The Czech Minister of Health Svatopluk Němeček and Prague mayor Tomáš Hudeček have announced plans to form a commission to tackle an epidemic of ambulance patients in the city forced to wait hours to be admitted to hospitals. In the latest reported incident, a woman died of a brain hemorrhage after allegedly being forced to wait for almost two hours until a hospital could be found that would admit her.
The announcement of this commission represents something of a climb-down for the health minister. Several days ago, Minister Němeček was forced to announce that a “team” had been assembled to look into a growing number of incidents relating to Prague ambulance patient admittance. That team, since rendered defunct, was supposed to investigate cooperation levels between hospitals and ambulance services. But at the time, Němeček also suggested that the spate of recent patient incidents, including deaths, was being overblown by the media.
Meanwhile, Zdeněk Schwarz, head of the Prague Ambulance Service, has been escalating his public warnings in recent weeks, suggesting that the current system is putting lives at risk. The ambulance chief noted around 165 incidents of Prague hospitals refusing ambulance patients back in the month of March. Since then, he concedes the number has fallen as the Ministry of Health has begun to concern itself with the problem. Nonetheless, Schwarz has continued to label the problem as an epidemic caused by systemic failures.
Josef Mrázek is the vice president of the Czech Patients’ Association. He told me that he also believes that the problem is a systemic one. Patients arriving by ambulance are being turned away because hospitals are cutting back on beds. The reason for this is a payment system that wants fewer empty beds – meaning it doesn’t leave enough of a reserve for emergencies:
“The roots of the problem are in a faulty reimbursement system. And this kind of a restriction may be good sometimes to save money, but it is very bad to use it on a day-to-day basis. For example, diseases such as cancer need roughly the same number of beds each day. But emergencies need very different numbers due to unexpected accidents and so on.”
Mrázek described an inflexible bureaucratic system in which percentages are allocated to emergency versus chronic treatment, often leaving no available hospital beds in the process. The solution, he argues, is more beds allocated to emergency usage and greater flexibility. But getting through to the powers-that-be is proving to be a major obstacle.
“The official places did not want to hear the voices of the patients. We’ve been saying that this problem exists, and have been saying the very same for years, even decades. But nobody attempted to fix the system…Sit down and discuss this problem and increase the number of beds allocated in hospitals for emergency purposes.”
Officially, hospitals should operate at 85 percent capacity in order to have beds available should an emergency arise. But it appears that the pressures caused by a system that rewards austerity over care have ended up putting lives at risk.