most crews were already reduced to two members, that reserve would be lost. They warned that during a crisis affecting the health system or wider society, replacing staff could be difficult or temporarily impossible. The conflict between Ukraine and Russia has also shown that not all additional workers called in during a crisis or war will be able to report for duty, they said.

The Social Affairs Ministry plans to introduce the reform by 2028. It aims to expand the ambulance base network, change the locations of doctor-led crews, reduce their number, make some crews two-person teams and reduce the number of crews operating at night.

Social Affairs Minister Karmen Joller said in August that the reform would improve ambulance care. She said changes to crew composition would not reduce the quality of care, and that locating bases closer to people should help crews reach them faster. The ministry says the reform is based on prior analysis and modelling.