With a sad heart, back to the Hungarian ambulance service

Just when I was warmly greeting the separation of ambulance service from ordinary patient transport and applauding the the ministry of health for doing something about the absolutely crazy system of taking perfectly healthy patients home after a hospital stay in fully equipped ambulances, one hears the worst possible news: the new system isn’t working. The new organization with its fleet of minibuses or cars that was supposed to take over the ordinary transport of patients is swamped with calls. Doctors trying to phone the company can’t get through. On the other hand, the ambulance service is very satisfied with the new regime: they can get to really serious patients much sooner than before.

How did this happen? One’s first thought is that the changeover was not prepared properly. Perhaps the government and the ambulance service were in too much of a hurry to effect the necessary changes. But then one hears that this is not at all the case. The head of the company responsible for patient transport tells us that they have been working on the separation of the two functions for over a year. The problem is that the projected traffic is 30-40% higher than anticipated. What? What’s going on here?

The head of the company in charge of ordinary patient transport claims that the data they received from the ambulance service and upon which their estimates were based were faulty. The ambulance service reported X number of runs and the transport company decided that Y number of new cars would be necessary to satisfy the demands. But the input numbers were incorrect.

How could that happen? It is unlikely that the ambulance service simply falsified the numbers. At least not at this stage. However, it is possible that they falsified the figures at an earlier stage when it was to their advantage to report to the Health Care Fund (EP) as real ambulance services cases that were actually simple transportation services. The ambulance service received more money for ambulance runs than for ordinary patient taxi service. If this is the case, it shows the depth of corruption in the Hungarian health care system.

Of course, there is another, even more sinister explanation for the sudden 30-40% growth of demand for patient transportation. If you recall, the president of the Hungarian Medical Association didn’t make a secret of his and his colleagues’ intention to "trip them up everywhere we can." Meaning the reforms. I very much hope that Dr. Éger’s colleagues didn’t suddenly decide that more people need transportation home or to the hospital than a few months ago.

A third possibility is that people who would not have phoned an ambulance to take them for medical treatment figure that free "taxi service" is a good deal. Why pay for your own gas when the state will provide?

Whatever the case, this points to the incredible difficulty of reforming the health care system.