Author Topic: Interesting problems with private providers.  (Read 40560 times)

360Joules

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Interesting problems with private providers.
« on: April 18, 2010, 03:40:41 PM »
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« Last Edit: May 10, 2010, 10:59:40 PM by 360Joules »

Offline crashndash

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Re: Interesting problems with private providers.
« Reply #1 on: April 18, 2010, 06:44:13 PM »
so they're finding that common sense has pricked the double time nerve?

Poor lil boys and girls...fancy having to work for your salary when u could have been bubmbling around with a lap full of donuts on a cushy number

Offline disOrderly

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Re: Interesting problems with private providers.
« Reply #2 on: April 19, 2010, 03:51:12 AM »
The story doesn't make sense, First it says a Trauma Specialist and an RN, but then it says GP's later on.

I find it hard to believe a Trauma Specialist would be riding around in the back of an ambulance around a horse race course.

But they do make a point about having AV Paramedics being called regardless of the other medical service attending.
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Offline bajdas

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Re: Interesting problems with private providers.
« Reply #3 on: April 19, 2010, 12:26:20 PM »
In reference to the second to last paragraph of the article.

I would have thought the contract would be for providing services within the race track area (general public, harse areas, race track, etc), not a transport to hospital.

If this is correct, then wouldn't ambos be upset with the patient transfer from track to hospital because it is treading on their turf ?

Pls correct me if I am wrong.
Andrew Macmichael
lives at Pt Noarlunga South.

My personal opinion only.

360Joules

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Re: Interesting problems with private providers.
« Reply #4 on: April 19, 2010, 01:56:17 PM »
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« Last Edit: May 10, 2010, 10:59:58 PM by 360Joules »

Offline EmesisBag

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Re: Interesting problems with private providers.
« Reply #5 on: April 19, 2010, 10:29:21 PM »
360, I have to ask - why do you have such a chip on your shoulder about these private companies?

This article is from almost a year and a half ago.

I don't see how you can compare private companies doing event work to security guards taking over from police. It's not like these events are public domain work.
It's harder to compare here in SA as we don't have the 'user pays' police system for events like some other states, but in that situation you have to ask, if the security guards were good enough, why would events pay to have police there? So clearly events are happy with these companies, because they're still getting work - and there obviously is a market for it judging by the number that are popping up around the place.

If SAAS were so upset about private companies doing the work, perhaps they should be more competitive with pricing - and surely if these companies were so bad, the events wouldn't use them? It's not exactly a huge industry.

As far as patient transport stuff goes, that's a whole different kettle of fish IMO, and there should be regulation (although from what you've said with regards to getting the licensing etc, there is). Given the stories on here about the EMT mob running around playing emergency service, there should be a lot more scrutiny - both clinical and business management.

Offline disOrderly

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Re: Interesting problems with private providers.
« Reply #6 on: April 20, 2010, 06:18:29 AM »
I think that 360 has some valid concerns, obviously there are potential accountability and quality issues with private companies. But it is kind of guilty until proven innocent. We are assuming things will be bad and aren't waiting to see if any of these companies are actually going to run a proper, ethical and quality service.

Another issue is that the title 'Paramedic' is not protected legally, so I could go with my job as an Orderly and my Senior First Aid cert and employ myself as a Paramedic, despite not having the actual Paramedic qualifications and not be sued or convicted for it.
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Offline Blackfoot

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Re: Interesting problems with private providers.
« Reply #7 on: April 20, 2010, 12:12:40 PM »
Face it guys, SAAS priced themselves out of the market by maintaining a government mandated monopoly for far too long. They are about to do so again in the patient transport market.

If you want to see how to make a public service/private sector system work have a look at Singapore. Same system as South Australia but with integration at the operational level. I'm sure you older blokes in the AEA would remember the word integration from the 1980's.



Offline amboman69

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Re: Interesting problems with private providers.
« Reply #8 on: May 02, 2010, 04:56:31 PM »
I think the reason there is so much discussion about the privates and transfer work is that no one seems to have a clear idea how the system will work.  On the surface it seems simple - they bid for a contract and start hauling geriatrics back and forth, but think about it:

Will the privates be happy to wait up to an hour for a ward to send down a patient? (SAAS does)

If not, will they strike up a deal with the various unions to allow their staff to go to the hospital wards and get the patient themselves (SAAS can't)

Will the public hospitals be able to accommodate the need for a private enterprise to be efficient and profitable - or will some penalty be incurred by the public system, blowing out the original cost savings.

If a non emergency patient has ambulance cover, are they going to be happy paying the privates? (I think not - they will call SAAS)
To get over this, will the privates set up a deal with SAAS so that SAAS does the billing, collects the money and then pays the private company. (ie, SAAS does all the work)
Will the privates be happy shifting a non emergency patient back to a nursing home at 3 in the morning so that the ward bed can be used for another patient.

Remember, the last word in SAAS is "Service" - and this is a word that not too many private companies are comfortable with.  Most of SAAS's inefficiencies in the non emergency transfer sector are caused by our clients and the nature of the work

Offline bittenyakka

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Re: Interesting problems with private providers.
« Reply #9 on: May 02, 2010, 10:04:53 PM »
How d insurance companies look at these crowds? the threads here are giving them quiet a hard rap and I would assume that you wouldn't be able to get any liability insurance unless you demonstrated a certain level of consistent skill across your staff.

360Joules

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Re: Interesting problems with private providers.
« Reply #10 on: May 03, 2010, 09:16:25 AM »
 :-)
« Last Edit: May 10, 2010, 11:00:19 PM by 360Joules »

Offline amboman69

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Re: Interesting problems with private providers.
« Reply #11 on: May 05, 2010, 08:30:26 PM »
In reply,
>>>>AmboMan...... patients don't pay for anything on intra hospital transfers form public hospital that is, the hospital do. Hospitals want people who have solutions not problems. So if they are willing to go up to wards and get patients, the hospitals will love them.

I know that this is the way interhospital transfers work - even amongst the private hospitals, but what about those hundreds who get a SAAS ambulance INTO hospital, how do they get home? - in a private?, and if so - who pays?  You also forget that SAAS personnel cannot go past the reception area of a public hospital without causing a demarkation dispute with the orderlies (see todays medical directive that spells out the few times when we can take a patient to/from a public ward).  Many PTS crews would rather go up to the ward, meet the patient and get a proper handover

>>>>As a Paramedic of some years I have to disagree with your last comment. Most of PTS/ATS current woes and potential downfall is their own staff not willing to do certain jobs even though they are trained to do it, i.e an emergency crew, sprint car or EOC clinican downgrades the job from Emergency to ATS or ESS, then the ATS/ESS crew gets there are refuses to take a basic patient.

As an ATS/ESS officer of some years, I have to disagree with your last comment.  We are more than happy to jobs we are trained to do, but for so long we have been limited by restrictive policies and stifling initiative.  Remember when we wore a different uniform?, how about not letting us have glucometers because they were too complicated?, how about having to consult with an ICP or Hugh to administer penthrane. how about not being able to carry a patient who has had morphine within the last hour or so (obviously we are too stupid to recognise respiratory depression).

A PTS crew has every right to refuse to carry a patient they are not happy with or does not fit within their extremely limited protocols - maybe the initial emerg crew did not do any handover paperwork, maybe 4 or more hours had passed between being seen by SPRINT and the patient has deteriorated since then, maybe the ECP has been given a "bum steer" by hospital staff anxious to clear a bed - and yes, maybe the PTS could see the hospital from the front of the re-triaged patient's house and thought "stuff it - lazy p***s".  All of these things have happened to me.  Maybe they simply don't feel comfortable because they haven't had any meaningful training or development for the last year or two, no audits, no nothing.  Oh yes, I forgot the jobs where the EOC has downgraded the really sick patient (and not told us the patient's true condition) because all of the emerg cars are tied up.

Quite frankly, I don't care how many privates come in as competition, I just want the opportunity to compete on equal terms, and as 360 Joules says, work at the level we are trained for. And quite right, - limit the number of casuals so we don't spend all our time training uni students into future paramedics; if you want to transfer patients after midnight, don't put the only crews doing it at Port Adelaide; give us more dedicated PTS radio operators (not emerg fill-ins) who understand that good coordination is more than clearing the screen, and yes, get the guts to move on the deadwood who think that PTS/ESS is a quiet place to reside until retirement comes.

Maybe the ones that should really be worried are the Emerg crews.  "The Road Ahead" mentions that that up to 20% of emerg jobs are "low acuity"(??non emerg), how often are eight university trained para/ICPs needed at a four car bingle; are death rates so dramatically different in the country where Cert IV is the usual qualification; with SPRINT, ECP's etc as rapid backup, do we REALLY need to send fully qualified crews to "call direct" non responses, "lift onlys" or a hundred other basic jobs, - all at professional rates.  It would not be too hard to argue that greater efficiencies in SAAS could be had by increasing the non-emerg section.

Not that it will ever happen of course - just like there would never be competition for PTS.!!!

360Joules

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Re: Interesting problems with private providers.
« Reply #12 on: May 05, 2010, 10:00:56 PM »
 :-)
« Last Edit: May 10, 2010, 11:00:39 PM by 360Joules »

Offline 2468

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Re: Interesting problems with private providers.
« Reply #13 on: June 25, 2010, 08:28:16 PM »
Anyone know who drives the Rescue paramedic ambulance? Wears the Rescue Paramedic tshirt? Saw him at the BP on South road regency Park. Full Blue and red lights... NSW plate? Looked like a fit operator tho...

Offline bert

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Re: Interesting problems with private providers.
« Reply #14 on: June 27, 2010, 10:37:03 AM »
Anyone know who drives the Rescue paramedic ambulance? Wears the Rescue Paramedic tshirt? Saw him at the BP on South road regency Park. Full Blue and red lights... NSW plate? Looked like a fit operator tho...

SAAS S.O.T.

Offline 6739264

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Re: Interesting problems with private providers.
« Reply #15 on: June 27, 2010, 08:09:46 PM »
Golly,

NSW Plates? Sounds like there are some NSW Ambulance Service Rescue Paramedics still on the run!

Someone call the Fire Brigade!
To think they employed me as a drooling retard...

Offline 2468

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Re: Interesting problems with private providers.
« Reply #16 on: June 28, 2010, 09:14:34 AM »
Yeah which company is that?

Offline RubberChicken

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Re: Interesting problems with private providers.
« Reply #17 on: June 28, 2010, 03:14:50 PM »
The unit belongs to emc rescue from NSW.
www.emcrescue.com.au

One is sitting at merc benz on cnr of south rd and grand junction.

Red and blue lights......tut tut. ADRs and vehicle standards breach in SA.

No plates on the vehicle at merc benz.

Maybe a new player in town???? Rescue Paramedics...wonder what area they will be working in...unit seen around CBD ...is there a new Emeregncy Ambulance Servive in Adelaide...thought it was only SAAS...and..................EMT Adelaide hahaha.?? 

rescue5271

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Re: Interesting problems with private providers.
« Reply #18 on: June 29, 2010, 07:08:36 AM »
There are a number of ambulances in SA(adeliade) that are being seen around town but are being refurb for the mines and other private use...

Offline boredmatrix

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Re: Interesting problems with private providers.
« Reply #19 on: June 29, 2010, 07:15:21 AM »
The unit belongs to emc rescue from NSW.
www.emcrescue.com.au

One is sitting at merc benz on cnr of south rd and grand junction.

Red and blue lights......tut tut. ADRs and vehicle standards breach in SA.

No plates on the vehicle at merc benz.

Maybe a new player in town???? Rescue Paramedics...wonder what area they will be working in...unit seen around CBD ...is there a new Emeregncy Ambulance Servive in Adelaide...thought it was only SAAS...and..................EMT Adelaide hahaha.?? 

Nope..he's subcontracting to the health service at the desal plant.

Offline disOrderly

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Re: Interesting problems with private providers.
« Reply #20 on: July 01, 2010, 03:21:06 AM »
Had an IMS crew come in the other day. They had a patient who was from a nursing home and had a fall. Would this be a transfer or emergency?

Also, their stretcher was really nifty, but they don't use sheets so we had to slide the patient using their clothes which was weird. The crew almost left without handing over to the appropriate nurses aside from the triage nurse too!
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Offline IMS2009

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Re: Interesting problems with private providers.
« Reply #21 on: July 01, 2010, 03:43:02 PM »
Disorderly you are getting confused with the other company.

Firstly, IMS does not currently have contracts with Nursing Homes and does not perform inbound cases. Private hospital transfers only. We attend RAH but only for admission of a patient out of a private into public 'or' for outpatients/appointments at RAH.  So an inbound elderly patient to RAH post fall is the other provider..who do have direct contracts with a few Nursing Homes.

The other provider also reportedly uses 'paper sheet' type covers on their stretchers (you will have to ask them why???).  A few hospitals have commented on this practice by the other provider and held similar views regarding the issue of transferring on to a bed from stretcher.

IMS has NEVER transferred a patient without sheets...and our crews.being predominantly SAAS personnel we adopt identical standards ATS/PTS.

Please get your facts correct. Check the uniform and vehicle before you decide to post comments misrepresenting our company.







Offline disOrderly

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Re: Interesting problems with private providers.
« Reply #22 on: July 03, 2010, 08:11:21 AM »
My mistake, I do remember the crew being a Paramedical Services crew. I had seen an IMS truck in the bay also that day, so that's where I got confused!

And the paper sheets are indeed silly.

I appologise for making that error and I have yet to work with an IMS crew. However, I don't think what I said was that negative and aside from the sheet issue, the mistake made was one that any crew can make so your company was hardly misrepresented.   
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rescue5271

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Re: Interesting problems with private providers.
« Reply #23 on: July 04, 2010, 07:54:27 AM »
Would be nice if some of these private units did some country work so local crews just have to deal with Emergency cases would make life a lot easy for  all....

Offline disOrderly

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Re: Interesting problems with private providers.
« Reply #24 on: July 04, 2010, 08:28:44 AM »


I know that this is the way interhospital transfers work - even amongst the private hospitals, but what about those hundreds who get a SAAS ambulance INTO hospital, how do they get home? - in a private?, and if so - who pays?  You also forget that SAAS personnel cannot go past the reception area of a public hospital without causing a demarkation dispute with the orderlies (see todays medical directive that spells out the few times when we can take a patient to/from a public ward).  Many PTS crews would rather go up to the ward, meet the patient and get a proper handover

With regards to this, I believe this issue arose when the government Orderlies were around. They were concerned about losing their jobs (which they did due to their own fault) and decided that ambos couldn't pick up pt's from the ward. However, times have changed and we are now contracted. There were over 100 government Orderlies on staff, there are now approximately 70 and the workload is astronomically bigger than the government days. I believe most of our staff (and I speak for myself and not the company) would prefer it to escort ambos to the wards rather than picking the patient up ourselves for a number of reasons:

-It is quicker for SAAS/companies
-It reduces our workload
-Does not remove nursing staff from ward
-Orderlies are not trained to use the Ferno and are not allowed to lower the stretcher. Most times the patient will be out of bed and as a result, they must be put back into bed, raised and slid or wiggled across which takes more time than lowering the stretcher.

Having said that, I quite enjoy doing these tasks, but on the whole I can see its inefficiencies.
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