Emergency response by fire brigade and medical services in the Netherlands
Emergency response by fire brigade and medical services in the Netherlands
Preface
The safety risks facing Dutch society demand for This brochure offers an overview of current a government that can offer a clear, effective and developments concerning the response by the fire predictable response to emergencies. brigade and medical services in case of major An administrative structure ensuring a strong accidents and disasters in the Netherlands. functionality and democratic control is needed. This has given rise to the establishment of safety Limiting itself to the main facets of both regions. A safety region is a geographical area in organisations, this brochure does not deal with all which various administrations and services work aspects of the fire brigade and EMS. For further together in fire fighting, disaster & crisis control, information, please consult the websites and other emergency medical services (EMS) and information sources mentioned in this brochure. maintaining public order. The safety regions are You can, of course, also contact the employees of based on the existing police regions, which implies the Fire Brigade and EMS department. After all, that the Netherlands comprises 25 safety regions we recognise that good communication between (under establishment). the field, the ministry and the public at large is a vital element in working towards improved safety. In order to raise the safety regions to the required level, further improvements will have to be made The Minister of the Interior and Kingdom during the coming year to the fire brigade and Relations, EMS in the Netherlands. In 2006, the J.W. Remkes administrations of the EMS and the regional fire brigade will merge to form a single organ with a view to better coordination and a reduced administrative burden. With integration with the regional police board planned for 2008, safety regions will become a platform for regional cooperation across the full spectrum of safety services.
3 4 Contents
Preface
1 Emergency response by fire brigade and medical services in the Netherlands 1.1 Vision of safety 1.2 Safety policy in the Netherlands 1.3 Administrative division of responsibility
2 Fire brigade 2.1 History 2.2 Organisation 2.3 Tasks 2.4 Personnel 2.5 Equipment 2.6 Quality
3 Emergency medical services (EMS) 3.1 History 3.2 Organisation 3.3 Tasks 3.4 Personnel 3.5 Equipment 3.6 Quality
4 Multidisciplinary 4.1 Safety region 4.2 Alarm centre 4.3 Communication 4.4 National Disaster Relief Facility 4.5 Public Order and Safety Inspectorate
5 International 5.1 History 5.2 Developments 5.3 Urban search and rescue team
Appendix A Laws and regulations
Appendix B Statistics
5 1
6 1 Emergency response by fire brigade and medical services in the Netherlands
It may prove useful to explain a little about the Netherlands itself, before proceeding to portray the position held by the fire brigade and EMS. The country has a population in excess of 16 million, 20% of whom come from ethnic backgrounds 1. The Netherlands is a constitutional monarchy, whose Head of State is Queen Beatrix. Dutch parliamentary democracy is characterised by a division of power between the legislature (parliament), the executive (administration) and the judiciary (administration of justice). The parliament consists of the Upper and Lower Houses (First and Second Chambers), while the government comprises a council of ministers, led by the Prime Minister. The Netherlands has borders with German in the east and Belgium in the south. The North Sea lies to the west. The country has a total surface area of 41,500 km_, of which some 33,800 km2 is land and 7,700 km2 is made up of water. This implies that it has 482 inhabitants for each square kilometre of territory. The country comprises 12 provinces and over 450 municipalities. Home to 739,000 inhabitants, its Capital, Amsterdam, has the largest population of all Dutch municipalities 2.
1 Statistics Netherlands (CBS), January 2005 7 2 Statistics Netherlands (CBS), March 2005 1.1 Vision of safety The programme entitled 'Bewust veiliger' 4 or Consciously Safer describes both the objectives Taking care of safety is one of the government's that the Cabinet intends to pursue during the next major responsibilities. It is also an issue that is few years and the means by which it intends to high on the political agenda, due to the increasing achieve them: number of contingencies occurring both in the – improving safety awareness Netherlands and abroad. Steps to ensure the – establishing quality standards and stepping-up improvement of disaster and crisis management monitoring were implemented following the explosion of a – regionalising disaster management and fire fireworks factory in Enschede in 2000 brigade through the formation of 25 safety (22 fatalities and 1000 casualties) and a bar fire in regions. Volendam in 2001 (14 fatalities and 245 casualties) . These events have since been followed by the Improving safety awareness terrorist attacks in New York (2001), Madrid (2004) and London (2005). It is the government's duty to inform the public Dutch citizens expect a great deal of the of the possible risks that citizens, businesses government. They naturally expect the government and authorities face in their living environment. to shoulder its responsibilities in the field of public However, the government also notifies citizens of safety. It is nevertheless essential that one bears in opportunities to minimise risks, while also taking mind that we live in a society that is subject to personal responsibility, for example, by purchasing risks, in which it is impossible to entirely prevent fire alarms. all threats and disasters. The government therefore cannot issue assurances of total safety. Setting and monitoring quality standards Furthermore, citizens themselves also bear a certain responsibility in ensuring a safe society. In order to prevent or deal with disasters, the fire brigade, the EMS and the police have to be 1.2 Safety policy in the Netherlands properly organised. They have to be capable of both cooperating with one another and readily Safety is a major social issue for a great many increasing their capacity whenever the proportions Dutch. The government therefore also gives top of an incident increase (escalation). Each of these priority to the social and physical aspects of safety. organisations remains responsible for its own Public safety is determined by the absence of 'the quality assurance system. The Ministry of the inherent danger (or the threat thereof) to humans Interior and Kingdom Relations ensures that the and animals posed by human behaviour towards various quality assurance systems are coherent. other people's health, personal integrity, honour, opinions, customs and possessions. Physical safety closely linked to 'the inherent danger (or the threat thereof) to humans and animals posed by the development, state and utilisation of land/water/ air, buildings, roads railways and waterways, modes of transport, technical resources, sources of energy and chemical substances´.
4 'Bewust veiliger' is the programme of action of the Fire Service Department and EMS (2002-2006). It contains details of all the coherent activities, which are designed to help improve public safety awareness. These activities form a substantial part of the policy objectives and activities of the management clusters. 8 1.3 Administrative division of responsibility
Municipal responsibility
In the existing situation, the municipalities bear responsibility for: – the fire brigade services – the organisation, the management and the duties of the fire brigade – the establishment and maintenance of a regional fire brigade – the preparation for and actual response to disasters and major accidents The State has stepped-up its monitoring of – the formulation of van disaster plans and preparations for disaster relief. This has been disaster management plans formalised in such legislative measures as the – the medical assistance in the event of disasters Disaster Relief Quality Improvement Act (Wet and major accidents. kwaliteitsbevordering rampenbestrijding). After all, there is no margin for free will in the In the event of a major accident or disaster, or a field of safety. justifiable fear of such occurring, the mayor takes command of everyone involved in the response. Reinforcing disaster relief and fire brigade In the event that several municipalities are involved, then the mayors appoint one of their The fire brigade, EMS and police ensure physical number as the coordinating mayor. This is usually safety. Safety regions have been formed with a the mayor of the largest municipality. In the event view to enabling smooth cooperation. Until just of a disaster or major accident of more than local recently, these fire brigade, EMS, and police proportions, the Queen's Commissioner shall organisations applied their own regional divisions. issue the mayor instructions as to the policy to be In the safety region, however, the emergency pursued. Whenever it is considered necessary in services will share the same regional divisions the interests of public safety, the Minister of the and preferably the same administrative bodies. Interior and Kingdom Relations shall issue the Queen's Commissioner instructions as to the Another priority is the joint accommodation of the policy to be pursued. In all cases, however, the police control centres, the regional fire brigade administrative bodies involved remain responsible emergency call centres and those of the regional for the manner in which they follow these ambulance services. This is designed to improve instructions. cooperation between the various emergency services.
5 Please consult 5.1 6 Please consult 5.2 9 Safety region councils involved and the regional safety board as fully informed as possible as to his or her actions Developments in the area of the safety region within the policy team. have made in necessary to alter the division of responsibilities. The regional safety board of the Provincial responsibility safety region is to assume responsibility for not only the policy and management of the regional The province bears responsibility for monitoring fire brigade and the EMS, but also the disaster preparations for disaster relief by the and crisis control and management of the joint municipalities and the regional emergency emergency centre. Decision-making by the safety services. The provinces establish whether the board process shall take place on the basis of a planned preparations are carried out on time, majority vote. The safety board is authorised to appropriately, consistently with regard to content determine the weight of the votes itself. Its Chair and in mutual consultation. This provincial shall cast the deciding vote in the event of a tie. supervision is carried out on the basis of The regional safety board shall comprise all of the supervisory frameworks jointly developed by the mayors in the region. provinces. The mayor remains in charge in the event of contingencies, or a significant threat of their Ministerial responsibility occurrence, the effects of which are restricted to within the municipal boundaries. In the event of Various Cabinet ministers are in charge of safety a disaster or crisis affecting several municipalities, in the Netherlands. The Minister of the Interior the Chair of the regional safety board fulfils an and Kingdom Relations bears responsibility for exceptional role. The Chair establishes on the basis issues including public order and safety. of statutory criteria whether this is the case, and if This responsibility also comprises the organisation so he or she may convene a meeting of the of the fire brigade, the response to disasters and regional policy team either independently, or at t major accidents, national and local crisis control he request of a member of the safety board or the and the organisation of the EMS. The minister is Minister of the Interior and Kingdom Relations. responsible for the administrative structure of the This policy team shall comprise at least the mayors EMS, whilst he also creates the basic conditions in whose municipalities are involved. The Chair which this might be carried out under the auspices consults the policy team as to the measures to be of public administration. The Minister of Health, taken. The mayors exercise their authority in Welfare and Sport is responsible for the medical accordance with the outcome of the consultations. content of the medical health sector, whatever the The Chair remains answerable to the Minister of circumstances. The Minister of the Interior and the Interior and Kingdom Relations as to his or Kingdom Relations also bears responsibility for her actions within the policy team. Furthermore, the system of disaster relief. He defines the he or she is also obliged to keep the municipal frameworks by means of regulation and
10 legislation, whilst creating the basic conditions necessary to enable all the bodies responsible to provide services and perform their duties appropriately. In addition, he assesses the quality of the disaster relief chain, bears a portion of the costs involved and implements additional measures to enable large-scale operations, such as connections, the public alarm system and the necessary equipment. And finally, the Minister of the Interior and Kingdom Relations reports to the Second Chamber at least four times a year concerning the current state of affairs with regard to disaster relief and the corresponding preparations.
11 2
12 2 Fire brigade
13 2.1 History Then in the seventeenth century - in the larger cities in particular - these primitive, mediaeval Guarding against war, water and fire firefighting organisations developed into organised fire brigades, which were equipped with fire In the early Middle Ages, war, water and fire were pumps. Some firefighting organisations were the most significant threats to mankind. As wars based on a form of civil conscription, while others and floods usually did not strike unannounced, comprised volunteers, who were granted people could take measures to protect themselves. exemption from military service in return. However, a minor fire in those days of open furnaces, timber dwellings and thatched roofs, Until the turn of the twentieth century, protection could suddenly get out of hand and trigger an from familiar hazards, such as fire, was primarily uncontrollable conflagration. the responsibility of the local authorities. The motorisation of fire brigade equipment rendered it The most primitive means of firefighting no longer necessary to mobilise large numbers of equipment were tubs and buckets of water, damp people to convey water to the scenes of fires. A tarpaulins, hooks and axes. As such hooks and smaller group of devoted staff that was suitably axes could be indiscriminately used to demolish trained in the use of the modern equipment thatches and even entire houses, however, in offered greater protection, after all. attempts to halt the progress of a fire, organisation and regulation became essential. The authorities During the course of the further industrialisation therefore opted to draw up fire regulations. of the Netherlands, it became clear that an The oldest existing copy of fire regulations dates outbreak of fire might well exceed local resources. back to the fourteenth century. It prescribes how Alliances were therefore forged. During the everyone was to be warned and mobilised, who occupation, bombardment and acts of war that was in charge of the firefighting operations, and WWII brought, the benefits of compulsory how blame and the ensuing costs were to be standardisation, training, tactics and regional apportioned. cooperation became evident. Following the liberation, substantial attention was devoted to professionalizing the fire brigade and its equipment. The nature and position of fire brigade
14 The municipal fire brigades are affiliated to one of the 25 regional fire brigade organisations. These alliances yield greater safety at reduced costs. The regional fire brigade is in charge of the umbrella duties in the field of fire services and disaster relief. It serves as the backbone of the organisational structure and performs a coordinating role in the response to major accidents and disasters and the corresponding preparations. The regional fire brigade operates the emergency call centre, organises training courses and drills and arranges for assistance in the form of personnel and equipment whenever a municipal brigade requests it. Further duties include the management of special equipment, which all municipal brigades in the region may utilise. The Board of the regional fire brigade comprises the mayors of the municipalities involved. The Regional Fire Chief is in charge itself became the subject of lengthy, in-depth of operational control. discussions, which led to fire brigade services being allocated a municipal responsibility. The events of the past decade, however, have rendered regionalisation essential. At the same time - largely due to the increasing risks of today's society - substantial amounts of funds and effort were devoted to more large-scale cooperation, training and drills. The organisations established prior to WWII and during the Cold War to protect the civilian population from the effects of wartime disasters were finally disbanded in the nineteen- eighties - primarily due to a lack of public support. Their duties were transferred to the non-combat organisations. The primarily regional fire brigade plays a major role in the revamped disaster relief organisation. Brandweerregio's 2006
2.2 Organisation
A Dutch fire brigade does not exist as such. The fire brigade in the Netherlands comprises over 450 municipal and 25 regional brigades. The municipal brigades are responsible for basic fire services. The Municipal Executive (Mayor and Aldermen) forms the Board of the municipal fire brigade.
Bron: BKZ
Source: Volksgezondheid Toekomst Verkenning, Nationale Atlas (Future Public Health Survey, National Atlas) 15 2.3 Duties Pro-action
The fire brigade's duties are laid down in the Pro-action: The removal of structural causes of Netherlands Fire Services Act of 1985 and in the physical danger and avoiding their occurrence. Disaster Response Act. Both acts describe the manner in which the government fulfils its The fire brigade provides advice concerning obligation to protect its citizens. The fire brigade's the safety of residential, working and living primary duty has shifted from extinguishing fires environments at the earliest possible stage. (repression) to providing technical assistance in This applies to the aversion of risks, the the event of accidents, disasters and crises. The fire accessibility and transport of dangerous goods brigade's further duties are as follows: pro-activity, and the design of major structures. The fire prevention, preparation and aftercare. In these brigade assesses the plans of new development days of substantial and unforeseeable risks, the areas, identifies risks and ensures that the best fire brigade faces increasing political and public possible accessibility to new development areas demands for high quality assistance. and buildings is guaranteed.
Prevention
Prevention: Averting the immediate causes of fires, accidents and disasters, and minimising the consequences thereof.
The fire brigade is involved in preventing the occurrence of situations that might lead to disasters and major accidents. In this role, it advises the competent authorities on the subject of environmental permits and permits prescribed by the Spatial Planning Act, whilst focusing primarily on the facilities for self-preservation and the provision of assistance. In addition, the fire brigade is involved in averting situations in which fire might break out or spread. For instance, it checks construction plans for their compliance with fire safety regulations and escape routes. And finally, the fire brigade provides both advice on how to improve the fire safety of existing buildings and fire prevention information.
7 Appendix A 16 Pro-action
Preparation Aftercare Prevention Preparation: The actual organisation of all action to be taken in the event of fires, major accidents and crises.
The fire brigade prepares its personnel to fight Repression Preparation fires and to operate and provide assistance in the event of accidents, disasters and crises. This is carried out training and drilling personnel, providing public information and checking 2.4 Personnel firefighting resources and emergency water supplies. Furthermore, the brigade checks that Complement buildings and residential and industrial estates offer suitable accessibility to fire crews. It also Regional fire brigade organisations draws up plans of attack and approach for specific The further regionalisation of the fire brigade works and routes for the transport of dangerous means that increasing numbers of regions employ goods. personnel in regional service. The government is currently discussing the issue of the minimum Repression percentage of personnel that should be employed in regional service. The current preference is for Repression: The actual handling of the incident. all non-repressive personnel and the executive repressive personnel. It is the fire brigade's job to offer both humans and animals immediate assistance in the event of fire. Municipal fire brigade organisations However, firefighting is just one aspect of fire The some 450 municipal fire brigade brigade work. The fire brigade also assists in the organisations in the Netherlands have a total of event of road traffic accidents, waterborne around 27,000 male and female personnel. accidents, flooding and storm damage. Since the No fewer that 82% (22,000) are engaged as past few years, the fire brigade has also been volunteers or part-time personnel, while 18% increasingly approached to assist in resolving (5,000) are professionals. Generally speaking, the environmental incidents and accidents involving larger a municipality is the greater the percentage hazardous substances. Firefighters are also trained of professionals it employs. Five municipal to save lives. They rescue people from perilous brigades consist purely of professional firefighters, situations, such road traffic or diving accidents. while approximately 65 municipalities have a solely volunteer force. Aftercare Professional and volunteer firefighters have to Aftercare: Everything that is required to restore comply with the same professional competence 'normal' conditions as swiftly as possible. requirements, and perform the same duties.
Aftercare consists of care for victims and personnel, informing people living in the surroundings and assessment of the actual performance. There has been increasing attention to the issue of aftercare during the past few years.
17 On a national scale, the fire brigade comprises With regard to medical suitability, education 95% men and 5% women. As recently as 1995, and age, there are national guidelines for both in fact, a mere 1.5% were women. Some 3% of all professional and volunteer brigades. firefighters are from a minority background. Guidelines have yet to be drawn up for Of all fire brigade personnel, 5% are high ranking, determining physical and psychological suitability. 19% medium ranking, and 76% low ranking. The job requirements for professionals and The personnel complements of brigades in large volunteers are identical. Additional suitability municipalities are no different from those in small requirements are, however, often applied in fire ones. brigade organisations with primarily professional personnel.
Ratio professionals/volunteers within New firefighters for brigades comprising fire brigades in the Netherlands volunteers are often selected by existing fire brigade volunteers, who put forward the names of people they consider suitable firefighters to the brigade management. The municipal executive officially appoints fire brigade personnel. If this
vrijwilligers recruitment process fails to yield suitable beroepskrachten candidates, then the vacancy is published in the local media or local campaigns are organised.
Ratio men/women within fire brigades in the Netherlands Special campaigns are sometimes organised to recruit women or candidates from minority groups. Vacancies for professional firefighters are advertised in trade publications and newspapers.
man Training vrouw All firefighters must have the same knowledge and
Division of ranks within fire brigades in the Netherlands skills. The training courses therefore have a modular structure and a diploma is a prerequisite for any post within the fire brigade. Firefighters can take various training courses, depending on
lower rank their own interests, input and qualifications and middle rank the existing complement of the fire brigade senior rank organisation where they work.
The training programmes for each level comprise Recruitment and selection compulsory and optional modules, each of which concludes with a state examination. Firefighters have to comply with the applicable The compulsory modules comprise course standards for education, age and medical, physical material that is essential to enable the firefighters' and psychological suitability. Furthermore, they overall deployment at the levels in question. have to be able to work as a team. Fire brigade The optional modules offer candidates the volunteers are subject to additional requirements opportunity to acquire a specialisation at one or pertaining to their main occupation and place of more levels of training. In most cases, this involves residence. part-time training courses, which are attended both during the day and in the evening.
18 Figure: Table of positions
Level Rank Repressive positions Management positions Specialist positions
University level chief commodore regional chief
University level deputy- chief fire chief strategic manager safety manager commodore
Higher Vocational commodore commanding duty dangerous tactical manager policy & board risk & safety planning and Education officer substances consultant specialist disaster manage- consultant ment specialist
Higher Vocational fire chief duty officer operational manager fire prevention training & Education specialist drills specialist
Senior Secondary chief firefighter officer in charge team leader prevention instructor Vocational inspector Education switchboard operator
(Senior) Secondary leading firefighter leading firefighter fire brigade diver monitoring officer Vocational Education dive team leader
(Senior) Secondary firefighter firefighter driver/ pumping Vocational appliance operator Education chemical suit operative
The training programme commences with basic training, during which participants are taught basic control and operational knowledge and skills.
On completion of their basic training, the participants proceed to a training course for a particular management or operational post, or both, depending on the individual's competences. There is a separate strategic leadership programme for managerial positions. The length of training varies according to the participants' qualifications and previous experience and the training course they have chosen. It is the intention that the training courses be further aligned with regular education, and therefore gain recognition beyond the fire brigade.
19 Independent managing bodies With subsidy from the Ministry of the Interior and Kingdom Relations, the institute recently Netherlands Fire Brigade & Disaster Relief commenced with the development of its own Institute (Nibra) multi-year programme of research covering the The Nibra is a training and knowledge institute f following themes: or the fire brigade, EMS and disaster & crisis – Self-preservation (mid-2004 to mid-2007) management. Its core operations are: training, – Simulations (2005 to 2008) care, research and development of drills, – Crisis Management (mid-2005 to mid-2008). consultancy, publicising and publication, The objective of this programme of research is to organising and facilitating conferences and broaden the knowledge of fire brigade EMS, workshops. disaster relief and crisis management professionals. Training The Nibra plays a key role in training fire brigade International and disaster relief organisation personnel. The Nibra has representatives among various The institute develops course material for the international consultative bodies. The institute regional training centres, where fire brigade focuses increasingly on the dissemination and personnel receive training up to officer level. mobilisation of knowledge at international level. The Nibra itself provides the officer training programme, which produces some 75 fire brigade Netherlands fire brigade examination officers a year. The Nibra also organises a two-year agency (Nbbe) Master of Crisis and Disaster Management The Minister of the Interior and Kingdom programme in cooperation with the Netherlands Relations is responsible for the quality of fire School for Public Administration. And finally, the brigade personnel. The Netherlands fire brigade institute organises regular workshops, conferences examination agency (Nbbe) is one of the and seminars. instruments at the minister's disposal for this purpose. As an independent administrative body, Drilling the Nbbe is charged with the development, In practice, there is a demand for specialised and execution, organisation and administration of all professional emergency workers. state examinations in the field of fire brigade care The Nibra has therefore developed corresponding and disaster relief. training programmes, aimed at both the administrative and operational teams. It also has The minister sets the national guidelines. virtual training programs. The organisation and execution of the examinations are governed by the regulations laid Information The Nibra publishes a great deal of its knowledge. For instance, it develops and publishes educational and project material for all positions within the fire brigade and disaster relief organisations. Anyone keen to remain abreast of national and international developments, should contact the Nibra, which has developed into an international documentation centre over the years.
Research The Nibra is often commissioned - by a municipality, brigade or ministry for example - to perform research in the broad field of safety.
20 trained, while new developments are incorporated. In the case of repressive posts, the actual work - call-outs and providing assistance - is often limited. Drills therefore serve as an important supplement.
Drill policy Drilling is one of the fire brigade's core activities. It is the ideal means of maintaining and improving its levels of knowledge and skills. These skills include physical, motor and social competences, such as decision-making. However, communication is also considered a skill, as the fire brigade often has to operate as a team. The drills involved may be realistic - the performance of a true-to-life exercise - or desktop and virtual. down by the minister and the board of the Nbbe in the 'Decree on the national fire brigade Anyone who completes the fire brigade training examination and the examination regulations' course by attaining the diploma has achieved a and the 'Implementation regulation and manuals' basic level of knowledge and skills. He or she will, respectively. The Nbbe operates entirely however, have to continue to expand and develop independently of the training institutes for fire this knowledge, while the skills have to be brigade education. regularly put into practice to ensure the adequate performance of the fire brigade. Acts and skills The Nbbe comprises a management board and an learned during training have to be applied as a executive agency. In addition to its statutory duty to team in the most wide-ranging and complex provide the state fire brigade examinations, the circumstances - and sometimes in unison with agency is involved in the development and other units and/or disciplines. The objective, organisation of examinations in the area of fire therefore, is to hold drills that are as realistic as brigade and disaster relief. The Nbbe supplements humanly possible. Furthermore, this provides a its operations by providing non-state organised fire structural basis on which to critically assess both brigade examinations and (custom) examinations one's own performance and that of others. for the Netherlands Antilles and Aruba and crisis A continuous effort to further professionalize management and disaster relief examinations. (individual) fire brigade performance calls for more than practical experience alone. The Nbbe provides some eighty types of Drill situations are therefore utilised with a view examinations, ranging from lower vocational to optimising both existing and new working education to post-graduate level. A total of over methods. 50,000 state fire brigade examinations and more The fire brigade holds mono and multidisciplinary than 2,500 non-state organised examinations are drills. taken annually. • Monodisciplinary drill: exercises performed from Professional competence the perspective of a single discipline. In the Netherlands, the municipal council bears The maintenance of the professional competence responsibility for the drilling of municipal fire of fire brigade personnel through further training, brigade personnel. The fire brigades focus on actual work and drilling is of vital importance. monodisciplinary drills, in which they work Competences, knowledge, skills and behaviour are towards performing a final drill together with other emergency organisations (multidisciplinary).
21 • Multidisciplinary drill: exercise involving various services (e.g. police, EMS, municipal services, water authorities). The regional fire brigade is responsible for the multidisciplinary drills. The fire brigade almost invariably operates in conjunction with one or more aid services. The larger an incident becomes, the more organisations become involved in accident response. The fire brigade therefore focuses not only on its own duties, but also on cooperation with other disciplines.
Netherlands Association for Fire Brigade Services & Disaster Relief (NVBR) The Netherlands Association for Fire Brigade Service & Disaster Relief (NVBR) is the sector association for fire brigade and disaster relief in the Netherlands. It plays a binding role in supporting the fire brigade and other organisations involved in the field of disaster relief, in the care they provide with a view to ensuring the safety of the society in which we live.
The (inter)municipal, regional and company fire brigade brigades in the Netherlands are affiliated with the NVBR through their chiefs. The association therefore represents all Dutch fire The monodisciplinary drilling system applied brigade organisations. in the Netherlands has been laid down in the The board of the NVBR is supported by two 'Leidraad Oefenen' or Drill Guidelines, which consultative bodies. The first is the Council of are based on an annual drill cycle. These Drill Regional Chiefs, on/in which all 25 of the Guidelines define a number of phases of the drill Netherlands' regional chiefs hold seats. schedule, which together form the drill cycle. The second is the Advisory Council, which is formed by the regional chiefs and the 25 municipal The drill cycle consists of: chiefs. – Establishing the job responsibilities; there is a drill chart for every fire brigade duty. – Drawing up the drill charts. – Scheduling the drills; from basic to final drills. – The execution of the drill schedule. – The measurement of drill performance; participants in a drill are assessed on the basis of drill chart criteria. – Registering the numbers of drills; each individual is recorded in a drill registration system (drill log) as well as the extent to which the applicable criteria are met. – Analysis of the drill data; the recorded data is analysed with a view to achieving an ideal balance of the drill time allocation and the skills that fire brigade personnel have to acquire.
22 The NVBR represents the interests of the fire pumping appliance, accompanied by an assistance brigade in the Netherlands in the broadest sense vehicle and/or personnel & equipment vehicle and of the term. The association: service vehicles. Service vehicles are deployed for – Puts out feelers, identifies bottlenecks and personnel transport and repressive duties, such as proposes solutions a Command Officer's vehicle. The municipal fire – Boosts the quality of the Dutch fire brigade by brigade often acquires equipment in cooperation means of joint policy-making. with the regional fire brigade. – Ensures that the Dutch fire brigade is placed on and remains on the political agenda. In the event of specialist fire brigade operations, – Provides a platform for discussion and the the fire brigade utilises equipment that is available exchange of knowledge and experience. regionally, such as turntable ladders, assistance – Contributes to the support for the fire brigade vehicles or water accident response vehicles. organisation and its personnel, in the field of The municipal fire brigades of large(r) safety, technological developments, management municipalities often possess such specialised fire issues and quality, etc. brigade vehicles of their own. – Cooperates with other associations and organisations operating within the Dutch fire The regional fire brigade maintains the state- brigade. owned equipment for disaster relief, while – Maintains close contact with fire brigade supporting and advising the municipal brigades in organisations, authorities, trade organisations their acquisition (regional framework agreements) and other operational services both within the and ensuring 'regional' standardisation of Netherlands and abroad. equipment. The purchase of specialist fire brigade equipment using the regional budget is a Activities significant development in this respect. The NVBR's broad range of activities comprises The combined purchase policy that this increase in such aspects as advising members as to the latest scale yields both purchase savings and contributes developments in the area of safety, technological to the standardisation of 'regional' equipment. developments, management issues and quality, These are significant benefits. Central government etc. In addition, it develops practical instruments coordinates the management of the equipment at and products for its members. Examples of such regional level. are the manual containing plans of attack and accessibility maps and the emergency water The Fire Services Act of 1985 prescribes that the supplies and accessibility manual. regional fire brigade bears ultimate responsibility Furthermore, the NVBR organises workshops, for disaster relief in the Netherlands. In order to conferences, keynote meetings and working cope adequately with this burden, a system of conferences. It represents the fire brigade in escalation was devised, the 'brandweer compagnie' external concertation networks and consultative or fire brigade company. bodies and supports the knowledge infrastructure. Fire brigade company The fire brigade company is a combination of the 2.5 Equipment following components: – one command unit Equipment for small and large-scale – two fire brigade platoons operations – one support platoon.
Introduction The fire brigade platoons are deployable for both In responding to small-scale incidents within their technical assistance and firefighting. The support own municipality, the fire brigade generally uses platoon provides logistical support, even if only its 'own' equipment. This largely comprises the one platoon is called out to assist.
23 The pumping appliances serve as the basis for the Logistics fire brigade platoon. The basic equipment aboard – one swap body vehicle (municipal/regional fire the pumping appliances is in principle sufficient to brigade equipment) perform all technical operations required in the – two swap body vehicles (state-owned equipment) field of assistance and firefighting. – one truck (state-owned equipment)
A fire brigade company can perform the following Command/communications duties: – two official cars (municipal/regional fire brigade – large-scale technical assistance (locating and equipment) rescuing victims in the event of crushing/ – three service vehicles (municipal/regional fire structural collapse, fire and/or the presence of brigade equipment) hazardous chemicals) – one command & communications vehicle (state- – large-scale firefighting owned equipment) – large-scale operations in the event of accidents – one swap body for command purposes (state- involving hazardous chemicals and owned equipment) environmental incidents.
In the case of large-scale fire brigade operations, the municipalities and fire brigade regions utilise not only their own fire brigade equipment, but also state-owned equipment for disaster relief. This belongs to the Ministry of the Interior and Kingdom Relations and is maintained by the regional fire brigades, which receive government funds with which to do so.
The fire brigade company's equipment comprises:
Firefighting – nine pumping appliances (municipal/regional fire brigade equipment) – one immersion pump trailer (state-owned equipment) – two combi swap bodies with immersion pump (including 1 km of 150-mm hose) (state-owned equipment) – one swap body equipped with 3 km of 150-mm hose (state-owned equipment)
Technical assistance – nine pumping appliances (municipal/regional fire brigade equipment) – two assistance vehicles (municipal/regional fire brigade equipment) – two swap bodies containing basic assistance equipment (state-owned equipment) – one swap body containing specialist assistance equipment (state-owned equipment)
24 Future developments In 2005, the Ministry of the Interior and Kingdom Relations commenced with the development of a new vision of the fire brigade's large-scale operations, based on experiences gained from the deployment of the fire brigade company. This vision meets the equipment requirements for the fire brigade's large-scale operations.
Fire brigade uniform
The fire brigade is issued with both operational and dress uniforms. Its dress uniform was recently modified. The police uniform served as the basic model for this modification. The new dress uniform is in keeping with the needs of municipal and regional fire brigades.
2.6 Quality assurance
The fire brigade is expected to provide quality. With a view to gaining insight into the operation and performance of the brigades, the fire brigade increasingly utilises a quality assurance system that is based on the INK's management model. The quality cycle is completed every four years.
25 26 3 Emergency Medical Services (EMS) 3
27 3.2 Organisation
Various medial institutions play a role in disaster relief and crisis management, such as hospitals, the Municipal Health Services (GGD), ambulance services, the Red Cross, GPs and mental health institutions responsible for psychosocial care and aftercare. It is essential that these medical services prove capable of operating as links in the chain of a single organisation whenever a major accident or disaster occurs. They therefore cooperate with other institution within the EMS. 3.1 History In the event of a disaster of major accident, the The survey report entitled 'De keten rammelt' rescue of victims and provision of medical (1994) or The chain is ramshackle published by assistance takes priority. The administrative the Health Care Inspectorate revealed that responsibility for the performance and cooperation within the health care chain left much unambiguous organisation of the escalated to be desired. A joint study carried out by the Fire medical assistance chain is regionally organised Services and Disaster Relief Inspectorate and the in the form of a mutual agreement within the Health Care Inspectorate (1995) confirmed these municipality in the EMS region. These regions are findings. Collaboration between authorities and on the same scale as the police and fire brigade public bodies proved simply inadequate. regions. The Board appoints the Regional Medical The Ministries of van Health and the Interior Officer (RMO) as head of the EMS. therefore decided to improve medical assistance in The Netherlands has a total of 25 Regional Medical the event of major accidents and disasters. This led Officers. to the launch of the Emergency Medical Services Project (PGHOR) in 1997. A year later, 26 interim EMS boards were formed, designed to create a recognisable medical link in the disaster relief organisation. Next, Regional Medical Officers (RMOs) were appointed in each of the regions. These officers are responsible for preparations for GHOR-regio's 2006 the provision of medical assistance, including pro- activity, prevention and preparation. In the event of repressive situations due to major accidents and disasters, these officers assume administrative control of the EMS processes. The post of regional medical officer is comparable to that of Fire Chief in the fire brigade and Chief of Police in the police force. Then towards the close of 1999, an administrative board of EMS mayors and Board of regional medical officers were established. The EMS mayor is the mayor of the EMS region chaired by the EMS board.
Bron: BKZ
Source: Volksgezondheid Toekomst Verkenning, Nationale Atlas (Future Public Health Survey, National Atlas)
28 The Regional Medical Officers have united to form the national Board of RMOs, which enjoys the support of the National Emergency Medical Services Agency. This agency also acts as the secretariat for the EMS Council, the administrative counterpart of the Board of Regional Medical Officers. The Board pursues the following principal strategic objectives: – contributing to the foundation of a clear structure for the EMS and cooperating with the partners in the chain; these include not only medical partners, but also the fire brigade, police and municipalities. – Psychosocial aftercare of victims: psychosocial – contributing to the (regional) foundation of an care for victims immediately following the EMS organisation that is competent to perform disaster in reception centres, with a view to its role. preventing, reducing and identifying traumatic disorders and boosting the mental resilience of Well-educated and trained personnel, who share those affected. their knowledge and experience with one another, – Preventative Public Health Care: measures to are essential in this context. safeguard public health in the event that Furthermore, standardisation of the primary radiological, nuclear, biological, chemical or operating procedures and the escalation and related substances are released due to accidents downscaling is crucial. The extent to which an and disasters, which pose a threat to human assistance unit is prepared for a disaster or crisis health or the environment, with a view to is largely determined by its planning. The primary preventing (further) injuries or the exacerbation element of planning is the organisation of the of existing injuries. command and control structure of the response, which is largely definitive for the success of disaster management plans. 3.4 Personnel
Complement 3.3 Duties The EMS comprises a minor contingent of The EMS board bears responsibility for setting up permanent staff, many of whom work for one of and maintaining the emergency care centre. the regional agencies in the 25 safety regions. The board is authorised to choose the geographic They usually perform preparatory and operational location of the emergency ambulance service duties. The Regional Medical Officer's staff unit centre, whilst bearing responsibility for the entire prepares for operational duties, organises training infrastructure. and drills, and maintains both the monodisciplinary The Regional Medical Officer is responsible for the and multidisciplinary networks. In the case of preparations for medical assistance, including pro- actual operational deployment, however, regular activity, prevention and preparation. He or she is health professionals are engaged. This involves in charge of the administration of three processes 31 individual roles (see table below), some of which in the event of a major accident or disaster: are deployed in the area coordination and others in – Medical assistance (somatic): care for the injured the field of care. The existing organisations have to and emergency medical care. allocate these roles in the event of an emergency, while the permanent office staff assumes some of the coordinating roles. The regular care sector
29 forms the basis for the provision of medical 30 emergency treatment paramedic assistance in the event of disasters and large-scale 31 mobile medical team paramedic accidents, while in exceptional circumstances it is This list of operational roles is dynamic escalated as laid down in the covenants. The remainder of the roles are largely filled by Regional Ambulance Services ambulance service personnel. Key positions, such Ambulance assistance in the Netherlands is as Regional Medical Officer, Head of EMS section provided by the Regional Ambulance Service. and Medical Chief/duty officer are assumed The transport is provided partly by public and according to rota. To ensure that the post of partly by private operators. In the future, the Regional Medical Officer can always be Minister of Welfare, Health and Cultural Affairs is operationally manned, a total of some eighty to grant a permit for a regional ambulance service people are appointed who are capable of doing so. in each region. 25 of these are formal administrative managers of The crew of an ambulance comprises a driver the EMS in the regions. and a paramedic, who have completed a special training course in addition to their vocational List of positions within the operational EMS. training. On the basis of this training and according to protocol, ambulance paramedics are The 31 operational roles within the EMS currently authorised to perform certain procedures in the distinguished are as follows: absence of a physician, which may otherwise solely 1 ambulance driver be performed by a trained physician. 2 ambulance paramedic Ambulance paramedics are also authorised to 3 mobile medical team doctor perform triage. The Regional Ambulance Service 4 coordinator of transport of the injured also comprises an ambulance assistance 5 medical duty officer emergency centre, which can deploy staff to the 6 central ambulance transport switchboard site of the disaster. In the event of major incidents, operator the emergency centre ensures that a post is set up 7 crisis coordinator at the site of the disaster to coordinate transport of 8 health consultant hazardous chemicals the injured. Each region's levels of assistance are 9 head of EMS action centre laid down in an ambulance assistance plan, which 10 head of central ambulance station ensures that sufficient transport capacity is made 11 head of casualty centre available for the injured in the event of major 12 head of EMS section incidents. A national plan for the distribution of 13 General Practitioner the injured is currently being drawn up. 14 vital psychosocial assistance team leader 15 reception team leader 16 liaison national medical coordination centre 17 liaison provincial medical coordination centre 18 vital psychosocial assistance team member 19 pilot's post officer 20 reception team assistant 21 medical specialist 22 medical duty officer 23 operational assistant EMS action centre 24 regional disaster relief coordinator NRK 25 Regional Medical Officer 26 SIGMA driver 27 SIGMA leader 28 SIGMA member 29 emergency treatment doctor
30 Whenever a disaster or other major incident occurs, the status is escalated and the EMS can call on the following care institutions for support:
Hospitals The government has appointed ten hospitals as trauma centres, each of which has a land-based mobile medical team to provide medical assistance outside the hospital. Four of these teams also have deployed - even in the event of escalated access to a helicopter, and are regularly deployed to circumstances - either as a single or as separate provide day-to-day emergency medical assistance. units. A mobile medical team comprises a doctor and a paramedic with experience in the field of pre- Ambulance crew as part of a medical combination hospital emergency medical assistance. The ambulance crew (paramedic and driver) They perform triage and emergency surgical and performs procedures designed to maintain or anaesthetic procedures at the site of the disaster. restore the vital functions and stabilise victims. The team's duties do not include the transport of Medical combination victims to hospitals. The medical combination ensures that the transition from the usual day-to-day, small-scale SIGMA teams emergency medical assistance to operations in the A SIGMA (Snel Inzetbare Groep ter Medische event of major accidents or disasters proceeds Assistentie = Rapid Deployment Medical smoothly. A medical combination comprises a Assistance Group) team is a group specially mobile medical team, two specially trained trained Red Cross volunteers, who are deployed in ambulance crews and a SIGMA team, and it is the event of major accidents and disasters. The equipped with a hospital tent. The 'medical duty volunteers support ambulance staff and trauma officer' appointed by the region is in charge of the teams in providing medical assistance. They are combination. A medical combination can be primarily responsible for setting up the working environment and replenishing supplies. The Netherlands has 49 SIGMA teams, each with a permanent complement of eight people, including a team leader.
31 Recruitment and selection Drills In addition to the education and training required Every health care institution bears responsibility for the various positions, drills have to be held to for the recruitment and training of sufficient maintain suitable levels of professional numbers of qualified personnel to occupy the EMS competence and to ensure that cooperation is positions. adequate. Monodisciplinary drills form the basis for effective performance within the health care Training sector. Care institutions bear responsibility for holding drills within their own establishments. During the course of its training, the EMS The regional EMS Board, however, is responsible distinguishes between regular care positions and for joint care institution drills, multidisciplinary specific EMS roles. This is due to the fact that such cooperation and the administrative and positions have to be embedded in the various organisational management. This is laid down in organisations involved in providing medical the regional drill plan. As the performance of assistance during large-scale operations. physical drills within the health care sector places a substantial burden on the already scarce care The regular EMS positions are occupied by people resources, the emphasis is placed on other forms working in the regular care sector. The sector also of exercises, such as virtual drills. At national level, bears responsibility for the additional training the Swedish Emergo Train System is widely used, required for large-scale operations. The Health which simulates the entire process of rescuing Care Inspectorate ensures that health care victims at the site of the disaster, right up to their institutions remain suitably prepared. discharge from hospital. Furthermore, as a director, the Regional Medical Officer's duties include the encouragement and facilitation of all care partners.
The specific EMS positions are aimed solely at dealing with large-scale operations. These positions fall within the responsibility of the Board, which draws up a training plan based on the national advisory model for the job descriptions. The basic level comprises the 'basic EMS course material', for which a national examination is held under the auspices of the Board of Regional Medical Officers. The development of a national system for professional competence and certification of the various positions commenced in 2005.
32 3.5 Equipment This Medical Administrative Information Service (G-BIV) project is also to include a victim tracking Medical combination's equipment system, an ambulance assistance plan, a plan for the distribution of the injured, a victim registration The medical combination's equipment comprises card, and a website for care capacity and related the operating resources for the (land-based) mobile registration and information. A victim tracking medical team, the ambulance crews and the system will ensure that the RMO has access to the SIGMA team. The total operating resources are information required (numbers of victims and sufficient for four hours of medical assistance at nature of their injuries) to manage the distribution the site of the disaster. A mobile medical team has of the injured. The competent authorities, one vehicle, while a SIGMA team and ambulance municipalities and hospitals will also be supplied crew each have one vehicle with a trailer with the necessary information. The ambulance containing operating resources for two hours. assistance plan is designed to provide an overview In the event that additional operating resources for of the EMS resources available in the event of a a further two hours are required, the teams have disaster involving substantial numbers of victims. access to one swap body. A plan for the distribution of the injured should ensure that, once triage has been performed, it can Operating resources for the mobile medical team: swiftly be determined which hospitals the injured – specialised medical equipment are to be taken to. The website for care capacity – Advanced Life Support equipment should enable the swift and effective admission and transfer of patients. Operating resources for the ambulance: – Advanced Life Support equipment – stretchers 3.6 Quality – materials for the treatment of burns – oxygen Professional standards form the basis for the quality of the care, both in normal and exceptional Operating resources for the SIGMA team: circumstances. A quality assurance system has – a tent, including a diesel generator, mobile been developed for the EMS, which is based on (hot air) heating and lighting set the Harmonised Care Institutions (Quality) Act – First Aid kits certification scheme (Harmonisatie Kwaliteitswet – bandages Zorginstellingen). At the request of the Board of Regional Medical Officers, the EMS certification Support resources scheme was developed, which applies to the agencies that organise medical assistance in the For several years, the Ministry of the Interior and event of accidents and disasters. It covers the Kingdom Relations has been involved in a project duties and responsibilities of the Regional Medical designed to create a management information Officer and the agency that supports him/her. system for the EMS. A facility is currently being All EMS regions are to be certified by 2007. set up by combining various existing infrastructures and databases on the basis of administrative agreements, and through the implementation of standards yet to be concluded.
33 4
34 4 Multidisciplinary
35 4.1 Opgeschaalde basiszorg
The regular assistance organisations in the Netherlands are developing additional quality and capacity to enable them to not only provide basic care, but also deal with major incidents and disasters. This combination of duties yields a number of advantages. The organisations involved regularly take part in drills with one another, while they also benefit from mutual contacts in day-to- day practice. In the case of a road traffic accident in which a person has become trapped, for example, the fire brigade intervenes to free the victim, while the ambulance staff provides medical assistance and the police cordon off the scene of the accident and direct other traffic. Suitable multidisciplinary cooperation between the fire brigade, EMS and have its own joint emergency centre, where police is crucial. It is the backbone of the safety switchboard operators from the three emergency chain. services cooperate with one another.
The safety region is to become the heart of disaster 4.2 Safety region and crisis management operations. Each of the regions is to be managed by a Regional Safety A survey of recent disasters has shown constant Board, which will comprise managers representing attention needs to be devoted to cooperation at the fire brigade, medical organisations and the regional level. The government is therefore keen to police. This is to be organised along the lines of regionalise. Greater power, improved cooperation, an extended local board; a joint scheme is to be reduced optionality and a more professional fire set up to this end. Short lines of communication, brigade are the basic principles of the Cabinet direct alignment, improved cooperation and Position on Safety Regions. The government decisiveness, more effective deployment of people therefore intends to establish 25 safety regions, and resources, clear allocation of authority and in which the fire brigade, ambulance and police reduced bureaucracy are preconditions for the assistance of citizens is arranged. Each region will improvement of performance in the field of
36 disaster relief and crisis management. Citizens are to receive more adequate professional assistance more swiftly, and should therefore be shielded and protected from possible threats as well as possible.
Safety regions are not an objective in themselves. They are simply an administrative and operational means of adequately addressing the safety risks and swiftly responding to the accidents, disasters, crises and acts of terror that may befall the society in which we live. GRIP
4.3 Communications GRIP has been introduced with a view to enabling the simple alignment of the relief organisation Emergency centre with the scale of an incident. GRIP stands for 'Gecoördineerde Regionaal Incidentenbestrijdings The emergency centre is the link between Procedure' or Coordinated Regional Incident citizens in need of swift and adequate help and Response Procedure. In the case of acute incidents the emergency services, fire brigade, police and in particular, unambiguous and established levels ambulance assistance. The mobilisation of of escalation are essential. Furthermore, as no assistance in the event of both minor and major single region of the Netherlands is capable of incidents is the emergency centre's main task. coping with a disaster without assistance, uniform It will therefore have to operate as smoothly as levels of escalation are crucial. possible. The Ministry of the Interior and Kingdom Relations expects to achieve this by C2000 setting up a joint emergency centre, in which the various emergency services operate in unison C2000 is the national coverage network for mobile whenever necessary under joint management. communications between the police, fire brigade, The objective is: to bring about a tangible ambulance service and the Royal Military improvement in the quality of both day-to-day and Constabulary. It is the first of its kind in the world, large-scale assistance by boosting the quality of the in that the project opted for a multidisciplinary emergency centre. approach from the very outset. The C2000 The main objective has been elaborated to define network is designed to ensure that citizens can rely the following six policy objectives for the on improved assistance. This communications emergency centre: network speech and data transmission is based on – Increase the emergency centre's level of digital technology and the European TETRA professionalism. standard. Just as GSM has become the standard – Improve the quality of management of the units. for consumer mobile telephony, TETRA is the – Reduce the lead time from the receipt of a call to open European mobile communications standard alert. – Increase preparedness for large-scale incidents and disasters. – Improve efficiency. – Improve operational continuity.
37 for the Public Order and Safety Services. and operational logistics to all partners in the All members of the police, fire brigade, ambulance safety chain. A key component of this is the Urban service and the Royal Military Constabulary who Search and Rescue Team (USAR, see 5.3) (are due to) perform operational roles will shortly be provided with C2000 peripheral equipment. It is the intention that the National Disaster Relief This means that everyone who provides assistance Facility will eventually assume the duties that the will be equipped with a swift and secure means of Ministry of the Interior and Kingdom Relations communication, even when they are located in currently performs (such as care for material unusual places, such as on open water or in disaster relief and assistance teams). However, it is tunnels. All road vehicles, ships, boats and aircraft also to remain receptive to requests from the other belonging to the police, fire brigade, ambulance partners in the safety chain (fire brigade, police, service and the Royal Military Constabulary are medical services). fitted with C2000 equipment. The National Disaster Relief Facility currently Cross-border communications being set up is to translate the policy in the field of disaster relief into the necessary equipment, National digital networks have been set up medical equipment, logistics, public warning throughout Europe with a view to updating the provisions and requirements with regard to mobile radio communications systems of the occupational safety, insofar as the National Public Order and Safety Services. To enable cross- Disaster Relief Facility is appointed to do so. border communications between the Public Order and Safety Services of various countries, however, The National Disaster Relief Facility's duties will equipment will have to be developed with which also include the acquisition, management, to connect these networks to one another. registration and distribution of equipment and The various TETRA networks are eventually to be resources for large-scale operations in the field of linked by means of an InterSystem Interface (ISI). disaster relief and physical safety. And finally, the Belgium, Germany, France and the Netherlands facility will be involved in both setting up are currently laying the foundations for the maintaining and facilitating supra-regional and development of such an ISI. Applications are due national assistance teams and structuring shared to be made for European subsidies for this project. services for operational units. The expectations are that it will take several years more before this ISI actually becomes available. In the meantime, interim solutions are to be used 4.5 Public Order and Safety Inspectorate for cross-border communications. The Public Order and Safety Inspectorate monitors the quality of execution of public duties by the 4.4 National Disaster Relief Facility police, police training institutes, fire brigade and disaster relief organisations. The Public Order and Since 1 January 2005, the Ministry of the Interior Safety Inspectorate aims to improve safety by and Kingdom Relations has been engaged in rendering the quality of the duties performed by establishing a new facility: the National Disaster the police, fire brigade, disaster and crisis Relief Facility. The primary role of the National management organisations more transparent and Disaster Relief Facility is to provide mutually comparable. This should enable all multidisciplinary support, including assistance parties involved to shoulder their responsibilities
38 as fully as possible. The inspection reports drawn Incidental investigation up - and their publication - should have a positive The Public Order and Safety Inspectorate may effect on the improvement of execution. decide to perform an investigation due to the The Public Order and Safety Inspectorate has no occurrence of an incident, accident or disaster. power of sanction. For instance, the outbreak of fire in the Koning- kerk church in Haarlem in 2003, in which three The Public Order and Safety Inspectorate was firefighters lost their lives. This type of established in 2002, by means of a merger of the investigation naturally takes the duties and Police Inspectorate and the Fire Brigade and authority of the Safety Investigation Board into Disaster Relief Inspectorate. As a unit of the consideration. Ministry of the Interior and Kingdom Relations, the Inspectorate falls under ministerial Incidental investigation and consultancy responsibility. The Head of the Public Order and The Inspectorate is regularly involved in 'minor' Safety Inspectorate reports directly to the minister. issues in the field of fire brigade services. In most As the minister is not involved in formulating the cases, the Public Order and Safety Inspectorate inspectorate's findings, the body can be considered performs this type of investigation in conjunction suitably independent. The Inspectorate has a with other inspections. workforce of around fifty. General Disaster Relief Survey Types of investigative survey Various disasters that have occurred in recent years have shown that there is a need for In performing investigations, the Public Order and systematic and structured insight into preparing Safety Inspectorate utilises a range of instruments, for disasters. A standardised survey has therefore which may vary from one field of investigation to been performed in each safety region. the next. The themes and target groups The manner in which the police, fire brigade, investigated are largely selected on the basis of risk EMS organisation, emergency centre and a analysis. representative selection of municipalities prevent, minimise and manage disasters is investigated Systematic investigation during this survey. This form of investigation is performed at the level of individual organisations. In the case of the fire Publication of report findings brigade, the systematic investigation focuses on a Once the Public Order and Safety Inspectorate has risk analysis of a limited number of aspects of fire presented its findings to the organisations involved brigade services. A standard investigation has been and the responsible board, the inspection reports developed for disaster relief organisations: the are published - on the Internet, etc. - and 'Algemene Doorlichting Rampenbestrijding' or presented to the Minister of the Interior and General Disaster Relief Survey. Kingdom Relations and the boards primarily responsible at regional or local level. After all, they Thematic investigation bear responsibility for the implementation of When performing a thematic investigation, the improvements. The democratic inspection bodies Public Order and Safety Inspectorate investigates a (the Lower House, the Provincial Council and the particular aspect of the duties performed. This type municipal councils) are also presented with copies of investigation is carried out on the basis of either of the inspection reports, so that they might the findings of the systematic investigation or a enforce the findings in the course of their socio-political issue or an incident. monitoring duties. Thematic investigations provide a nationwide impression of a particular aspect, while identifying The EMS are monitored by means of cooperation and analysing any bottlenecks encountered. between the Public Order and Safety Inspectorate A prime example of this is the investigation into and the Health Care Inspectorate. safety awareness among fire brigade personnel.
39 5
40 5 International
41 5.1 History 5.2 Developments
When it came to the financial settlement relating A number of initiatives have since been launched to Belgian assistance in fighting the fire on in various subsectors. For instance, agreements Kalmthoutse Heide in the late nineteen-seventies, were concluded with regard to the mutual it transpired that there was very little in the way of authorisation of ambulance crews. A draft existing arrangements for such incidents. agreement with Belgium with regard to emergency A number of workgroups were therefore set up medical assistance is currently being debated. with a view to studying cross-border assistance in This agreement proposes improved alignment of the event of disasters and major accidents. ambulance assistance and large-scale medical These workgroups published their (joint) report assistance in the event of disasters. Provided the in 1980. The recommendations contained in the Belgian Federal Ministry of Health passes the draft report have since been followed up, resulting in bill, the amended agreement will be finalised and the conclusion of treaties with Belgium (1984) attached to the Dutch-Belgian treaty. As the and Germany (1988, amended in 1997). These so- differences from German procedures are minor, called assistance agreements contain procedures an amended agreement in this area is not for requesting and providing assistance in the considered necessary. event of disasters. Municipalities were also given the opportunity to conclude neighbourly assistance Water is a major issue in the Netherlands. A joint agreements with municipalities in Belgium and approach has therefore been adopted to establish Germany. Furthermore, a number of practical the risks of cross-border flooding of the Rhine and arrangements were also made, such as the Schelde rivers. In the case of the Rhine, the former remuneration of expenses, liability and claims for Poldevac (polder evacuation model) project has damages. One of the key aspects of the agreement been continued as the Viking project, a regional with the two countries is the principle that each high water information system containing relevant country undertakes to cover its own costs of data for administrators. The Netherlands is also providing assistance. cooperating with Belgium to improve the disaster management plans for the Schelde and the The agreements were later amended to include Schelde delta. This is also of importance to the provisions pertaining to specific matters. The agreement between the Netherlands and Flanders agreement with Belgium, for instance, contains a concerning the proposed deepening of the Schelde clause relating to the exchange of information in 2007. concerning disasters that may affect the neighbouring country. The Disasters and Major Accidents Act states that municipal disaster plans and disaster management plans have to be aligned - wherever this would prove beneficial - with those of neighbouring countries. Although this is often far from simple in practice, favourable results have nevertheless been achieved in the Dutch provinces of Zeeland, The Netherlands Belgium Noord-Limburg, Nijmegen and Twente. Regular Germany drills have also been held during the past few years in cooperation with Belgium and Germany.
Cross-border fire brigade operations are currently experiencing a clear development. Cross-border operations were formerly performed in incidental circumstances - such as the deployment of German firefighters to assist following the
8 In 1976, a substantial portion of the Kalmthoutse Heide heath area was destroyed by fire. This area lies partially within Belgian and partially in Dutch territory. The Dutch fire brigade requested the 42 assistance of its Belgian counterpart in fighting the fire at the time.. firework disaster in Enschede. There are now clear In the event that a request is received for signs that cross-border alignment is taking place in assistance following a major incident or disaster in the area of the provision of information, the the Netherlands of the Netherlands Antilles and exchange of risk data, the alignment of plans and Aruba, the Ministry of the Interior and Kingdom intensification of cross-border drills. The most far- Relations determines whether the Urban Search reaching phenomenon is the assumption of fire and Rescue Team is deployed on the basis of brigade duties - for a fee - in a municipality on the established deployment criteria. In the case of a opposite side of the border. Advanced plans in this request for assistance from abroad, the Ministry of field have already been drawn up in Maastricht and Foreign Affairs decides. The team is so fully its neighbouring Belgian municipality of Lanaken. equipped that it need not place too great a burden on the local resources in the area of the disaster.
5.3 Urban Search and Rescue team In the event of participation in domestic operations, the Urban Search and Rescue team The Netherlands has internationally deployable remains under local command, while operational assistance team, the Urban Search and Rescue coordination takes place in accordance with the team (USAR) which was founded following the applicable protocols. When operating abroad, the earthquake in Turkey and the firework disaster in USAR is commanded by the Minister of Foreign Enschede. The team's duties include searching for, Affairs. In such circumstances, operational rescuing and assisting victims in adverse coordination proceeds in accordance with conditions, such as earthquakes, accidents in established United Nations structures. tunnels, the collapse of major structures and tidal waves. The team has some 65 members, who are mainly fire brigade, police, EMS and defence personnel. The Urban Search and Rescue Team comprises four rescues groups, a support group, a staff group and a command group. All USAR members receive the same basic training, before proceeding to complete a training & drill programme in keeping with their position.
43 44 Appendices
45 A Laws and regulations
The Fire Services Act, the Disasters and Major accidents. The core of the organisation structure is Accidents Act and the Disasters and Major formed by the fire brigade, which assumes a Accidents (Medical Assistance) Act lay down the coordinating role in preparing for and execution of administrative and operational framework for the the actual control measures. In the interests of physical aspects involved in protecting public thorough preparation, the Disasters and Major safety. The three acts are based on the principle Accidents Act prescribes five types of plan: disaster that responsibility rests at local level. In light of plan, disaster management plan, provincial developments surrounding the safety regions, an coordination plan, organisation plan and control act on the organisation of safety regions is under plans. In addition, this act also defines the role of preparation. the Queen's Commissioner in the province.
Fire Services Act
The Fire Services Act of 1985 entrusts the municipal authorities with fire brigade services, describes the tasks of the municipal fire brigade and states that local authorities are responsible for, inter alia: the organisation and management of the fire brigade; establishing and maintaining a fire brigade and preparing the coordination structure to deal with disasters and major accidents. Besides setting up a regional fire brigade service, in which various neigbouring municipalities will participate, this act also regulates the role of the national institutes Nibra and Nbbe, which are responsible for the training of fire fighters and the drafting, organisation and taking of fire brigade exams, respectively.
Disasters and Major Accidents Act
The Disasters and Major Accidents Act describes a disaster or major accident as an occurrence that causes signficant disruption of the public safety, constitutes a (potential) hazard to large material interests and the life and health of many persons, and whereby a coordinated deployment of the organisations of various disciplines is required in order to remove the threat or to limit the damage caused. This description also covers a major accident requiring a response from various emergency services, such as the fire brigade, police and medical assistance. The point of departure in dealing with disasters and major accidents is that the services charged with daily assistance also perform these tasks in case of disasters and major
46 47 B Statistics Fire brigade and EMS
EMS trends
Table 1: Developments in ambulance care from 1996 to 2004 (Van der Veen et al., 2001; Kommer et al., 2003, CTG/ZAio).
1996 1997 1998 1999 2000 2001 2002 2003 2004
CPAs 37 36 36 28 28 28 27 25 24
Ambulance services 131 116 105 92 92 75 71 59 51
Stations 213 194 - 191 - 195 - - 203
Source: RIVM, 2006
Table 2: Number of organisations and ambulances (Bron: CTG, RIVM).
2000 2001 2002 2003 2004 av. an. gr. (%)
CPAs 28 28 27 25 24
Ambulance services 92 75 71 59 51 -13.7
Ambulance locations 190 190 190 190 190 0.0
Ambulances* 641 645 648 648 652 0.4
Helicentres n.k. 4444
Mobile Medical Teams n.k. 10 n.k. n.k. n.k.
Source: RIVM, 2006
48 Aantal per 100.000 inwoners 1,9 - 2,3 2,3 - 2,7 2,7 - 3,1 3,1 - 3,5 3,5 - 5,9
50 48,9%
40 procenten
30 29,4%
20 16,1%
10 5,3% 0,4%
0-3 3-8 8-13 13-18 18-23 > 23
Source: RIVM, 2006
49 Fire bigade trends incurred, response by the fire brigade in case of fire and (technical) assistance. Fire statistics, which have officially been kept since 1948, are compiled on the basis of information Reported fires provided by municipal and regional fire brigade The total number of fires reported has been rising service. The Central Bureau of Statistics (CBS) steadily since the mid 1990s and reached 146,000 performs the statistics to produce an overview of in 2003. The total number of fires remains stable. the number of fires, their nature and the response Increased use of fire-alarm systems has sharply by the fire brigade. Also, the CBS collects data on driven up the number of false alarms. Measures in costs, personnel, equipment, amount of loss recent years to curb this trend appear successful, with the number of false alarms stabilising.
Meldingen naar type 1990-2003
60
x 1.000 50
40
30
20
10
0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Branden Hulpverleningen Loos alarm
bron: CBS
False alarms of fire and assistance 1990-2003
60
x 1.000 50
40
30
20
10
0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Calls by fire alarm system Calls by other means Calls for assistance
50 source: CBS Nature of the fire Call-out time of the fire brigade The majority of fires take place outside. In 2003, A distinction can be made between turnout times, almost half the outside fires were set on purpose travel times and call-out times. The call-out time is and occur predominantly in the dry summer the turnout time plus the travel time. Recent years months. reflect a trend towards rising turnout times and thus also call-out times. This trend is expected to continue.
Call-out per municipality category 2003
100 %
90
80
70
60
50
40
30
20
10
0 1991 1993 1995 1997 1999 2001
< 5 min 5-7 min 8-9 min 10-15 min ≥ 16 min inhabitants x 1.000
source: CBS
51 Victims and rescues at fires In case of victims, a distinction is made between injuries and fatalities. The number of victims per 1000 fires fluctuated between 22 and 31 during the period 1990-2003.
Victims and rescues at fires 1990-2003
1.600
number 1.400
1.200
1.000
800
600
400
200
0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Injured Rescued by fire brigade Rescued by other Dead
source: CBS
52 The number of persons injured in home fires is declining during recent years. Most victims by far occur in terraced houses and flats. This downward trend is due in part to the positive influence of improved prevention and information campaigns by the fire brigade.
Victims of hom fires (exc. fire brigade personnel) 1990-2003
80 800 dead injured
70 700
60 600
50 500
40 400
30 300
20 200
10 100
0 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Dead Injured
source: CBS
53 Direct financial loss from fire Expressed in financial terms, the amount in loss from fires is increasing year on year, up to almost 1.3 billion euro in 2003.
Trend in fires, fires with damage, amount in loss Fires 1990-2003
250
200 1990/2003=100
150
100
50
0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Fires Fires with damage Amount in loss
source: CBS
54 Assistance The fire brigade has a role not only in case of fires, but also in providing assistance, whereby it can perform several assistance tasks. The CBS makes a distinction between 'buildings' and 'non-buildings' related assistance. In 2003, 41% of the assistance provided by the fire brigade was buildings related.
Assistance per 100 000 inhabitants, per province and municipality category
1990 1995 2000 2001 2002 2003
Groningen 198 173 176 175 225 168 Friesland 116 113 164 140 202 142 Drenthe 204 198 222 196 212 172 Overijssel 159 178 186 201 218 196
Flevoland 321 154 230 205 298 168 Gelderland 180 187 226 219 270 200 Utrecht 172 178 250 224 309 207 Noord-Holland 268 276 280 343 435 308
Zuid-Holland 257 268 322 327 384 278 Zeeland 174 111 154 150 218 134 Noord-Brabant 202 184 211 193 231 182 Limburg 407 277 261 188 275 185
Netherlands 229 218 249 248 308 224
Municipalities with ... inhabitants
250 000 or more 318 366 438 508 574 435 150 000 to 250 000 326 309 268 234 258 207 100 000 to 150 000 413 256 288 284 337 262
50 000 to 100 000 259 253 266 238 325 220 20 000 to 50 000 200 172 192 187 233 162 Fewer than 20 000 137 153 196 177 252 182
Source: CBS.
55 Costs per inhabitant The municipal fire brigade has since 1995 seen the costs per inhabitant double to an average of 44 euro. The average costs per call-out are nearly 5000 euro.
Costs per inhabitant/call-out per municipality category 2003
15 100
10
50 Costs per call-out (1,000 euro) Costs Costs per inhabitant (1,000 euro) Costs 5
0 0 < 5 5 - < 10 10 - < 20 20 - < 50 50 - < 100 100 - < 150 150 - < 250 ≥ 250
Costs/call-out Costs/inhabitant
source: CBS
In line with the declining number of municipalities in the Netherlands, there are also fewer municipalities without an own fire brigade (from 38 in 1995 to 11 in 2003). At present there are 10 joint fire brigades in which multiple municipalities cooperate.
56
Emergency response by fire brigade and medical services in the Netherlands