New ambulances, disassembled and left to sleep outdoors: "The medication crystallizes"

PalmOf the 130 scheduled transport ambulances that IB-Salut acquired through a lease to replace its aging fleet, 55 have had to be dismantled because they exceeded 3,500 kilograms, the maximum weight allowed by the Category B driving license held by most drivers and technicians. These vehicles have lost hydraulic ramps, which allow wheelchairs to be loaded, as well as some seats. "It's like they're taxis taking people from one place to another because, ideally, they only allow people without any physical limitations to get in," explains Vicente Nadal, UGT delegate for Healthcare Management of the Balearic Islands (GSAIB) in Ibiza and Formentera. Driving vehicles over 3,500 kilograms requires a Category C license, which 80% of the scheduled services staff do not have. In Ibiza, in addition to the technical problem, many ambulances, both scheduled and emergency, are left outdoors, exposed to the sun, rain, and even flooding. "In winter, the medication and IV fluids crystallize. And in summer, the cabin reaches temperatures between 45 and 50 degrees Celsius. The medication also deteriorates due to the humidity," Nadal reports.

Socialist MP and former Health Minister, Patricia Gómez, explains how this situation arose, with part of the fleet having to be decommissioned. By 2023, the ambulances in service had accumulated a significant amount of mileage. "We left a tender process completed and awarded. When the new government took over, the contract was terminated overnight." "It took them two years to launch a new tender to acquire 246 ambulances, including those for scheduled and emergency services. They were awarded on a leasing basis for 56 million euros, with a monthly cost of 800,000 euros," Gómez explains. ARA Baleares contacted IB-Salut to obtain their position on the issues covered in this report, but received no response.

The dismantling of the ambulances has a direct impact on the service's dynamics. "The vehicles are configured with fixed seats that prevent the normal installation of wheelchairs. This creates complicated situations, such as when technicians go to pick up a patient and find them dizzy, weak, or in need of a stretcher, and they can't transport them because the vehicle isn't adapted," explains the former councilor. Complaints from patients about transfers that aren't carried out or are canceled are multiplying.

Sunny Ambulances

Adding to this operational situation are infrastructure problems, especially visible in Ibiza. A significant number of ambulances are parked outdoors, for example, in the old Can Misses Hospital building. "In the summer they're left out in the sun, which is awful, because the ambulances are full of medical supplies, IV fluids... And it's not good in the winter either, because they get damaged," Nadal complains. At Can Misses, there's a covered parking area, but it floods when it rains, as can be seen in the video at the top of this article. "The cables for charging the ambulances and the electromedical equipment are on the ground and get wet. It's dangerous," he explains. "At the Vila Health Center, the cables are also hanging loose," the delegate adds. The lack of adequate parking means that ambulances are parked "wherever they can," from areas adjacent to hospitals to spaces reserved for private cars, which also makes charging and the loading of electromedical equipment difficult. The delegate complains that, regarding infrastructure, GESAIB passes the buck to the 061 emergency service and nothing is being imported. Meanwhile, a large number of ambulances—both fully operational and decommissioned—are sitting out in the open. "If they were supposed to last six years, they'll last two," Nadal concludes.

Three models

In Ibiza, there are 15 ambulances for scheduled transport. Of these, three are type A (with seats and a bunk) and three are type C (with seats and a hydraulic ramp). The rest, according to Nadal, "are an invention of the Regional Ministry." They've been called type B and only have seats because the ramps have been removed. There are nine of them. No matter how many ramps are removed, the service's needs don't change. "There's an overload, especially with the type C ambulances. Patients have to wait between 13 and 15 hours. Orders have been given from Palma not to cancel dialysis sessions, which are a priority, but rehabilitation sessions are being canceled. This affects, for example, stroke patients who need the patient to undergo treatment. [The text abruptly ends here, so the translation stops as well.]

The professionals try to compensate for the shortcomings of the transport system as best they can. Thus, they often opt to load patients through the side doors, which has the drawback of a high step, making access difficult for people with reduced mobility or the elderly. In addition to the lack of ramps, only three vehicles have a bed. "In the previous tender, all ambulances except three had them, and now that's been reversed," UGT complains.