Health was at the forefront of Tuesday night’s leadership debate in Victoria ahead of this weekend’s state election.
“We had the best ambulance response times in our state’s history … just weeks before COVID hit,” Premier Daniel Andrews claimed.
He repeated the statement minutes later, praising the paramedics for “providing the best EMS response times in the history of our state” and again saying that the paramedics are “absolutely determined to repeat … what they did just weeks before the arrival of COVID: provide the best response times in the history of our state .”
They echo a statement he made at a press conference on October 19, where he told reporters:
On the day we were sworn in, emergency services were in a terrible state. We then worked hard in partnership with our paramedics to deliver the best EMS response times ever. This was before the pandemic. In fact, just weeks before the pandemic.
So, were Victoria’s ambulance response times the best in the state’s history just before the pandemic?
RMIT ABC Fact Check is investigating.
Mr. Andrews’ claim is a twist.
While ambulances have operated in some form in Victoria for almost 140 years, less than two decades of comparable data are available to assess his claim.
According to the Productivity Commission, even some of this data may not be comparable.
This would mean that only 15 years of data are available.
A maximum of 18 years of data is available. This data shows that ambulance response times were at their best during the Bracks Labor government, but this era is not directly comparable.
Even so, response times had improved significantly under the Andrews government before the pandemic, although they were at their best a year before the pandemic, not weeks.
Since then they have fallen.
There is no comparable data on EMS response times for most of the state’s history. (ABC News: Seraphine Charpentier Andre)
What are the ambulance response times?
Ambulance Victoria said response time “is measured from the time a triple zero (000) call is received until paramedics arrive at the scene”.
Each call is “assessed based on clinical need.” Code 1 patients are designated as requiring urgent paramedic and hospital treatment, in other words a “lights and sirens” response.
“Lights and Sirens” EMS is referred to as “Code 1”. (ABC News)
They are time critical and Ambulance Victoria has “two official response time targets” they aim to meet:
Respond to Code 1 incidents within 15 minutes 85% of the time statewide and
Respond to Code 1 incidents within 15 minutes 90% of the time in centers with over 7,500 residents.
Code 2 incidents are “acute but not time critical” and do not require a lights and siren approach.
Malcolm Boyle, associate professor and academic lead for paramedic education at Griffith University, told Fact Check that on-time response rates are the key performance indicator the organization reports to the government.
What data is available?
As Fact Check has previously explained, Victoria has had ambulances since 1883 and began using radio dispatchers to assign them jobs in 1954.
Ambulance Victoria began operations at the start of the 2008-2009 financial year following the amalgamation of previously operating metropolitan and rural services.
In recent years, the organization has published quarterly response times and included annual response times in annual reports dating back to 2004-2005. up to a year.
The data prior to this is not consistent and therefore not comparable, as a prior fact check on this topic found.
In addition to the percentage of responses achieved within 15 minutes, Ambulance Victoria’s quarterly reports also include the average response times for code 1 and code 2 calls in minutes and seconds. It started publishing this data in 2014-2015.
Data is also available from the Federal Government Productivity Commission, which since 1998 has included information on ambulance response times for each state and territory in its annual Government Services Reports.
Its data is for the 50th and 90th percentiles of code 1 responses – “the time (in minutes) it takes for 50% and 90% of first responder EMS resources to arrive on scene.”
A small amount of data is also available in a 2010 report by Victoria’s Auditor General Des Pearson, which looked at the decline in ambulance performance over the past six years.
What are the problems with past data?
Ambulance response times in Victoria fell after the pandemic was declared. (AAP: Joe Castro)
Ambulance Victoria’s annual reports state that in 2007-2008 a different data storage system has been used since
It was when the computer aided dispatch (CAD) system was introduced to record response times in metropolitan areas, an Ambulance Victoria spokeswoman said. Metropolitan paramedics had previously completed patient care records (PCRs) by hand.
“This means that PCRs are rounded minutes and recorded manually, whereas CAD is a computerized system of minutes and seconds,” an Ambulance Victoria spokeswoman said.
Ambulance Victoria also notes that the pre-merger data is compiled from figures collected by the replaced services, with some of this estimated to be due to discrepancies in previous reporting systems.
Unlike Ambulance Victoria, the Productivity Commission says this change in reporting methods will not result in 2007-08. the results of the year before are “directly comparable to previous years”.
Victoria’s Auditor General also noted the issue of data comparability in his report and nevertheless made a series of strong claims about reduced response times.
“The big picture is clear,” he said, “the trend of worsening ambulance response times was evident before the amalgamation” and continues under Ambulance Victoria.
“Ambulances are taking longer to respond to code 1 emergencies, with 2009-2010 recording the worst performance since 2004-2005,” he said.
When contacted by Fact Check, Ambulance Victoria’s data analysis team said “you can compare the data” although “technically it’s not ‘directly comparable'”, while the Productivity Commission reiterated that data from previous years “is not directly comparable”.
Fact Check previously concluded that “based on the available data, ambulance response times cannot be fairly compared over the 60 years Victoria has operated radio-dispatched ambulances.
“There is no data for early years, and response times have been measured in different ways since the 1980s, making a direct comparison impossible.”
The source of the statement
Mr Andrews’ office said his claim was based on a February 2019 press release from Ambulance Victoria, which said the service had “again recorded its best ever response time”.
If you simply refer to the short history of Ambulance Victoria, this press release was correct at the time.
What does Ambulance Victoria’s data say?
Ambulance Victoria’s national Code 1 target data shows response times peaked in the first year of the series, with 87.7 per cent of all Code 1 responses under 15 minutes in 2004-05.
It went downhill from there, including after Mr Andrews became health minister under the previous Brumby Labor government.
It continued to fall after Labor lost the 2010 state election and reached 71.8 per cent towards the end of the coalition’s one term.
Since Andrews became premier, the rate has improved significantly, reaching 84.2 per cent at the start of 2019 – the highest figure since Ambulance Victoria amalgamated.
Before the pandemic was declared a year later on March 11, 2020, the rate had fallen slightly.
It has since fallen to the mid-60s, with a low of 64.0 percent in 2021-22. in the last quarter of the year.
The data for Ambulance Victoria’s 90 per cent target (which excludes calls to less populated areas) does not include figures from those earlier years, but follows a similar trend when data is available, peaking in early 2019.
The fastest result for Code 1 average response times in Ambulance Victoria data was also recorded in early 2019. However, this time – 11 minutes 03 seconds – is below the best figure in the Auditor General’s report – 10 minutes 36 seconds in 2004-2005. .
For code 2 calls, Ambulance Victoria’s quarterly reports recorded the fastest average response time in early 2019 (23 minutes 36 seconds), a year before the pandemic.
Ambulance Victoria’s recent annual reports have also included data on response times for zero-priority cases involving the “most critically ill” patients, such as those who are not breathing or are unconscious.
Ambulance Victoria exceeded its priority target of zero in both 2018-2019 and 2019-2020, although Dr Boyle noted that those cases also involved firefighters who are only equipped to carry out the duties of some paramedics, which could affect the figure.
What does the Productivity Commission data say?
If we exclude 2007-2008 data from before 2018, the Productivity Commission’s 50th percentile best result was achieved in 2018-2019, the last full financial year before the pandemic.
That time, 9.5 minutes, was not as fast as the 9.0 minutes recorded in 2004-05, 2005-04 and 2006-07, but the commission does not consider the data comparable.
For 90th percentile data, 18.0 minutes were recorded in 2018-19. This is probably the best time of the years for which the commission evaluates comparable data, but lags behind previous years.
What do the experts say?
“Andrews’ claim that the best recorded response times were achieved just before the pandemic cannot be considered factually correct,” said Simon Sawyer, director of education at the Australian College of Paramedics and a registered paramedic.
A limited data set means “it is…