If all you have is a hammer, everything looks like a nail. (Why ambulances aren't always the best for medical coverage.)
Let's take a look at these events:
Event | Event Type | Duration | Participant Count | Location |
|---|---|---|---|---|
Corporate Leadership Summit | MICE / Conference | 8 hours | 600 delegates | Convention centre ballroom |
Non-profit concert featuring people with disabilities | Entertainment | 4 hours | 100 performers and 2,000 attendees | Indoor concert hall |
National Youth Football Tournament | Sporting | 3 days, 10 hours each | 200 players + spectators | Sports complex with 4 pitches |
National Day Community Observance | Community | 6 hours | 2,000 attendees | Outdoor community centre |
Charity Gala Dinner with Ministerial Attendance | High Profile | 3 hours | 300 guests | Hotel ballroom |
Single Day Trade Exhibition | Exhibition | 10 hours | 5,000 visitors | Exhibition hall |
New Run Club Fundraising Event | Sporting | 2 hours | 20 runners | Urban streets with a 10km route |
Tell me, what's similar with all the above events?
If you say "nothing similar", that's right. Well they are certainly all events, but that's where the similarity ends.
Some are sedentary, others are physically demanding. Some involve children, others involve VIPs. Some are outdoors, some are indoors. Some are multi-day, multi-hours, some last shorter than a banquet.
Current Available Services
The majority of private companies offering event medical coverage services are private ambulance operators (PAOs). What would they offer? Putting an ambulance in each of the event, and billing per hour of standby.
If a company owns ambulances, hires ambulance crews, and prices its services around ambulance transportation, it is unsurprising that its answer to many event medical enquiries will be: “Here's an ambulance, at $X per hour."
That may be appropriate for some events. For most, it is usually cost-excessive, poorly targeted, and clinically limited than a properly planned on-site medical team.
This is not necessarily bad faith. While researching the quote attributed to Abraham Maslow ("If all you have is a hammer, everything looks like a nail.") in the title, this concept is called narrow-minded instrumentalism; or if you fancy, déformation professionnelle (French for "looking at things from the point of view of one's profession").
When your main tool is an ambulance, you naturally view event medical coverage through the lens of putting an ambulance in the event. The ambulance becomes the default unit of planning. The quotation starts with the vehicle, then works backwards to the event.
Limitations
An ambulance is a transportation platform. It is useful when a patient needs to be moved from point A to B, when emergency equipment needs to be immediately transported to the scene, or when the event risk profile justifies dedicated evacuation capability. But an ambulance parked outside a venue does not automatically mean the event is well covered.
I have personally witnessed an ambulance covering a trail run within MacRitchie Nature Park.
The ambulance: parked outside MacRitchie Nature Park. The trail run: happening inside MacRitchie Nature Park.
Walking through the trail I noted that there were no other visible medical responders along the route.
How the crew would exactly respond is beyond my knowledge, but from my experiences in the national prehospital ambulance services, it's likely they have to walk into the trail from where they parked, and either push the cot stretcher on muddy ground, or manually lift and carry the patient out on the stretcher canvas.
This is not a criticism of the crew; but a criticism of poor medical planning that is ill-suited for the nature of the event.
Limited Clinical Capacity
A private ambulance in Singapore is limited to one paramedic and one driver trained in first aid. The driver is mostly relegated to driving roles. For a simple low risk event it that may be enough. For a physically demanding event, or an event with multiple instances of simultaneous minor injuries, it can become very limiting very quickly.
In sports such as touch rugby, football, minor injuries happen frequently. Most of these are not urgent medical emergencies needing immediate evacuation; they are sprains, abrasions, cramps, epistaxis, or players who need assessment before returning to play. These cases require people on the ground who can assess, monitor, treat, and escalate when needed.
An ambulance crew (of one paramedic) can do some of that, but if the entire medical provision is tied to one main clinician, the event organiser may not be getting much actual medical coverage across the field of play. The event proposal and the coverage portion offered by a standby ambulance looks reassuring but in reality the actual clinical capacity remains thin and tied to one clinician in the ambulance only.
An ambulance may not effectively cover multiple pitches, halls, routes, or activity zones. Getting multiple ambulances for multiple locations would easily rack up your costs, as most companies start their rates upwards from $100/hr.
High Costs
The industry rate for ambulance coverage is anywhere from $120 to $160 per hour, excluding GST. Services offering less than $100/hr seem initially attractive, especially for community or student event organisers. However, these services usually charge additional fees for medical supplies used and/or procedures done. Be wary of the low upfront rate!
This is unfair to event organisers because it makes the real cost of medical coverage difficult to predict. The organiser may approve what appears to be the cheapest quotation, only to receive a higher final bill after the event because many patrons/participants needed basic dressings or basic treatments. By law (Healthcare Services Act, 2020), all private ambulance companies will be required to publish their fees as part of price transparency requirements. This price transparency however is only applicable for transportation services - not event medical coverage. An unscrupulous company may charge $100.00 per hour for medical coverage, only to bill you an extra $20.00 per procedure and item used.
Event organisers should not have to worry that every item used on a casualty will become another line item on the invoice. When a participant is injured or unwell, the focus should be on timely care, not on whether a bandage, oxygen mask, splint, or piece of equipment is billable.
Gaps in Coverage
If there is indeed a genuine case requiring ambulance conveyance, the problem does not end there. Once the ambulance leaves with the patient, the event is left without its medical standby. The very moment the ambulance is finally used for its core purpose - transportation and evacuation - it ironically removes the only medical resource the organiser has paid for.
Some ambulance providers, for this very reason, refuse to convey even the most critical of cases, citing their obligation to remain on standby throughout the event. Instead, a public emergency ambulance has to be activated to perform the conveyance, even when an ambulance is already physically present at the scene.
This creates a rather absurd situation: an ambulance has been paid to attend an event in anticipation of a medical emergency, yet when that emergency actually occurs, another ambulance must be summoned to do the job.
The critical patient is now dependent on the availability and response time of an external emergency ambulance, while the contracted ambulance remains parked at the event.
These limitations do not mean that having an ambulance on standby means it lacks value. Instead this highlights the importance of integrating one asset into a larger medical strategy.
Solution: This is precisely why on-site medical care and emergency ambulance conveyance should be treated as two distinct and complementary services, rather than assumed to be interchangeable.
A dedicated on-site medical team can continue providing assessment, treatment and emergency response while an ambulance performs its transport function. Appropriately qualified personnel, supported by suitable medical equipment and clear escalation protocols, can also provide a higher level of immediate care without being tied to an ambulance vehicle.
Strengths
To give credit where it's due, when an ambulance is matched to the event's actual risks it can provide reassurance for good reason. In remote locations, at higher-risk events, or where routes are spread across a large area, having an ambulance asset available is the logical choice.
We've supported a round-island cycling event (same event as pictured in the header) and coordinated with our ambulance partner to deploy one ambulance covering the Lim Chu Kang (Neo Tiew Road) area first, and then repositioned it as cyclists start to flow eastwards towards Tanah Merah Coastal Road. These two areas are beyond the 11-minute SCDF ambulance arrival time, making the presence of an on-site ambulance to respond in these remote areas both practical and pragmatic.
Stakeholders know that a dedicated transport resource is on site. Organisers gain confidence that serious incidents can be managed without waiting for public ambulance resources to arrive. The on-site medical team also benefits from having a direct escalation and evacuation platform available when circumstances require it. These are meaningful advantages, provided they are supported by realistic planning rather than "cookie-cutter" assumptions.
Alternatives
For certain events, an ambulance on standby forms an essential component of event medical response.
Yet sometimes (most times) the better answer is having a dedicated on-site medical team: either in a medical post, on bicycles, pitch-side responders, roaming teams, and a properly planned escalation pathway. In many cases, a well-designed combination of on-site clinicians + clear and available evacuation arrangements provides better practical coverage than a single ambulance waiting at the edge of the venue.
This is where an experienced service such as REDSTAFF Medical can add real value. Rather than simply recommending the most visible resource, we focus on the actual needs of your event, then match the medical coverage to it. That means assessing risks, venue layout, participant demographics, operational requirements, and budget considerations before recommending a solution. Being equitable does not mean giving every event the same package; that neglects the event-specific nuances and requirements. Our goal is not to sell a standard package, but to build a practical and proportionate medical plan that works when it matters most.
A corporate seminar and a trail run with the same kind of coverage makes little sense.
A youth football tournament holds different risks than a concert involving people with disabilities.
The medical plan should follow the event and its activities, not the event client's budget nor the provider’s inventory.
Medical coverage should be supported in a way that supports good care, not in a way that penalises the organiser every time the medical asset actually does its job. Event organisers should not begin with the question, “Do we need an ambulance?”. Most times no, some times yes. But is it appropriate? Then they should begin with a different question: “What kind of medical support does this event actually need?”
Take Home Message:
An ambulance for standby in your event may not be the most appropriate. There is a time and place for one. Event organisers should be cognisant of the shortfalls and limitations of an ambulance on standby. Services offering medical coverage should assess the event's activities and calibrate their response.
