Estonia to postpone hospital and ambulance crisis readiness requirements

Ambulances and fire trucks.
Ambulances and fire trucks. Source: Siim Lõvi/ERR

Even though hospitals and ambulance are obligated to be prepared for crises by law, the state has not found the necessary resources so far. Requirements that entered into force on January 1 will be postponed by three years, with deliberations concerning funding set to kick off in spring.

Emergency medical teams have to reach people in every situation, irrespective of whether there is mobile coverage, power or whether gas stations have fuel. Ambulances must remain operational under such circumstances for at least 72 hours. Estonia's seven largest hospitals must also be able to function for 72 hours in a crisis, including their blood banks, emergency and intensive care rooms. Diagnosis and laboratory capacity must also be maintained.

This is the picture painted by the Ministry of Social Affairs about three years ago. However, the minister's signature on the regulation did not produce generators and fuel stockpiles.

"The situation today is that no hospital or emergency medical brigade has full continuity. Regional and central hospitals are the best prepared," said Maiheleen Rostok, chief specialist for the Health Board.

The board's calculations suggest hospitals and emergency medical service providers would need about €21 million in all. Agris Koppel, who heads the ministry's health system development department, said that continuity was an important keyword in 2018.

"Because crisis readiness was a hot topic on the state level, we hoped that investments into healthcare would be made inside the following two years."

Maiheleen Rostok said that generators are the first priority. That would take up about a quarter of the €21 million needed.

"Power outages could incapacitate heating, water and information systems. A hospital is very vulnerable to power outages."

The government has been approached twice for funds necessary to ensure continuity. Both requests came to nothing. Maiheleen Rostok recalls state budget strategy talks from last spring. "We were told that continuity had not been funded in any sector yet and we were no exception."

Because the regulation's deadline came and went three days ago, the social ministry found a solution. An amendment will postpone the regulation's entry into force by another three years. The explanatory memorandum reads that the Health Board will ask for funds again during state budget strategy deliberations in spring. Agris Koppel said that there are no agreements as things stand. She added that she hopes the fall storm taught everyone a valuable lesson.

"I believe we need an integral approach to crisis preparedness in which healthcare is but one part. I think that we need a principled decision to boost relevant spending not only in healthcare, but other sectors as well, and that we all try to develop our systems in a way not to allow so-called run-of-the-mill crises to knock us down over the next three-five years."


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Editor: Marcus Turovski

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