Estonia plans to reduce doctor-staffed ambulance teams

Estonia’s Social Affairs Ministry plans to reduce the number of ambulance teams staffed by both a doctor and a nurse, ERR reports. There are currently 13 such teams, and the ministry says it will review where they are needed. It has not yet decided how many doctors could lose their jobs.

Medical professionals disagree over the proposal. Arvi Vask, head of South Estonia Hospital, said the doctor-staffed teams were not an efficient use of medical resources, arguing that nurses could handle the work just as well. The Estonian Health Insurance Fund pays 15,000 euros more per month for a doctor-staffed team than for a nurse-staffed one, although Vask said not all of that money goes towards doctors’ salaries.

Vask said the doctors could instead work in primary care or hospital emergency departments, where he said there are about 60 vacant doctor positions.

Tuuli Paju, a board member of Tartu Ambulance, said the proposal might be intended to ease staff shortages at smaller hospitals. She said some ambulance doctors already work in emergency departments and hospitals, while others have specialisations that would not lead them to take jobs at county emergency departments.

Paju said doctors should remain on ambulance teams in smaller towns, where hospitals are far away and a separate doctor could take too long to reach an emergency. Tartu Ambulance has doctors on duty in Paide, Viljandi, Põltsamaa and Räpina, as well as a team that rotates between Otepää, Jõgeva and Tartu.

The ministry says it will not eliminate doctor-staffed teams entirely, but wants to ensure they are not sent to calls that nurses can manage. A new plan for ambulance services is expected to be published in the coming weeks.