This paper explores issues surrounding the role of ambulance officers by posing the question "Should ambulance officers re-assess their role to better meet then needs of Australia's current and future health system?"

In considering this question I argue that the history of ambulance services and the non-reflexive official policies that define ambulance officer roles have driven the delivery of ambulance services for too long. The ongoing escalating demand for ambulance services may provide ambulance officers and policy makers with an ideal opportunity to review the role of ambulance services in Australia.

Several warning bells pointing to the need to re-assess the role of ambulance officers in current health care delivery are highlighted: That the major performance measure used by ambulance services is response times. This reflects the fact that historically ambulance services are designed primarily to provide urgent life-saving treatment, despite the fact that the majority of patients do not have life-threatening illnesses. That ambulance services worldwide are experiencing growing demand for services, with little understanding of the causes for this increase in demand. That anecdotal evidence suggests ambulance services are increasingly spending time caring for patients whilst looking for a hospital to accept patients into their care, with ambulance officers required to spend long hours waiting with patients to be handed over to department of emergency staff.

I then suggest how this re-evaluation might proceed and who should be involved. Research and communication will be key factors. Ambulance services are currently poorly placed to review models of care, as there is a dearth of service delivery research. What is needed is a combination of expertise from economists through to behavioural scientists. Management, researchers and policy advisors will have important roles in evaluating services at the system level, while ambulance officers and researchers can ensure that those making decisions have relevant information from the field. Education providers must also be at the forefront of change, by ensuring the ambulance officers' curriculum reflects the changing environment.

There is increasingly an imperative for ambulance services to reflect on their role within the current health system and position themselves strategically to meet future health care needs. The increasing pressure on our health system sees governments attempting to contain health care costs. Unfortunately these pressures are set within an Australia where health consumers have rising expectations of care, and health service providers are increasingly afraid of litigation. There is no doubt that ambulance services have an important role in providing Australians with high quality care, but they need to ensure they are effective in the provision of this care by ongoing review and reflection. I conclude that 'yes', ambulance officers should re-assess their role.

Author Biography

Researcher, University Department of Rural Health, Tasmania