INEKO: Nationalisation of Emergency Medical Service Carries Risk of Corruption

Bratislava, 23 August (TASR) – Dusan Zachar, the director of the Institute for Economic and Social Reforms (INEKO), sees risks of corruption and cronyism in the proposed nationalisation of the emergency medical service. „There would be increased risk of political appointments and inefficient use of public funds,” Zachar told TASR. „We would lose a valuable basis for comparison, as well as the innovative pressure from private ambulance operators. A relatively large amount of public finances would need to be found in a short period of time — and during a time of fiscal consolidation — to purchase a significant number of ambulances and set up emergency service facilities. As a state monopoly, the system would risk stagnation due to a lack of external pressure,” he said. Even with the introduction of priority rights for state and public entities to operate ambulances, Zachar believes the risk of corruption would grow. „There would be even more ‘extended hands’ demanding compensation for their (non-)participation in tenders. They would gain privileged status, which would also increase the value of their decisions,” Zachar added. He warned that such a move could distort the market and spark conflicts between different ministries or service providers. Regarding proposals to place the system under the management of “emergency” hospitals, Zachar noted that not all hospitals would be interested in taking on such a role. Running ambulance services, he said, requires resources, capacity, and know-how that many hospitals lack. „Many hospitals certainly prefer when the ambulance service is provided by other specialised entities and do not want to be burdened with it. After all, only a handful of hospitals participated in the current tender,” he concluded. As for the cancelled ambulance tender, several organisations are calling for fundamental reforms of the emergency medical system. The Medical Trade Union Association and paramedic unions are advocating for a stronger state role. The Federation of Employers' Associations and the Association of Hospitals of Slovakia propose assigning ambulances to hospitals with emergency departments. According to Health Minister Kamil Sasko (Voice-SD), the system under current conditions has proven to be flawed. He said that future steps will be “crystal clear”. Expert analyses are expected to determine how best to structure EMS operations, with three potential solutions outlined: nationalisation of ambulance services, granting priority rights to state and public institutions, and integrating ambulances into the so-called integrated rescue system. mf