WORLD: Why do we now have a state of emergency every day in the Berlin rescue service?
Oliver Mertens: We have a problem of supply and demand. The expectations of the people do not correspond to the actual tasks of emergency rescue and the means that are available for them. The city is growing, and so is the bureaucracy, while at the same time the ability to help yourself is declining. We have longer journeys, are stuck in traffic, the ambulances are also tied up for longer due to greater bureaucracy in documentation, in refusal to transport, in hospital handover. We are now witnessing the consequences of years of austerity.
WORLD: Do people call 112 too quickly or does the system have errors?
Mertens: People call 112 in emergency situations, but this is perceived differently. The task of emergency rescue is to preserve the life or health of emergency patients, to make them transportable and to transport them under professional care to a facility suitable for further care. Emergency patients are people who are in a life-threatening condition or who are at risk of serious health damage if they do not receive appropriate medical attention promptly. However, we are often also seen as a service provider, are easier to contact and with less effort than going to the doctor or the rescue center. We see people standing on the street with their suitcases packed, waiting for the ambulance and their relatives then following in their own car.
WORLD: What has to happen for the situation to relax?
Mertens: There is no one-size-fits-all solution, but we have ideas that would improve the situation quickly and sustainably. We have to change the rescue service law, strengthen people’s personal responsibility and move away from the one-person constellation of the medical director, who alone bears responsibility. It would also be conceivable that the location of the emergency vehicles would be recorded using a location system in the future and the vehicle that was available as soon as possible would be dispatched.
WORLD: Anyone who calls 112 ends up in Berlin in the control center of the fire brigade. There, based on a standardized query protocol, a decision is made as to whether there is an emergency or not. It is criticized that ambulances drive through the city with blue lights even when there are trifles and that the fire brigade also plays it safe for liability reasons. Does this process have to be changed in the control center?
Mertens: Yes, it has to be adjusted. In terms of quality, every use from calling 112 to the medical examination of the patient in the hospital must ultimately be considered. Was the patient an emergency patient or not? What information was given on the emergency call, how was the situation on site assessed after the first examination and what did the examination in the hospital reveal? Was the effort justified or not? With these findings, the query protocol and the subsequent measures can be adjusted.
WORLD: So the alarm codes in the control center would have to be updated?
Mertens: We need hospitals to report back so that they can find out how an operation went and use this data to adjust the alert codes in the control center. We need mandatory first aid courses in high school and an expansion of the network of first responders, i.e. those teams that are on site first. There is also a need for a joint ambulance transport control center for the private ambulance transport companies, which can, among other things, provide telephone advice on first aid. In any case, we need the option of prioritizing the ambulance loading according to conditions.
WORLD: Does the Association of Statutory Health Insurance Physicians have to be more involved? If there is no emergency, it is actually a patient transport.
Mertens: Yes. The services must be made more attractive and perhaps also more obligatory, because we often want to place bets but fail to do so. The fire brigade cannot solve the problems of this city alone.
World: How do you rate the crisis management of the Berlin fire brigade and the Senator for the Interior.
Mertens: The interior senator and the Berlin fire brigade are reacting to the current situation within the scope of their possibilities within the legal scope, which, however, does not really come as a surprise. Unfortunately, the way this crisis has built up over decades cannot be overcome with the stroke of a pen. But Berlin’s politicians must find interdepartmental short-term solutions before the last firefighters are burned. If you drive constantly in the red speed range, you won’t get very far.
WORLD: Munich does not know the Berlin problems. Does the Berlin fire brigade have to get out of the rescue service business as a last resort?
Mertens: I doubt whether the Munich way can be a solution for Berlin to outsource the rescue service. Berlin has not necessarily had good experiences with the privatization of water supply, the electricity grid, hospitals, security tasks and others. If you look at the rescue service as a business, then it may be attractive for one or the other, but where do we want to develop with our society? Will only those who can show a health card be transported?
