The contracts, the amounts, and the contractors – The "tariff" per kilometer.
65,000 euros is the cost of a new ambulance.
How the government, which could not prevent the weakening of the National Center for Emergency Care (EKAV), at the same time opened the way with the Law 2022 under Minister Plevris for private clinic and company ambulances to "invade" the National Health System (NHS) for secondary transfers.
The taxpayer loses, while the private companies based in the same cities as the public hospitals win, thus ensuring the constant renewal of direct award contracts.
Financial "suicide" in the medium term is the temporary solution of leasing, a coup de grace for the ambulance service.
On January 2, 2024, a sanitation worker for the city of Alexandroupolis collapsed at work just
100 meters from the emergency room of the city's general hospital. Due to bureaucratic
procedures, it took 15 minutes for an available ambulance from the nearby hospital to reach
him. It was determined that he had suffered a stroke. For the next few weeks, he fought for
his life in intensive care. The hospital itself finally admitted that it was not 15 minutes, but…
13.
Last July, a woman died helplessly on a beach in Lesvos while waiting for an ambulance that arrived late because there were reportedly not enough drivers to cover shifts. The same thing happened in Peristeri in the same month and in Kavala in November.
In Attica, for example, only half of the 90 ambulances that should be operational are available in the morning and afternoon, and similarly, only 25 out of 50 are available at night. The response time to incidents is often 4-5 hours.
According to union representatives, the system lacks not only ambulances but also at least 1,000 paramedics. The solution of “mobilizing” military personnel to fill the vacancies, which has been in place since last summer, doesn’t seem to be effective. Moreover, the transfers require specialized personnel with professional licenses.
Instead of reinforcing the crews, repairing ambulances that are out of service due to heavy use or lack of spare parts, and purchasing new ones, the Greek government has chosen the dead-end path of “patching up”. One of these measures is to rent private ambulances “by the hour,” with contracts that drive up costs for taxpayers while leaving the emergency medical service increasingly weakened.
(ΚΟΝΤΑΡΙΝΗΣ ΓΙΩΡΓΟΣ EUROKNISSI)
News of deaths and delays in transfers due to the weakened National Center for Emergency Care is understandably causing fear and anxiety among citizens. They now more easily accept such costly “interventions” with short-term prospects in the public health system. Meanwhile, the government has the excuse of its “strategic” inaction to proceed with decisions to gradually integrate private ambulances into the NHS, initially for secondary transfers.
What changed with the December 2022 law
According to a law passed in 2022, during the tenure of Thanasis Plevris at the Ministry of Health, contracts between public hospitals and private ambulances were allowed for secondary transfers. These transfers involve transporting patients from the hospital to their homes, or transporting them to and from hospitals for examinations, etc.
However, the cost of these hires proved prohibitive compared to the purchase of new ambulances by the NHS and significant staffing increases.
According to Law 4999 of December 2022 (Official Gazette A 225/7.12.2022), “the transfer of patients after their discharge from hospitals may also be carried out by the hospitals of the National Health System in which they are hospitalized. To facilitate these transfers, hospitals within the National Health System may optionally enter into contracts with natural or legal persons who own licensed private ambulance vehicles.
(ΔΗΜΗΤΡΗΣ ΠΑΠΑΜΗΤΣΟΣ/EUROKINISSI)
1.7 million euros spent by 40 hospitals in just 15 months
From the implementation of the law to date, a period of 15 months, the total expenditure on contracts between hospitals and private ambulance companies has reached 1.7 million Euros (1,698,151.72 €). More than 70 contracts from 40 hospitals – mainly in the region – have been registered in the Central Electronic Public Procurement Register (KIMDIS) since the day the law came into force.
This amount continues to grow at an increasingly rapid pace. Expenditures are escalating, but none of the vital problems of the NHS are being addressed; instead, the NHS is being marginalized and slowly disappearing.
The contract of the EKAV in 2023 for the purchase of 52 ambulances at the cost of 65,000 euros each (pdf)
Η σύμβαση του ΕΚΑΒ το 2023 για την αγορά 52 ασθενοφόρων με κόστος 65.000 ευρώ το καθένα
…………
How much does a new ambulance cost?
For comparison, the cost of purchasing a new ambulance does not exceed 65,000 Euros. In addition, no special and expensive equipment is required for secondary transfers.
In a procurement contract for ambulances presented today and signed by the EKAV (National Center for Emergency Care) with a car sales company on February 8, 2023, the cost of an ambulance is 65,000 Euros including VAT!
As stated in the contract, “the cost for the procurement of 52 ambulances 4X2 type B DIESEL, for the needs of EKAV, in the regions of Attica and South Aegean, amounts to 3.381 million Euros including VAT.
(ΔΗΜΗΤΡΗΣ ΠΑΠΑΜΗΤΣΟΣ/EUROKINISSI)
This means that if the 1.7 million Euros spent in just 15 months on renting private ambulances had been invested directly in EKAV, it could have purchased 25 new ambulances.
The government, despite its occasional announcements, does not take any action to strengthen the EKAV with ambulances and personnel. The continuous devaluation of the EKAV, which began with previous governments, increases the fears of the citizens, and a solution that is initially presented as “temporary”, such as renting private ambulances, ends up becoming permanent, possibly even expanded. Even if it turns out to be a burden for the public treasury and a coup de grace for EKAV.
The contract of the Serres Hospital for the rental of private ambulances in January 2024 (pdf)
Η σύμβαση του Νοσοκομείου Σερρών για ενοικίαση ιδιωτικών ασθενοφόρων τον Ιανουάριο 2024
Charges to the “Attikon Hospital” for the transportation of patients both within and outside of the region of Attica.
Το κόστος που επιβαρύνεται το «Αττικόν» για τις διακομιδές εντός κι εκτός Αττικής
Direct awards per route and kilometer
Public hospitals usually award contracts at the direct award threshold, i.e. up to €30,000 excluding VAT and until the amount is exhausted. Some of them have already signed more than one contract.
Prices range from €40 to €70 per route, depending on the distance. The costs are more precise when the ambulance has to travel long distances or when a ship is involved (e.g. Corfu).
One of the most recent expressions of interest was announced – by direct award – by the General Hospital of Serres on January 16, 2024. It concerned the “provision of ambulance rental services for secondary transfers”. The estimated expenditure is up to the amount of 30,000 euros plus VAT, i.e. 37,200 euros.
On the same day as the expression of interest, the contract was signed, which stipulates a cost of 60 euros for transfers up to 25 km and a cost of 60 euros plus 2 euros/km for transfers over 25 km.
The contract stipulates that “the hours of availability of the ambulances will be from 8:00 a.m. to 8:00 p.m. on weekdays, weekends, and holidays, without limitation on the daily number of transports,” and that “the response time will be within two hours after notification by the hospital, otherwise there will be a 50% surcharge on the route.”
The Contractor’s private ambulances undertake:
1. The transportation of discharged patients from the hospital to their homes, and
2. The transportation of hospitalized patients to diagnostic centers within the city of Serres for diagnostic tests not performed in the hospital and their return to the hospital.
The duration of such contracts up to 30,000 euros, which are the most common, is unpredictable, as the exhaustion of the amount depends on the frequency of incidents. In other cases, such as in the General Hospital of Corfu, monthly contracts of 11,000 euros are signed (or until the amount is exhausted), as happened on February 2, 2024.
In another contract signed by “Attikon” on April 10, 2023, for the provision of ambulance rental services for transfers, we can also see the costs for Attica with differences inside and outside the prefecture. Within Attica, it is 38 euros, but for Megara, it increases to 70 euros, for Anavyssos to 100 euros, the same for Lavrio. The waiting time per hour, at the request of the attending physician, is priced at 40 euros.
All contracts, amounts, and contractors
Data Journalists today present all contracts between hospitals and private companies for ambulance rentals signed since the law was passed in December 2022 until today, including amounts per contract and contractors. There are more than 70 contracts from 40 public hospitals.
As anyone can easily see, especially for the region, the renewal of contracts usually results in “standard” contractors based in the same cities as the hospitals, while larger companies can compete for contracts in hospitals in other areas.
……..
1 of 4
-+
………
* In those contracts where no amount is indicated, the agreement provided for a fee per route per month and the relevant official invoices have not yet been issued.
