Vulnerable people, especially those residing in remote areas, have difficulties in accessing health care services. Patients who do not require ambulance services ought to utilize public or private transportation options. Public transport routes and time tables may not be in line with patients’ needs, who often resort to enlisting help from family members, neighbours or friends, with costs of private transfers being prohibitively expensive. The precise number of patients requiring transportation is not known. Nevertheless, for some for some of them a small number of municipalities have implemented minimal logistical support. As a result, in 2023 the government introduced a limited patient transportation scheme with the view of expanding the service nationally in 2024.
The ongoing reform of the hospital network seeking to concentrate the delivery of specialist services in major urban centres exacerbates the problem of access to health care outside the cities. Moreover, the implementation of centralization within the ambulance service has removed the possibility for patients to be transported from the centers to municipalities, where the ambulance vehicles were previously stationed.
The primary aim of the reform is to improve access to specialist services for patients living in rural areas through implementation of the patient transportation scheme.
The initial pilot is scheduled to run for 12 months from mid-2023 to mid-2024 in 20 (out of 60) municipalities. Current eligibility criteria cover people with low income and over 75 years old or severe disabilities or those socially vulnerable.
A set of essential legislation was issued in 2022–2023. In summer 2023, transportation was available for patients requiring haemodialysis and transplant services. From autumn 2023, the service was expanded to wider groups (see eligibility criteria above). In 2024, it is expected that the transportation service will be expanded country-wide. An initial state budget allocation of €7 million is projected to cover 40 000 journeys.
As of early 2024, the pilot data is being collected with no formal evaluation of the project carried out to date.