Lok Sabha Question No. 2215 (UNSTARRED), answered on 2023-12-15
Subject: Streamlining Emergency Response System
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sangeeta Azad

## GOVERNMENTOFINDIA MINISTRYOF HEALTH & FAMILY WELFARE DEPARTMENTOFHEALTH & FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2215 TO BE ANSWERED ON 15th DECEMBER, 2023

## STREAMLINING EMERGENCY RESPONSE SYSTEM

## 2215. SHRIMATI SANGEETA AZAD:

Will the Minister of HEALTH AND FAMILYWELFARE be pleased to state:

- (a) whether the Government proposes to create India's 911 emergency network and if so, the details thereof;
- (b) whether the said model would aim to streamline emergency response systems, particularly addressing he challenge of delays and fragmentation in the current scenario;
- (c) the manner in which the Government plans to enhance the accessibility, reliability and quality of medical assistance, expecially in rural regions where the challenges are even more pronounced;
- (d) the role played by air ambulances in addressing the healthcare needs of a largely rural country like India along with dhallenges being faced in this segment;
- (e) the details regarding the steps taken/proposed to be taken to shift towards becoming a direct-to consumer brand;
- (f) the manner in which such a transition would benefit the patients along with the strategies proposed to be put in place to increase the percentage of Indians seeking qualified emergency services particularly keeping in view of the fact that only 14 percent reach out to such providers in emergncies: and
- (g) the role private entities can pay in complementing and strengthening Government-led initiatives across the critical domain?

## ANSWER THE MINSTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARTI PRAVIN PAWAR)

(a) to (c) The Government of India has been supporting the states in developing an integrated emergency care system through the National Health Mission (NHM), which has become synonymous with the accessible and affordable healthcare system in India.

-  The National Ambulance Services (NAS), under the NHM has become an integral part of our healthcare system as they play a significant role in bringing the patient closer to a healthcare facility. With the advent of NAS, the Emergency Medical Services (EMS) in India have expanded exponentially and geographically, shifting focus from being a mere transport vehicle concept to a lifesaving emergency medical transportation. There has been an increase in the total number of ambulances from 12,000 in 2012, to 28,863 in 2023.
-  The COVID-19 pandemic greatly highlighted the need to strengthen health systems'

response and availability of adequate referral and infrastructure. During the second wave, India's COVID-19 Emergency Response and Health Systems Preparedness Package (ECRP-II) funds were allocated to strengthen the referral transport system by augmenting the existing fleet of ambulances.

-  A critical intervention to make emergency systems more robust is the adoption and deployment of technology to support enhanced EMS performance across the whole continuum of care. Having committed to making India a digital health forerunner, gradual steps are being taken to position technology such that it not only accelerates processes but also helps in saving innumerable lives while creating a sustainable and effective framework for future generations.
-  National Program for Prevention & Management of Trauma and Burn Injuries aims to establish a network of trauma care facilities to reduce the incidence of preventable deaths due to traffic accidents by observing golden hour principle and to develop proper referral and communication network between ambulances and trauma centres and within the trauma centres.
-  In addition, to ensure Quality, Safety, and improved users satisfaction in public health facilities, the Ministry of Health and Family Welfare initiated the country's Quality journey by launching the National Quality Assurance Standards (NQAS). NQAS has established a credible, sustainable, inbuilt, explicitly measurable quality system at all levels of public health facilities -from District Hospitals to Ayushman Arogya Mandir.
-  Pradhan Mantri Ayushman Bharat Health Infrastructure Mission aims to develop Critical Care Blocks in districts over 5 lakh population. These CCBs are envisaged to augment the capacity of the district for assured treatment and management of patients with infectious diseases or critical illnesses as well as ensure health system preparedness for future outbreaks.

(d) & (e) The various initiatives and programs under the NHM such as the expansion of the National Ambulance Services, training through the National Emergency Life Support (NELS) courses, and the adoption of technology, suggest a movement towards a more patient-centric and accessible emergency care system. These steps, while not directly framed as a shift to a direct-to-consumer brand, contribute to making emergency medical services more directly accessible and responsive to consumer (patient) needs.

(f) Enhanced ambulance services, improved training for medical staff, and the adoption of technology can lead to quicker and more effective response times in emergencies, potentially saving more lives. States/UTs have the flexibility to deploy the ambulances as per time-tocare approach so that these ambulances are easily accessible to all. 108 Emergency Response Service is a 24x7 emergency service. Dial 108 is predominantly an emergency response system, primarily designed to attend to patients of critical care, trauma and accident victims etc. Dial 102 services essentially consist of basic patient transport aimed to cater the needs of pregnant women and children though other categories are also taking benefit and are not excluded.

(g) Private entities can provide support in the development and maintenance of critical infrastructure, technology, and training programs. This can significantly augment the government's resources, enabling the acquisition of state-of-the-art equipment and implementing advanced training protocols.

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