Estonia plans to reduce number of doctor-led ambulance crews
Estonia's Ministry of Social Affairs wants to cut back its 13 doctor-led ambulance crews. Medics are divided, and the impact on jobs remains unclear.
Estonia's Ministry of Social Affairs intends to reduce the number of ambulance crews led by doctors. There are currently 13 such crews, which include a doctor alongside a nurse. The plan has split opinion among medical professionals, and it is not yet clear whether jobs would be lost.
The crews operate in addition to mobile intensive care units. Both are funded by the Health Insurance Fund (Tervisekassa) at higher rates than standard crews.
Hospital head: not sensible
Arvi Vask, head of South Estonian Hospital, told the public broadcaster's news programme that doctor-led crews make little sense and that nurses can do the work just as well. He pointed to Annelinn in Tartu and to Otepää, where such crews were justified by the distance to the university hospital and by international events, calling those arguments nonsense. According to him, the fund pays €15,000 more per month for a doctor-led crew than for a nurse-led one, though not all of that goes to doctors' wages. Vask believes the doctors could replace family doctors or work in hospital emergency departments, while the total number of crews could grow.
Other views
Tuuli Paju, a management board member at the Tartu Ambulance Service, which covers much of South Estonia, said the proposal may be driven by staff shortages at smaller hospitals. In her view, some ambulance specialists would not take jobs in county hospital emergency departments. She added that smaller places cannot do without doctor-led crews because of distances.
The ministry confirmed the crews will not be scrapped entirely, but their number will be reviewed. Nikita Panjuškin, head of the ministry's healthcare services department, said the aim is to assess how many are needed and where. New arrangements are expected in the coming weeks.
Separately, Estonia plans to move to mostly two-person ambulance crews instead of three by 2028. By day there would be 63 three-person and 43 two-person crews, and at night 63 three-person and 30 two-person crews.
