E X T R A C T
Provisional Legislative Council

PLC Paper No. CB(2) 901
(The minutes have been seen
by the Administration)

Ref. : CB2/PL/SE/1

Provisional Legislative Council
Panel on Security
Minutes of Meeting
held on Thursday, 20 November 1997 at 2:30 pm
in the Chamber of the Legislative Council Building

VI. Emergency ambulance service

(PLC Paper No. CB(2) 618(05))
(Part I of Chapter 6 of the Director of Audit's Report No. 29, October 1997)

Briefing by the Administration

33.Deputy Secretary for Security 2 briefed members on the Administration's information paper. He highlighted that the Fire Services Department (FSD) was committed to achieving the current target of responding to 92.5% of all emergency calls within 10-minute travel time, and then eventually to 95% of the calls. In this connection, resources had been secured for the provision of 222 posts and additional ambulances over two years by phase as follows :

September 1997Filling of 75 newly created posts
March 1998Filling of 79 newly created posts and provision of 22 additional ambulances
September 1998Filling of 57 newly created posts


34. Deputy Secretary for Security 2 pointed out that since the filling of the 75 newly created posts in September 1997, the FSD was able to respond to 91.6% of all emergency calls within the 10-minute travel time. It was expected that with the provision of additional resources in 1998, the performance of emergency ambulance service (EAS) would be further improved.

Discussions

Performance of EAS35.

35.Members were concerned about the deteriorated performance of EAS in recent years. In 1994, it responded to 91.7% of emergency calls within 10-minute travel time but in 1996 , it could only respond to 89.7%. In response to members' queries, Deputy Secretary for Security 2 advised that the FSD had carried out analysis of the cases which had not achieved the 10-minute travel time target and identified various causes involved, such as long distance and traffic congestion. The Chairman considered that the failure to achieve the target, due to long distance travelled, highlighted deficiencies in the deployment of ambulances to attend to emergency calls. She suggested that further analysis be conducted to identify the problems involved in deployment. Chief Ambulance Officer (Atg) pointed out that the subject had already been covered by the 1995 Consultancy Study. At present, the Fire Services Communication Centre (FSCC) served as a mobilization and control centre for fire-fighting and ambulance operations. It operated a computer-aided despatch system, which was linked to all fire stations, ambulance depots, fire appliances and ambulances. In the case of an incident, staff of the FSCC would mobilize the nearest available ambulances with the assistance of the computer-aided despatch system. FSD would closely monitor the deployment of ambulances to ensure an effective emergency cover was maintained.

36. Mr LEE Kai-ming was concerned when the performance target could be met. Deputy Secretary for Security 2 reassured members that the Administration was actively implementing the recommendations of the 1995 Consultancy Study with an aim to achieve the performance target.

37. In response to Mr Henry WU's enquiry, Deputy Secretary for Security 2 advised that the Administration had, as recommended by the 1995 Consultancy Study, included the turn-outs of Ambulance Aid Motorcycles (AAMCs ) in the calculation of the performance of EAS. At present, a total of 13 AAMCs were available for deployment. The Administration planned to expand its fleet of AAMCs by 11. Responding to the Chairman, Chief Ambulance Officer (Atg) advised that normally, AAMCs would be deployed to respond to emergency cases where urgent attention was required so that stabilizing treatment might be rendered to the patients concerned at the earliest possible opportunity, often before the arrival of ambulances.

38.Performance measure based on response time but not travel time. Members pointed out that the public was most concerned about response time. Indeed, the 1995 Consultancy Study had raised that response time was the most appropriate measure for the performance of EAS in Hong Kong. Staff side of the FSD and some former Legislative Council Members had supported the use of response time when the matter was discussed in 1996. Members queried why the Administration was still using travel time as the performance target of EAS. Chief Ambulance Officer (Atg) advised that in fact, the 1995 Consultancy Study had recommended that : (a) the 10-minute travel time target should be retained until it was consistently achieved ; (b) a plan should be drawn up for adopting response time as the performance target for EAS.

39. Chief Ambulance Officer (Atg) added that the FSD was actively studying the feasibility of switching to response time. It had initiated a trial scheme to use a new Trunked Radio System in September 1997 to record response time. Data collected would be used to assess the suitability of using response time as the performance measure for EAS. Some members queried why the Administration had not started to implement the trial scheme earlier. Chief Ambulance Officer (Atg) advised that in calculating the response time, several data including the time of arrival at the address of the call were needed. The availability and accuracy of the time of arrival at the address of the call depended on successful transmission of the arrival code from the individual ambulance to the FSCC computer through the radio system. However, transmission had not been reliable due to interference of the existing radio system. To overcome this problem, FSD was replacing its radio system with the Trunked Radio System. Members urged the Administration to closely monitor the progress of the trial scheme and work for the early adoption of response time as the performance target. They suggested that the staff side should be kept informed so as to ease their worries. Responding to the Chairman, Chief Ambulance Officer (Atg) advised that on average, an ambulanceman was required to handle about 6 cases daily and that such workload level should not have imposed too much pressure on the staff concerned. The staff side was aware that the Administration had secured additional resources with which their workload would be reduced.

40.Time of attending to patients at the scene and time of travelling from the scene to hospital40. Responding to Mr MA Fung-kwok, Chief Ambulance Officer (Atg) advised that the 1995 Consultancy Study had provided the statistics that normally, the ambulancemen stayed at the scene for about 10 minutes to attend to the patients. Then it would took them no more than 30 minutes to travel to hospital but the actual time required would depend on the districts involved. In the past, it took comparatively more time for sending a patient from New Territories East to hospital. However, the situation had improved with the establishment of the Nethersole Hospital in Tai Po. Mr MA Fung-kwok requested the Administration to provide information on the distribution of resources in various districts.Adm

Provision of essential medical equipment on board of ambulances
41. Responding to the Chairman, Chief Ambulance Officer (Atg) advised that essential medical equipment was provided on board of all ambulances. Such provision was under constant review and various improvements had been made. For example, the FSD planned to equip all ambulances with defibrillators in 1998 while at present, only 124 ambulances had this equipment. Moreover, the FSD had engaged a medical doctor as the department's medical director in April 1997 to provide advice and assistance in the paramedic training programme and the equipment required. At present, a total of 33 ambulances were manned respectively by a Emergency Medical Assistant (EMA) who was qualified to provide paramedic ambulance service. Under the EMA II training programme, selected ambulance supervisors received paramedic training on intravenous fluid therapy, automatic external defibrillation, etc. At the end of the training, they were required to attach to a hospital where they had to demonstrate their competency in intravenous infusion technique by performing successful intravenous infusion operations. The FSD would expand the paramedic ambulance service with the availability of more qualified EMAs.

Serious mismatches between the type of ambulance and the type of emergency case in the deployment of EMA ambulances
42. Mr CHENG Kai-nam was concerned about the serious mismatches between the type of ambulance and the type of emergency case in the deployment of EMA ambulances as stated in the Director of Audit's Report. He sought clarification on the reasons for such mismatches. Chief Ambulance Officer (Atg) responded that the main purpose of EAS was to treat and carry patients to hospital as quickly and as safely as possible. Hence, there might be a situation where an EMA ambulance was deployed to attend to a non-EMA call if it was the nearest ambulance available at that time. Indeed, this might result in the unavailability of EMA ambulances in attending to EMA calls. However, all ambulances were provided with essential medical equipment which should be sufficient to cover the general emergency cases.

Others

43. At the Chairman's request, Deputy Secretary for Security 2 agreed to provide for members' reference a copy of the Administration's paper presented to the Public Accounts Committee on this subject.Adm


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Provisional Legislative Council Secretariat

14 January 1998