In Bangladesh, ambulance services represent one of the most important yet neglected areas of healthcare. In the struggle to save a patient’s life, every minute spent reaching the hospital can prove invaluable. However, in reality, ambulance services in the country have become disorganised, syndicate-controlled and unregulated.
Families of patients are often compelled to pay exorbitant fares at times of distress, yet in many cases they do not receive even the minimum level of service in return.
To overcome this situation, the idea of bringing ambulance services under a unified network has long been under discussion. The Health Reform Commission has also recommended this measure. A strong national authority should be established to oversee ambulance operations across the country and bring order to their activities. Under this authority, every ambulance must be registered, while ensuring fitness, safety and compliance with minimum service standards will be mandatory.
At present, the majority of so-called ambulances in our country are not genuine ambulances. Many are merely microbuses converted with superficial modifications. Inside, there are no facilities for providing emergency care. Yet, when a patient is transferred from one hospital to another, he or she remains under treatment, meaning that continuous medical care is required throughout the transfer. Therefore, an ambulance must have at least basic medical facilities, such as oxygen, essential life-saving equipment and the presence of trained medical person.
A strong national authority should be established to oversee ambulance operations across the country and bring order to their activities.
For this clear definitions are essential. What qualifies as an ambulance? What are the minimum requirements? How should the highest level of service be delivered? These standards must be set by the proposed authority.
At the same time, it should determine the fares – whether on per-kilometre basis or according to specific services provided. Most importantly, no additional charges beyond the approved fare may be collected and this must be made known to the common people through wide publicity. If necessary, a rating system may be introduced to review the quality of ambulance services.
Currently, patients’ families bear the responsibility of arranging ambulances privately. In the future, the government could estimate the overall cost of operating ambulances nationwide and take responsibility for meeting that expense. In the long term, if the health budget allocates increased resources to this sector, ordinary citizens could access ambulance services almost free of charge, or at a very minimal cost, during accidents or emergencies.
However, under present circumstances, it is not feasible for the government to bear the entire cost immediately. Therefore, as a first step, private ambulance services must be brought within a regulated network and framework. This would at least ensure fairness in fares, standards, and service quality.
Ambulance services are not merely a form of transport; they are intrinsically linked to saving lives. If these services can be managed and regulated within a network-based system, it would not only dismantle syndicate control but also add a new dimension to the country’s healthcare system. Patients would then have the assurance of receiving safe, fair, and quality services at moments of critical need.