Lack of funding means an Ambulance Victoria referral service that leaves more ambulances available for critically ill patients will not be expanded to rural Victoria, although those living there are less likely to survive a heart attack than city people.

The emergency referral service lowered emergency response demand in metropolitan areas by 8% in the past financial year, Ambulance Victoria’s annual report said.

The referral service transfers low priority emergency calls to alternative health care providers — local GPs or the Nurse on Call service, for example.  In the past financial year 31,781 of the 42,484 emergency calls it handled were referred to alternative care — up almost 10% on the previous year — so an ambulance was not needed.

“There is no doubt that dealing with patients in this way assists in maintaining availability of emergency ambulances for more critical cases,” said Mark Rogers, Ambulance Victoria’s general manager of specialist services.

But while the annual report said the referral service would be expanded when funding was available, it will not be introduced to rural areas any time soon. There will be “increased capability in the Metropolitan region” only, not to rural areas, Rogers said.

“The timing and extent of expansion of any service is dependent on the priorities with funding,” he said.

Meanwhile, ambulance response times continue to grow in rural areas, with average times rising from 13 minutes in 2004-2005 to 15 minutes in 2010-2011, according to Ambulance Victoria’s strategic plan 2012. Cardiac arrest patients in rural areas have a lower survival rate than those in metropolitan regions.

Ambulance Victoria was unable to provide a costing for an expansion to rural areas.  A spokeswoman said, “unfortunately we don’t have a figure available as of yet.”

Rogers said a rural referral service was not possible until the ambulance service’s rural communications were consolidated in its new Ballarat centre, a process due to be finished next month.  Even then, although Ambulance Victoria wanted to expand statewide, its introduction elsewhere was uncertain.

But it was “hopeful in gaining support for this initiative”, as it helped lower response times, Rogers said.

The state member for Macedon, Joanne Duncan, said, “increasing the number of available MICA paramedics in rural Victoria is critical”, to decrease response times and improve cardiac arrest survival rates.

Duncan said there were simple steps that could be taken to improve response times and even simpler steps to “dramatically impact upon survival rates for cardiac patients”, such as the introduction of more defibrillators in communities, particularly within sporting clubs.

These defibrillators could be used in the absence of an ambulance, but the state government had not approved funding for this plan.