Enhancing competition on ambulance services in Denmark

For decades market competion in Denmark on the provision of ambulance services has been relatively weak. In 2018, the five Danish regions recommended 18 joint actions to be taken in order to enhance competition on ambulance services in the future.

Current Danish healthcare regulation stipulate, that each of Denmark’s five regions are responsible for making ambulance services available throughout their entire geographical area. The regions can either provide these services themselves or, as an alternative, choose to have them provided by another region, a municipality or a private supplier.

For historic reasons ambulance services in Denmark have been provided by one single private supplier, Falck. Through decades, public health authorities in all parts of Denmark have mainly used the same private supplier of ambulance services.

In 2003, The Danish Complaints Board for Public Procurement established, that ambulance services are subject to public tendering in situations, in which the responsible public body (i.e. a region) chooses not to provide these services themself.

Subsequently and after 2003 ambulance services in Denmark have been publicly tendered twice. Today, approximately 70-80 per cent of Danish ambulance services are (still) provided by one private supplier.

 

18 recommendations to enhance competition

In order to stimulate and increase the level of competetion prior to the third round of ambulance service tenders, the five regions have jointly recommended 18 actions to be taken. The 18 recommendations draw attention to issues relating to:

  • Better recruitment and vocational training of ambulance staff
  • Adjusting and improving existing infrastructure
  • Enhanced use of flexible tendering procedures
  • Intensifying market dialougue with relevant contenders

Reports

The 18 recommendations concerning enhanced competition on ambulance services in Denmark were published by the regions in October 2018. The underlying reports are available online, but only in Danish:

Overview

Contracts and providers of ambulance services in all regions

20 ambulance service provision contracts, according to region.

North Denmark Region (1):

  • Falck: 1

Central Denmark Region (6):

  • Falck: 4
  • Responce (owned by Falck): 1
  • Samsø Assistance & Rescue: 1

Region of Southern Denmark (4):

  • Responce (owned by Falck): 1
  • South Denmark Ambulance Services: 3

Region Zealand (3):

  • Falck: 3

Capital Region of Denmark (6):

  • Falck: 4
  • Metropolitan Assistance & Resuce: 2

Furthermore, 9 other regional contracts exist concerning patient transportation and emergency dispatches. Falck is the sole service provider on the the contracts.