Ambulances from the Urgent Medical Care Service (SAMU) will no longer respond to urgent calls from rural areas that it considers are difficult to access according to the CICU, the Urgent Information and Coordination Centre of the Generalitat Valenciana. Instead, Primary Health care professionals, doctors and nurses, will be the ones who will first attend patients or injured in such locations.

The measure has been imposed by the Ministry of Health through the Remot Plan, although the Nursing Union, (SATSE) say that they have lodged their dissatisfaction with the scheme to the Labour Inspectorate.

The Ministry intends that, in future, doctors and nurses will leave any consultations they are dealing with in health centres or auxiliary offices, abandoning patients with appointments, or those who are sick, without assistance, and attend to those who have placed the urgent call in outlying areas.

And as the authority will not be providing any means of transport to move through rural roads and mountainous areas, they must do so by their own means – car, motorcycle, bike or walking – carrying medical equipment weighing 20 kilos,

According to the Remot Plan, on their arrival at the incident the health professionals will then assess the severity of the sick or injured, notifying the CICU if there is a need to send an ambulance. But what seems to have escaped the notice of the bureaucrats is that they will be prolonging the health response time in cases of vital emergency.

“Nobody needs reminding of the fact that the sending of a SAMU ambulance, properly equipped and with staff trained to deal with emergencies, is vital for the survival of the sick,” says the regional officer of the nursing union, SATSE.

Francisco Martínez also warns that “the Remot Plan does not only seriously endanger the health of the residents of interior areas, but it also contravenes the regulations relating to the Outpatient Emergency Department of the Ministry of Health.

The measure effects all rural areas of the Valencian Community but will be applied in phases, the first of which is restricted to 13 small towns in the region of El Comtat: Benilloba, Alcoleja, Balls, Benasau, Benifallim , Facheca, Benimassot, Famorca, Gorga, Millena, Penáguila, Quatretondeta and Tollos; and 12 towns of La Marina Alta: Orba, Benigembla, Benimeli, Castell de Castells, Ráfol d’Almunia, Fontilles, Murla, Sagra, Parcent, Tormos, La Vall de Laguar and Sanet and Negrals.

SATSE say that the plan will further contribute to the the depopulation of the rural zones as people move from the countryside and into large towns and cities

However, what many people are unclear about is just how the authorities will distinguish between the need for a Samu response or one from Primary Care. One medical professional told me “I think this means that if I have an accident on the road they will send a SAMU ambulance, but, if I get a strong pain in my chest, I have to call the doctor who will come to my house, where he will determine if I have had a heart attack or it is an accumulation of wind. He will then decide whether to call an ambulance, by which time I could be dead, so an ambulance will no longer be required.”