KwaZulu-Natal ambulance staff on the edge over non-payment from Road Accident Fund
Owed millions of rand for emergency services during lockdown, many paramedics and their families are in a desperate struggle to make ends meet. On Friday, 30 October 2020, members of the KZN Private Ambulance Association (KPAA) said they had received no payments from the Road Accident Fund (RAF) since March, the start of lockdown. This is despite being an essential service during the pandemic and working in a high-stress industry, exacerbated by the threat of contracting COVID-19 when treating accident victims. The KPAA consists of 26 private ambulance services, with more than 800 employees. Private ambulance services from across KZN gathered at King Dinuzulu Park yesterday morning and drove in convoy along Dr Pixley kaSeme Street to the RAF offices in central Durban. They went on a 24-hour suspension of emergency services to those who did not have medical aid or insurance, with emergency response only resuming at midnight last night. As traffic jammed in the central city area there was a visible police presence but ambulance providers stressed it was a peaceful march. When the convoy stopped outside the RAF offices and while waiting for officials to appear so they could hand over their memorandum of grievances, KPAA acting chair, Andile Nduli, said, “We are all small businesses and we operate in a stressful environment. “But it’s more stressful if we don’t have money, it’s putting more strain on us and our families. We are on the frontline but we are also breadwinners for our families who are relying on us.”
He said the emergency service providers had bought their own PPE equipment at the start of lockdown, as well as having to bear normal expenses, which include salaries and high petrol costs.
Nduli called on President Cyril Ramaphosa, Minister of Health Zweli Mkhize and Minister of Transport Fikile Mbalula to assist with their plight.
KPAA spokesperson, Garrith Jamieson, said more than R7 million was owed to ambulance service providers, with many facing huge difficulty in sustaining their businesses and some having to take their vehicles off the road. “Some had to close their services and others have had to park their vehicles. Yet we are an essential service provider, we are first responders to a scene and we are there to assist patients,” said Jamieson, adding that during the two-hour convoy, he had five emergency calls, “excluding calls from our own clients,” he said.
Jamieson said government emergency services would be unable to cope without private ambulance services.
He said the RAF had until 7 November 2020 to respond to their memorandum. If they did not, the KPAA would suspend services for a longer period than 24 hours.
The memorandum handed to officials stated that the amount owed was “close to R10 million. We are informed COVID-19 is the culprit”. “Lack of payment from March 2020 has caused extreme harm and suffering to our businesses. Many lives would have been lost unnecessarily, however ‘free service’ cannot continue forever,” it said.
It also said the private ambulance services were not paid for emergency services in cases such as when a patient dies on the way to hospital; single driver accidents because the assumption is the driver is the wrongdoer; victims who cannot be identified because of lack of documentation at the scene or without a known address and if the patient is an undocumented foreign national.
“In the health profession, human rights and ethical conduct issues are more pronounced than in many other sectors. Unreasonable rules and irrational decisions by RAF compromise road accident victims’ human rights, such as human dignity and equal rights,” added the memorandum.
Officials from the Road Accident Fund accepted the memorandum at the scene. Road Accident Fund spokesperson, William Maphutha, said, “We duly acknowledge the submitted memorandum. It must be noted that the memorandum was also addressed to other government departments, such as Health and Transport. It is critical that we engage with these departments as key stakeholders.
“As the Road Accident Fund, we will be looking intensively into all grievances raised and respond accordingly. Some of the matters raised require us to determine whether or not there exist contractual agreements. In addition, we also need to determine if there was a legal basis for the payment of the queried amounts in law. We welcome engagement and will continue to do so as a caring government.”
Subsequently reports stated that the Road Accident Fund said it will be re-evaluating its relationship with private ambulances following the recent protest. “We have to look into the relationships and the contractual obligations that we have with the service providers. We need to establish a common ground so that these problems do not arise in future.” said William Maphutha, RAF spokesperson.
KPAAA, a recently formed organisation of about 25 emergency services companies operating over 100 ambulances across the province. How the relationship between private ambulance services and the RAF works is that private ambulances assist someone who has been in an accident. The private ambulance company can either claim from the insurance company or the government (RAF) depending on whether the person has medical aid or not.
KPAA claims they are owed in excess of R10 million by the RAF for work dating back to March. Maphutha said he could not verify that figure. “The invoices need to be verified with other stakeholders and whether (hospital) records correspond with the claims being made. Money involves accountability, if we are not accountable there might be audit problems in future,” said Maphutha.
In the most recent financial report, RAF had a net deficit (liabilities exceeding assets) of R262 billion as of last year, with the auditor-general describing the state insurer’s solvency status as “unsustainable”. The RAF is funded mainly through the fuel levy tax, which Maphutha said was one of two problems that created the non-payments backlog. “The lockdown also played a part because movement on roads was restricted so people were obviously not buying petrol and that affected the monthly grant RAF gets,” he said. “There was also a backlog created by many of the staff working from home and not being able to engage with the physical and tangible evidence that forms a big part of our claims process.”
Source: The Independent, The Berea Mail