BlinkIt’s ‘10-Minute’ Ambulances and the Spectre of a Larger Malady
10-01-2025
11:15 PM

Context
- The relentless wail/ loud sound of an ambulance siren has become an indelible aspect of urban life in India, symbolising the growing demand for emergency medical services.
- An increasing prevalence of chronic illnesses and a rise in road accidents have significantly fuelled this demand, making ambulance services an indispensable link in the healthcare delivery system.
- However, the current state of ambulance services in India reveals a mix of progress and persistent challenges that call for urgent attention.
Evolution of Ambulances Services in India
- The Role of NGOs and Early Innovations
- A significant shift occurred in the 1980s when non-governmental organizations (NGOs) began filling the gaps left by the public health system.
- Southern India emerged as a leader in this movement, with voluntary and free ambulance services being introduced to cater to underserved populations.
- These early initiatives laid the groundwork for more organised ambulance networks, demonstrating the feasibility and importance of dedicated emergency transport.
- State Government Initiatives
- In subsequent decades, state governments recognised the critical role of ambulances in improving public health outcomes.
- Targeted services were introduced for vulnerable groups, such as women in the reproductive age group and children under five, under state-sponsored programs.
- The National Rural Health Mission (NRHM), launched in 2005, further institutionalised these efforts by integrating ambulance services into a broader public-private partnership framework.
- Introduction of 108 Emergency Response
- A landmark initiative under NRHM was the establishment of the 108 Emergency Response Service, which became a model for ambulance services across the country.
- Operated through a public-private partnership, it provided free access to emergency transport, significantly improving the reach of healthcare services in both urban and rural areas.
- The 108 service not only addressed the immediate need for transport but also emphasised timely response, coordination with healthcare facilities, and first aid administration during transit.
- The Rise of Private Sector Players
- The past two decades have witnessed a surge in private sector involvement in ambulance services, driven by rising healthcare demand and urbanization.
- Corporate hospitals began offering their own ambulance fleets equipped with state-of-the-art facilities, while standalone companies emerged to provide specialized services.
- Recent innovations by private players, such as Blinkit’s ‘10-minute’ ambulance service, represent a bold attempt to address urban challenges like traffic congestion.
- However, these initiatives also raise concerns about the practicality of such promises and the potential strain on service providers.
- Unlike public and NGO-run services, private ambulance operators often target middle- and high-income populations, leaving a significant portion of the population dependent on government schemes or basic transport options.
- The Shift Towards Specialisation
- Basic Life Support (BLS) ambulances, which were once the norm, are now complemented by Advanced Life Support (ALS) units, ICU ambulances, and air ambulances.
- These advancements are indicative of a growing recognition of the need for more sophisticated emergency care during transit.
- However, the adoption of such specialised services remains limited to urban centres and private facilities, reflecting a glaring disparity in access and quality.
Inadequate Definition and Standardization
- Policy and Regulatory Challenges
- One of the most pressing challenges is the lack of a clear and uniform definition of ambulance services.
- Many so-called ambulances are nothing more than patient transport vehicles, lacking even basic life-support facilities.
- Without clear guidelines on what constitutes an ambulance, the sector remains vulnerable to substandard services.
- For example, studies have found that while BLS and ALS ambulances are available, a significant proportion of these vehicles lack the equipment, infrastructure, or trained personnel to qualify as true emergency medical units.
- Fragmented Regulatory Framework
- The regulatory landscape for ambulance services in India is highly fragmented, with overlapping jurisdictions between central and state governments.
- Each state has its own licensing requirements, operational standards, and inspection protocols, leading to inconsistencies and inefficiencies.
- The lack of a centralised authority results in bureaucratic hurdles, delays in obtaining necessary approvals, and opportunities for corruption.
- For instance, private ambulance operators often face challenges in navigating complex licensing processes, which can deter them from entering the market or maintaining compliance.
- Uneven Resource Allocation
- Wealthier states with strong healthcare infrastructure, such as Gujarat and Maharashtra, are able to provide relatively robust ambulance services.
- In contrast, poorer and geographically challenging regions like the northeastern states suffer from acute shortages.
- The absence of a national policy for equitable resource allocation perpetuates these regional disparities, leaving large swathes of the population underserved.
- Traffic and Infrastructure Constraints
- Even the best-equipped ambulances struggle to navigate through crowded streets, leading to delays in reaching patients or healthcare facilities.
- This issue is particularly acute in metro cities, where traffic jams can significantly impact the golden hour, the critical period immediately following a medical emergency when timely intervention is most effective.
- Challenges in Regulating Private Players
- The rapid growth of private ambulance services has introduced additional complexities.
- While private players have filled gaps in service availability, their unregulated expansion has led to concerns about service quality, pricing, and ethical practices.
- For instance, anecdotal reports suggest that some private ambulance operators exploit patients during emergencies by charging exorbitant fees or prioritizing profits over patient welfare.
- The absence of price controls or quality benchmarks allows such practices to persist, further undermining public trust in the sector.
- Moreover, private operators often cater to urban and affluent populations, leaving rural and economically disadvantaged communities reliant on overstretched public services.
The Way Forward and Recommendations for Regulatory Reforms
- Strengthening the regulatory framework to ensure consistency and reduce corruption is very important.
- Publicly funded services, public-private partnerships, and civil society initiatives must complement private investment to ensure equitable access.
- In a country where high-cost private services are often unaffordable, such collaborations can bridge the gap between demand and supply.
- There is a need to develop and enforce uniform standards for ambulance equipment, staffing, and operations across the country to ensure consistent service quality.
- The government should create a centralised regulatory authority to oversee licensing, compliance, and monitoring, reducing bureaucratic hurdles and inconsistencies.
- A mechanism to implement systems for real-time tracking of ambulances, performance audits, and grievance redressal to improve accountability and transparency is essential.
- Authorities should work with urban planners to design traffic systems that prioritise the movement of emergency vehicles, such as dedicated ambulance lanes and smart traffic signals.
- To regulate private operators, the government can introduce price caps, quality benchmarks, and ethical guidelines for private ambulance services to prevent exploitation and ensure fairness.
Conclusion
- The demand for efficient and modern ambulance services in India is poised to grow, driven by factors such as increasing health emergencies and the need for elder care.
- While the sector offers promising opportunities for private investment, a balance must be struck to ensure affordability and accessibility.
- With strategic planning, regulatory reform, and investment in infrastructure and human resources, ambulance services can evolve into a robust pillar of India’s healthcare system, saving countless lives in the process.
Q) What are the major regulatory challenges faced by ambulance services in India?
Ambulance services in India face a multitude of regulatory challenges that hinder their efficiency and reliability. One of the key issues is the lack of uniform standards for equipment, staffing, and operations, which results in significant variations in service quality. The regulatory framework is highly fragmented, with overlapping state and central guidelines leading to inconsistencies and inefficiencies.
Q) How can regulatory reforms improve the quality of ambulance services in India?
Regulatory reforms have the potential to significantly enhance the quality of ambulance services in India. Establishing national standards for equipment, staffing, and service protocols can ensure consistency and reliability across the sector. A centralised authority for licensing and compliance would streamline processes, reduce bureaucratic delays, and improve accountability. Equitable resource distribution policies can address regional disparities, ensuring that underserved areas receive adequate services. Real-time tracking systems and performance audits can enhance transparency and accountability.
Source: The Indian Express