Poland Launches Ambitious Ambulance Upgrade Plan

The Polish Ministry of Health has launched a program to upgrade and expand Poland’s ambulance fleet with an investment of about U.S. $21 million in its first year. The initiative is part of efforts by the authorities to overhaul and modernize the country’s prehospital emergency healthcare, with funding for EMS on the rise.

“The Ambulance replacement program marks another step of the emergency medical services system, whose first phase was completed on April 1, 2019 through the launching of the state emergency medical services,” says Wojciech Andrusiewicz, spokesperson for the Polish Minister of Health. “Last year the Ministry of Health carried out a project under which 100 EMS stations throughout the country obtained new equipment to save lives. The program covers all of Poland’s [16] regions and will deliver modern EMS [capabilities] to emergency medical services stations across Poland.”

Increased spending on new ambulances reflects the ministry’s increased focus on EMS. In 2018 the ministry allocated almost half a billion U.S. dollars to improving it. A year later the contribution was expanded to more than $560 million—a robust increase of more than 17%. In addition to new ambulances and equipment, the additional funds are to be spent on raises for EMS personnel.

Modernizing the Fleet

With the upgrade program the share of overused vehicles in the country’s fleet is to be significantly decreased.

“We want to replace 200 ambulances across Poland,” said Polish Health Minister Lukasz Szumowski, as reported by local broadcaster Radio Dla Ciebie. “Each ambulance will be cofinanced by [a grant of] PLN 400,000 [more than $100,000]. We’re planning to modernize the fleet because some of the ambulances have been used for more than six years.” It is estimated that about one-third of Poland’s ambulances have been operated for at least that long.

The plan to replace the ambulances was first announced by Prime Minister Mateusz Morawiecki at a press conference last August. The program was unveiled last September at the official signing ceremony of a contract to procure new vehicles for the country’s central Masovia region, which contains Warsaw, the country’s capital and largest city. 

“The Masovia region will obtain 25 new ambulances,” Zdzislaw Sipiera, the region’s governor and a former member of parliament for the ruling Law and Justice party, said at the ceremony.

“Providing medical response teams with modern ambulances is key to allowing them to ensure immediate assistance [to patients]. [Polish] ambulances are dispatched…in total about 3.2 million times per year, which translates into close to six dispatches per ambulance every 24 hours,” the ministry said in a statement. “These dispatches are often carried out in extreme conditions or areas that are difficult to access. This causes the ambulances to incur damage and gradually become inoperable. It is estimated that ambulances should be replaced after five years of use. To date Polish patients have often been serviced by ambulances that have been used for more than a dozen years.”

The Health Ministry forecasts that as a result of the program’s implementation, the average age of Polish ambulances will be lowered by 2.5 years, according to Andrusiewicz.

Legislative Impacts

Despite the latest move by the Health Ministry to overhaul the publicly owned ambulance fleet, it is noteworthy that legislation drafted by the ministry that took effect last year decreased the number of ambulances that operate in Poland by imposing restrictions on the operations of privately owned EMS. Prior to April 2019 Poland’s state-run healthcare provider, the National Healthcare Fund, could sign contracts with privately owned EMS, but the amended legislation forces the fund to ink contracts solely with entities in which the Polish state or local governments are majority owners. The amended legislation was a term of an agreement signed by the Ministry of Health and National Trade Union of Emergency Medical Services Employees, ending protests by the union, which has long called on the government to nationalize the EMS industry.

At the same time the legislation eliminated some 135 privately owned ambulances from the sector, with some local observers voicing concern about the move’s negative impact on regions where private operators played a major role. 

Data from the state-run Central Vehicles Register indicates that as of mid-2019, some 1,386 ambulances were registered in Poland under different categories. Given Poland’s population of close to 38 million, this would translate into a ratio of one ambulance per roughly 27,400 inhabitants.

With all the ambulances becoming part of a single fleet, the Ministry of Health plans to unify the vehicles’ visual identification by 2028. Currently Polish ambulances are painted white or yellow, but in the coming years they all are to be yellow.

The ambulance modernization program and elimination of private ambulance operators have been carried out alongside other activities to centralize the country’s EMS. In Poland EMS can be accessed by calling either 9-9-9 or 1-1-2. Calls are received by 42 ambulance control centers, which replaced 200 smaller centers previously distributed across the country under the EMS bill from 2018. The ministry further plans to reduce their number to 18 by 2028. Those centers are to cover Poland’s 16 regions, with additional centers foreseen for two of the country’s most densely populated areas, the Masovia region and southwestern Silesia region.

Jaroslaw Adamowski is a freelance journalist based in Warsaw. Among other subjects he covers the EMS industry and related developments in Central and Eastern Europe.