Media Statement by the Hon. KZN MEC for Health Dr Sibongiseni Dhlomo: Implementation of new ambulance operator regulations in the Province

Emergency Medical Service Licence Application

31 August 2018

The KwaZulu-Natal Department of Health is initiating the implementation of the Emergency Medical Services Regulations, 2017 promulgated under the National Health Act, 2003. This means that all operators of emergency care services which are already in existence have until the end of November 2018 to submit applications to the KZN Department of Health so that their business operations can be assessed, in order for those who comply to be granted a licence to render emergency care services in the Province.

The licence will permit the operator to work only within a specific health district, and will be valid for a year and reviewed annually. Those whose licence applications are deemed unsuccessful, following the assessment, will be given reasons for this, and asked to rectify their shortcomings and resubmit their applications.

These Emergency Medical Services Regulations, 2017 affect all emergency care services operations, including the KZN Department of Health’s own emergency care services, which must also be assessed before being granted a license.

The primary aim of these regulations is to improve the quality of patient care and rid the sector of fly-by-night operators, whose conduct has, at times, placed patient’s lives at risk. In the current unregulated environment in the Province, there has been nothing to ensure that both public and private emergency care services are manned by registered and adequately trained staff, with proper and adequate equipment. These regulations seek to address this and also ensure consistency and standardisation of operations in the sector, so that the service is the same, anywhere, everywhere and at any time – regardless of the operator involved.

The licence application process will be overseen by an independent advisory committee which will make recommendations to the Head of the Department. This committee is composed of an expert in emergency medicine, a representative of South African Local Government Association (SALGA), one representative each from the public and private emergency care services, and a representative of health care users.

The Department is in the process of establishing an independent licensing and inspectorate unit which will administer the licensing and inspection processes, and act as a Secretariat to the advisory committee. This unit is part of the KZN Department of Health and will receive and process all applications before presenting them to the advisory committee. The unit is currently based at eThekwini District office, 83 King Cetshwayo Street, Mayville.

Stringent measures and proper due diligence will be applied in determining who qualifies to provide these services.

The licence application fee is R8,000.00 per operator and the inspection fee is R2,000.00 per station; R300.00 per ambulance; R300.00 per response vehicle; and R500.00 per rescue vehicle. The annual licence renewal fee is R2,000.00 per operator; R300.00 per ambulance; R300.00 per response vehicle; and R500.00 per response vehicle. There is also an additional R1,000.00 inspection fee per station. Payment details will be provided by the licensing and inspectorate unit which is being established.

Anyone may make representations for a waiver of any of the fees herein, in line with subparagraph 2 of regulation 19 of the Emergency Medical Services Regulations, 2017. A licence application may be withdrawn and the application fee reimbursed if the application is withdrawn before being processed by the advisory committee. However, the application fee will be forfeited once the application serves before the advisory committee.

Any operator who continues to provide emergency care services without a licence shall be guilty of an offence and may be liable, upon conviction, to a fine of up to R500,000.00 or a jail term of up to five years, or both.

In determining qualification for the licence, the advisory committee will consider the provisions of regulation 10 of the Emergency Medical Services Regulations, 2017 and may also consider, among other factors:

  • General Requirements: emergency care services must be supervised by a manager who is qualified and appropriately registered with the HPCSA. All operators are required to have a base station with rest facilities, permanent, plumbed, clean and hygienic ablution facilities. Furthermore, they must show capacity to clean contaminated equipment and linen, as well as vehicle washing facilities with the appropriate features and waste management services; or have an agreement with appropriate providers for such services.
  • Service Levels: Operators may be licensed for any or a combination of Intermediate Life Support; Advanced Life Support; Aeromedical Services; Event Medical Services; or Educational Institution for Emergency Medical Service, and the minimum requirements for each service are outlined in the Annexure to the regulations.
  • Minimum Staff Requirements: The staffing requirements for each level of emergency care and for each category of emergency care vehicle are outlined in the regulations. Furthermore, staffing levels must be appropriately aligned to the population size, demographic and the epidemiological characteristics of the health district served.
  • Vehicles: All emergency care vehicles must comply with national road traffic and safety legislation. Ambulances are required to have a siren, be properly configured to ensure complete access to patients for paramedics; have a two-way radio or cellular communication system or both, and be fitted with red warning lights that must be visible from the front, rear and both sides of the vehicle at all times.
  • Aeromedical Service: An aeromedical service operator must hold the appropriate license as specified by the Civil Aviation Authority of South Africa.
  • Equipment: All ambulances, medical response and medical rescue vehicles must have appropriate equipment as set out in the Emergency Medical Services Regulations, 2017.
  • We look forward to having an emergency care sector in the Province of KwaZulu-Natal that is well-regulated and subscribes to the highest standards of patient care.

    For enquiries, licence applicants are required to contact the licensing and inspectorate unit at the following address: Highway House, 83 King Cetshwayo Street, Mayville 4091. First Floor, 1A. Tel: 031 240 5300, ext 5511.

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This page last edited on 17 October, 2018

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