Tenders for a new air ambulance helicopter service may have closed, but advocates for the services are continuing fight for the retention of rescue helicopter bases in places like Rotorua, Taupō, Te Anau and Whitianga.
Concerned doctors have written to the Ministry of Health pointing out the flaws in the model being proposed by the National Ambulance Sector Office and questioning the lack of hard data available to support many of its basic assumptions.
Requests for proposals for air ambulance services closed last Monday, May 7.
Rescue helicopter advocate Simon O'Neill, who is a first responder based in National Park and previously had a career with the New Zealand Defence Force, says NASO's request for proposal for air ambulance services is "sloppily prepared" and full of holes.
He has picked up the challenge of seeking a review of the request for proposal on behalf of colleagues who were unable to do so because of their professional connections.
"I'm one of those first responders out there with a patient so desperately hanging on to hear the buzz of that helicopter coming in, it could be with Fire, Ambulance or one of our local search teams," he wrote in a lengthy email to the Acting Director-General and chief executive of the Ministry of Health, Stephen McKernan, and the Ministry of Health's chief medical officer Andrew Simpson.
O'Neill has experience in working on capability projects for the Defence Force and said part of that always included an information plan to support the process. That information was lacking in this case, he said.
"Professionally, I find it quite embarrassing that a big budget Government project like this does not have an accompanying information plan to present the facts and data that support and justify the RFP," he said.
O'Neill also believes that Health Minister David Clark has been misled about the proposal, with his answers to Parliament on the issue last week vague and inconclusive.
He would not directly address whether he could commit to the people of regional New Zealand that the timeliness and quality of the air ambulance service would not be diminished.
O'Neill has copies of letters written to the Ministry of Health from concerned doctors in Te Anau and Taupō, pointing out the shortcomings in NASO's plan.
Te Anau GP David Hamilton has noted the flaws in the NASO documentation and says he is seeking common sense in the matter. He says capability and flexibility will be reduced, response times will increase and local pilots' knowledge will be lost.
"Local knowledge is a vital asset (and will be lost with international tendering).
"It will be hard to get back the skills if they are discarded so easily. We should be working on the same side to be creating efficient optimum care ... not dismantling a service that is working well," Dr Hamilton wrote.
"Make no mistake, lives will be lost from these decisions. Do not let the decisions be made lightly."
A letter from a Taupō doctor, who did not want to be named in the media, to ACC Minister Iain Lees-Galloway and Health Minister David Clark, said taking the Taupō helicopter away would automatically mean longer response and waiting times, and fewer helicopters overall would also increase the chance that none were available in an emergency.
O'Neill said while response time is the critical issue under the proposed new air ambulance model, the whole request for proposal reads as though it has been structured to favour a small number of large air fleet operators.
Andrew Inder, the Ministry of Health's community and ambulance manager said in a statement he could not answer questions about NASO's request for proposal because the procurement information was confidential.
He said the Ministry and ACC had worked with NASO, district health boards, air ambulance helicopter services and other stakeholders to develop a 10-year modernisation programme.
"All parties agree that improvements are needed so that New Zealand has safe air ambulance helicopters that are clinically appropriate, nationally consistent, sustainable and people-centered."
"We want every community to have access to air ambulance helicopters that can rapidly get off the ground and to an emergency, have skilled and dedicated pilots and aviation crew, and specially trained clinical crews that have the space and equipment to perform life-saving care on patients while in the air and transport them safety to the best destination for care in our health system," Inder said.
"If we improve all four of these critical service elements our communities will receive a better, more clinically appropriate air ambulance service that delivers patients in to the care of the right dedicated specialists in the right hospital."
The 11-strong NASO governance group comprised nine public servants from the Ministry of Health, ACC and district health boards, plus one Scottish clinician and one New Zealand emergency medicine specialist. It did not include any rescue helicopter pilots or aviation consultants.
Overseas companies invited to tender
An Australian helicopter company has said it is excited to have been invited to tender for air ambulance services in New Zealand.
At present, air ambulance services, or rescue helicopters, are provided by a variety of trusts around the country.
Now CHC Helicopters (Australia) says it is seeking expressions of interest from pilots, engineers and technical crew interested in working on an air ambulance helicopter contract in New Zealand, although at this stage it was unable to provide further details such as locations and salary guidelines.
The advertisement appears to bear out fears among some in the rescue helicopter community that the National Ambulance Sector Office's request for proposal was effectively opening up the door to larger multi-national companies coming into New Zealand and submitting bids to provide for air ambulance helicopter services.