EMS Around the World: Czech Republic Modernizes Fleets

The 2020 coronavirus outbreak in the Czech Republic highlighted a need to acquire new ambulances for the country’s EMS and encouraged Czech regions to accelerate programs to modernize their fleets.

Local media reported on a number of ambulance procurements designed to upgrade the capacities of local EMS stations. Authorities in the tourist destination of Karlovy Vary, for instance, approved a tender to purchase five new trucks. This followed the procurement of 10 new ambulances for the Liberec region under a CZK 33 million (U.S. $1.3 million) deal and seven new ambulances by the EMS station in the Zlin region for some CZK 24 million (U.S. $950,000).

The country’s capital, Prague, a city of roughly 1.3 million, initially reported the most infections of all Czech cities and is leading the way with its ambitious ambulance acquisition program: Its municipal council adopted a plan to acquire 15 new ambulances in 2020 and 10 more in 2021, ultimately allowing the city’s EMS to operate up to 80 ambulances that have been in use for less than six years.

Asked about the Czech Republic’s investments in acquiring new ambulances for its EMS, Klára Doláková, a spokesperson for the Czech Ministry of Health, says the decision to upgrade ambulance fleets is “up to the individual regional rescue services,” which acted based on their evaluations of regional operational needs.

Decentralized Approach

This decentralized approach is rooted in the legislation that led to the creation of a region-oriented EMS system in the Czech Republic almost 20 years ago. In 2003 the Czech authorities established a countrywide network consisting of 14 regional rescue services, set up through mergers between 76 territorial service centers that were disbanded as part of the country’s administrative reform. 

These entities are established and partly financed by regional authorities but legally are completely independent. The Association of Emergency Medical Services is an umbrella organization supporting them, with voluntary participation but without legislative powers. “Ensuring a unified methodological guidance is the task of the Ministry of Health,” according to Doláková. 

A hybrid system combining public and private funds was designed to ensure funding for the Czech EMS system. “Financing for the rescue service is provided mainly by two types of income: About 60% is provided by the regions in the form of subsidies, and about 40% is payments by health insurance companies,” the Health Ministry’s representative said.

Under the current system most Czech ambulances are property of the 14 regions, and according to the latest data from the Health Ministry, some 823 ambulances are operated in the Czech Republic. Those are complemented by an undisclosed number of privately owned vehicles.

“According to the law, the regional rescue service may also include in its system a rescue group operated by a private person, and in this case the ambulance is the property of that private person,” Doláková says, adding that such ambulances do not constitute a large number in the Czech Republic. 

By Leaps and Bounds

In the Liberec region, located in the country’s northern part and with a population of close to 3.2 million, the deal to acquire 10 new ambulances is part of the region’s strategy to gradually modernize its fleet, according to senior EMS officials. The vehicles procured in 2020 included six Mercedes-Benz Sprinters and four Skoda Kodiaq ambulances. 

The Sprinters will be deployed to the EMS stations in Liberec, Cesky Dub, Jilemnice, Velké Hamry, and Ceská Lípa. The Kodiaqs will serve patients in Liberec, ČCeská Lípa, Jablonec nad Nisou, and Semily. The 10 ambulances that were replaced will not be phased out of service but will continue to serve patients in the Czech Republic’s northern part as backup vehicles, the region’s EMS said in a statement. 

Liberec’s ambulances travel a total of 1.7 million km (1.05 million miles) per year and attend to roughly 45 events daily, of which 30 are traffic accidents. To finance the purchase, the region provided some CZK 25 million (U.S. $980,000), or close to 76% of the acquisition, with the Liberec EMS securing the remaining CZK 8 million (U.S. $315,000), according to data from the service.

“Our philosophy is to replace at least five large ambulances and two regular ambulances every year, so we can have a completely modernized vehicle fleet,” Ludek Kramár, director of the region’s EMS, told local news agency CTK.

“We welcome the replacement of vehicles, for which the Liberec region has provided us with generous support. The modernization [of the regional ambulance fleet] is moving forward by leaps and bounds, and we are continuing to collect suggestions from our employees on what we can improve in our ambulances,” Kramár said.

Currently the region’s EMS has a fleet of 31 ambulances, which means that, should it proceed with the plan outlined by Kramár, Liberec could completely modernize its fleet in less than five years.  

Jaroslaw Adamowski is a freelance writer based in Warsaw, Poland.