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EMS and Ambulance Crisis Across South Africa: Who’s Liable?

ems ambulance crisis

An emergency medical services (EMS) and ambulance crisis across South Africa is putting lives at risk.

In a medical emergency, it may be critical to get to an emergency room. For the majority of South Africans, this means relying on a government ambulance to get to the nearest hospital.

A shortage of ambulances is making it less likely that patients will get the help they need in time. This is resulting in an unnecessary number of patients dying or suffering further harm due to delays and “no shows.”


If you suffer serious injury or the tragedy of losing a family member due to provable negligence by the state or another healthcare provider, you may be able to claim for damages. Contact us at DSC Attorneys for expert legal advice and representation.

The state of ambulance and EMS services in South Africa

A combination of mismanagement and resource shortages have brought provincial ambulance services to their knees.

According to Minister of Health, Joe Phaahla, our country has less than half the number of required ambulances. This is based on a recommended ratio of one ambulance per 10,000 people.

Statistics provided to parliament in 2022 point to a crisis-level shortage of ambulances across all provinces. For example:

  • North West needs 370 ambulances but is operating just 70
  • the Western Cape needs 570 ambulances but is operating 120
  • Gauteng needs 2,592 ambulances but is running 1,600
  • KwaZulu-Natal needs 1,174 ambulances but is running 432
  • the Eastern Cape needs 670 ambulances but is running 448.

In 2023, a News24 article noted that SA’s “…dire shortage of ambulances is placing patients’ lives at risk”.

In the context of failing state care, the private sector is experiencing huge demand for emergency medical services – but it lacks the capacity to meet this demand.

Other problems affecting emergency medical services

The shortage of ambulances is not the only issue plaguing state-run emergency medical services.

Slow response times are also exacerbated by:

  • shortages of basic medical supplies (like oxygen) in ambulances
  • shortages of trained paramedics
  • poorly trained emergency call centre staff
  • long distances between hospitals
  • difficulties accessing rural and township areas due to poor road conditions.

Ambulance and first responder delays have tragic results

Delays in getting a patient to a hospital can result in a worsened medical condition or death.

In May 2023, the Mail & Guardian reported that a woman died in the Cape after it took an ambulance 24 hours to arrive.

Six months earlier, a man died after an eight-hour wait for an ambulance in Matatiele, Eastern Cape.

At the time, just one state ambulance was serving the entire Matatiele area. This area spans 4,350 square kilometres and includes nearly 300 villages.

An earlier case in the Eastern Cape resulted in a young pregnant woman losing her baby. After a four-hour wait, the woman’s parents paid a neighbour to take her to the hospital. The ambulance arrived eight hours after the original call.

Liability when an ambulance is delayed or doesn’t arrive

If an ambulance is delayed or doesn’t arrive due to provable negligence or poor service delivery by the state, you might be able to claim for damages.

A claim could be made against one or more of the following parties:

  • the state, which is responsible for protecting South Africans’ constitutional right of access to healthcare (including emergency medical care)
  • the hospital or entity that managed and despatched the ambulance
  • the emergency medical technicians (EMTs) or paramedics on the ambulance, if their conduct could be considered negligent.

If you may have grounds for an ambulance or EMS negligence claim, you have the right to look at the records, charts and information related to your emergency transport in order to build your case.

Medical malpractice cases are complex and lengthy. It’s vital to make sure you have a strong case, along with sufficient legal representation and support.

Ambulance and EMS claims with DSC Attorneys

At DSC Attorneys, our attorneys and medico-legal team have extensive experience in handling medical and EMS malpractice claims.

We can assess your claim, send you for any necessary medical examinations, help prepare supporting evidence and represent you in legal proceedings, giving you the best chance of receiving the compensation you deserve.

We also work on a no win, no fee basis. Contact us for more information or to discuss your medical malpractice claim.

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