The deterioration of emergency medical services has become a nationwide worry. In October, a pregnant woman transported by ambulance was refused admission to eight hospitals in Tokyo and died after giving birth. In December, an elderly woman seriously injured in a traffic accident died after she was refused admission to six hospitals in Fukushima and Ibaraki prefectures.

The Fire and Disaster Management Agency’s 2008 white paper says that, in 2007, an ambulance took an average of seven minutes to pick up a patient — 0.4 minute more than in 2006 — and 26.4 minutes to take the patient to a medical institution that accepted him or her — one minute more than in 2006. Both times were the worst ever. The 26.4 minutes to transport a patient was 6.5 minutes longer than 10 years ago.

The education and science ministry plans to raise the student quota for medical schools by 700 to about 8,500 in fiscal 2009. But it will take a long time for students to become doctors. One way to help mitigate the impact of the current doctor shortage would be to give additional medical training to ambulance crew members and let them perform procedures in transit that could help stabilize patients before they are hospitalized. Unfortunately it is also becoming more difficult to recruit ambulance crew members because of cuts in the number of public servants. This problem must be remedied as well.

The Japan Society of Obstetrics and Gynecology has proposed giving priority to treating emergency cases within a given prefecture. This entails stationing specialists where they’re needed, installing intensive-care units for pregnant women and newborns, and sharing information among hospitals.

The society and the Japanese Association for Acute Medicine have also proposed tearing down walls between perinatal medical services and emergency medical services so that proper acute care can be administered to pregnant women as needed. They also propose that doctors from publicly run hospitals be allowed to treat emergency cases at private hospitals.

Local governments and hospitals clearly need to improve coordination and cooperation to better handle emergency cases. Motorists can do their part by promptly yielding to ambulances.

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