CORRESPONDENCE

Non-emergency patient transport - an integral part of accessible comprehensive health care

To the Editor: The Western Cape province operates a fleet of 73 vehicles specifically designed and dedicated to transport nonemergency patients within the provincial health care system. Its population of close to 5 million is spread over an area of 130 000 km², with 70% of the population located in the Cape Town metropole.

To provide equitable access to the full range of health services from clinics in the rural districts to central hospitals located in the metropole is a challenge being successfully addressed by Health Non-Emergency Transport (HealthNET). The service operates on different levels congruent with patients requiring non-emergency transport, as opposed to emergency care provided by the Ambulance Service.

Within the metropole and districts the daily service operates specifically for patients who for medical reasons cannot make use of public transport to attend special clinics such as tuberculosis and HIV services and specialist outpatient clinics at regional and central hospitals. The rural service alone transports over 3 000 patients per month to specialist departments only available at the Cape Town central hospitals. The discharge of inpatients from hospitals either to home or step-down facilities in the metropole or rural areas is also an important service in ensuring bed availability in our hospitals.

Expensive and scarce specialist facilities such as magnetic resonance imaging are made available to patients in all hospitals by HealthNET, which ensures that patients are delivered timeously for specific examinations and returned to their hospital of origin. A computer booking system linking hospitals with all the control centres in the metropole and districts ensures that the 900 patient places available daily in the transport fleet are used efficiently.

The HealthNET system is operated by Emergency Medical Services as an integral part of the Emergency Ambulance Service. This has enhanced emergency ambulance availability and provided additional minor patient injury capacity for dealing with multiple casualties occurring daily with minibus taxi accidents.

While difficult to quantify, there is no doubt that a well-resourced, efficient non-emergency patient transport system is a vital link in ensuring patient access to health care, while dealing with the reality, or impossibility, of providing affordable and scarce resources more widely.

A G Mac Mahon
alanjean@telkomsa.net