Bureaucrats' bickering mars Japan emergency medicine plan.

TOKYO, May 23 Kyodo

A government emergency medicine initiative to transport doctors to accident sites by helicopter has been grounded by bureaucratic bickering over the use of a radio frequency band to facilitate coordination of such operations, government sources said Tuesday.

The initiative, endorsed by the health ministry and implemented on a trial basis in several areas, has proved successful in reducing fatalities.

However, despite being slated for widespread adoption in April, the plan remains in limbo, with the Fire and Disaster Management Agency (FDMA) refusing to authorize the use of a radio band to allow communication between all the staff involved, on the grounds it could hamper operations of firefighters and other emergency medical services.

Transporting emergency doctors by air to accident sites is common in many Western countries such as Germany, which introduced it in 1970, and where deaths from traffic accidents have dropped significantly as a result.

The Health, Labor and Welfare Ministry implemented trial runs in 1999 and 2000 in Kanagawa and Okayama prefectures, and the ministry estimates deaths from cerebral apoplexy, traffic accidents and other situations requiring immediate medical attention, were nearly halved  as a result.

The ministry has drawn up a five-year plan from this April to eventually cover areas served by 30 hospitals, with doctors from six hospitals in Okayama, Shizuoka and Fukuoka prefectures taking part in the first year.

However, the FDMA has said allocating a radio frequency band for the chopper service could cause interference with other bands already used by firefighters and other ambulance services.

The health ministry said the FDMA has been making various demands as preconditions for allocating the radio frequency, forcing the ministry to offer the chopper transport since this April without being able to use its chosen radio frequency band.

But the FDMA says the health ministry has not made any specific requests with regard to which band it wants, and also said it does not make sense for the ministry to request a specific radio frequency band when it has not yet selected which hospitals will participate in the initiative.

Officials who took part in a recent trial run of the system said without a designated frequency band on which involved personnel can communicate, the effectiveness of the plan, and thereby the ability to save lives, would be limited.

In Shizuoka Prefecture, an official at Seirei Mikatagahara Hospital, which introduced a chopper service independently in 1999, said it has since provided more than 500 helicopter transports per year on average. Of these, 90% were prompted by requests by firefighters.

In these cases, doctors communicate with firefighters by telephone prior to boarding the chopper but are often stymied by their inability to communicate with ground crews while en route, meaning they are unable to prepare for sudden changes in patients' conditions or other critical factors, the official said.

Chopper pilots also want a communication channel to confirm whether they can safely land near the accident site, according to the official.