11 January 2025 : Indian Express Editorial Analysis

1. Symptom of a larger malady

(Source – Indian Express, Section – The Editorial Page – Page No. – 12)

Topic: GS2 – Governance

Context

The article highlights the growing demand for ambulance services in India.

Analysis of the news:

The Growing Importance of Ambulance Services in India

• The sirens of ambulances are an increasingly common feature of urban India, symbolizing both the rising demand for emergency medical care and the challenges of delivering it efficiently.
• The growing prevalence of chronic diseases, road accidents, and health emergencies has heightened the need for robust ambulance services.
• These vehicles are a vital link in providing timely medical care and transporting patients to healthcare facilities.
• However, the system faces various challenges, including quality disparities, regulatory issues, and infrastructural bottlenecks.

Evolution of Ambulance Services

• For decades, ambulances were predominantly hospital-based. The 1980s marked a significant shift when NGOs began offering voluntary and free ambulance services, particularly in southern India.
• Over time, government initiatives like the National Rural Health Mission introduced ambulances in public-private partnership modes, especially to support maternal and child health in urban areas.
• The past decade has seen private players and corporate hospitals entering the space, with innovations like Blinkit’s “10-minute” ambulance service in Gurugram, aimed at tackling urban emergencies.
• However, these services often grapple with urban traffic, cost concerns, and operational stress on drivers.

Current Landscape: Market Growth and Service Variations

• India’s ambulance market, valued at $1.5 billion in 2022, is expected to grow at a compound annual rate of over 5% from 2024-2028.
• Despite this growth, the primary focus remains on patient transport rather than critical emergency care.
• Only a fraction of operational ambulances are equipped with Advanced Life Support (ALS) units, revealing significant gaps in emergency preparedness.
• Geographical disparities also persist, with western and southern states having better infrastructure and accessibility compared to the underserved northeastern regions.

Ambulance services range from basic patient transport to specialised options like Basic Life Support (BLS) and ALS units, air ambulances, and ICU-equipped ambulances.

However, studies by Niti Aayog highlight the lack of technical staff and necessary infrastructure, with only 12% of hospitals offering specialised transportation care and a mere 3% employing Emergency Medical Technicians (EMTs).

Challenges in Quality and Regulation

• The expansion of ambulance services has not ensured quality. Many services are limited to patient transport, lacking life-saving capabilities.
• Urban traffic congestion and poor road planning exacerbate delays, reducing the effectiveness of even well-equipped ambulances.
• Regulatory shortcomings further hinder the sector. Fragmented and inconsistent licensing processes, coupled with weak accountability mechanisms, compromise operational efficiency and service standards.
• The absence of a unified toll-free helpline and standard protocols highlights the urgent need for reform.

Private sector growth in the ambulance market has been unregulated, leading to haphazard service quality and liability concerns. Investments in skilling and certifying paramedics, as well as standardising operational procedures, are essential for ensuring reliability and efficiency.

Way Forward

Efficient ambulance services are vital for a society facing an aging population and rising health emergencies. Public-private partnerships, publicly funded initiatives, and civil society involvement can provide affordable and accessible services to bridge the gaps left by high-cost private operators. Key recommendations include:

1. Standardised Protocols and Quality Assurance: Establish pan-India regulations for general and specialised ambulance services, ensuring uniform service standards and accountability.
2. Investments in Skilling and Infrastructure: Train and certify EMTs and paramedics while equipping ambulances with modern technology to handle emergencies effectively.
3. Improved Accessibility and Traffic Management: Address urban traffic congestion through better road planning and dedicated lanes for ambulances in metro areas.
4. Regulatory Overhaul: Streamline licensing processes, reduce bureaucratic hurdles, and ensure robust monitoring to curb inconsistencies and corruption.

Conclusion

• India’s ambulance sector is at a crossroads, with increasing private investment and growing public demand highlighting both opportunities and challenges.
• While the market is expanding, systemic improvements in regulation, infrastructure, and quality assurance are critical to ensuring that ambulance services provide timely and efficient emergency care.
• Collaborative efforts between public, private, and civil society stakeholders will be essential in transforming this crucial aspect of healthcare delivery.

India’s Need for Ambulance Services

Pandemic lessons: The COVID-19 pandemic exposed severe shortages in ambulance services, particularly during emergencies. Current landscape: India has 17,495 operational Basic Life Support (BLS) ambulances and only 3,441 Advanced Life Support (ALS) ambulances. Regional disparities persist, with northeastern states particularly underserved. Importance of ALS ambulances: These are crucial for trauma-related emergencies during the “golden hour” and are better equipped for critical care.

Practice Question:  The increasing demand for ambulance services in India highlights significant gaps in quality, accessibility, and regulation. Critically examine the role of public and private sectors in addressing these challenges, and suggest measures to improve the efficiency and equity of emergency medical services. (250 Words /15 marks)

For more such UPSC related Current Affairs, Check Out: 10 January 2025 : Indian Express Editorial Analysis