The committee that comprises representatives from the District Administration Office, District Pubic Health Office (DPHO) and Red Cross Society (RCS) has already fixed ambulance fares for various destinations from the district but they are yet to be implemented.

There are 28 ambulances, four run by the Red Cross, registered in the district. However, one can rarely depend on the ambulance service at emergency situations.

Concerned stakeholders say most ambulance operators in the district are charging exorbitant tariffs and misusing ambulances of late.

Moreover, most ambulances, except those operated by the Charak Hospital and Mountain Trust in Baidam, fall under the 'C' category. The 'C' grade ambulances, basically passenger vehicles turned into ambulances do not meet the standards set by Ambulance Service Regulations 2003. According to the regulations, 'C' grade ambulances must be equipped with, at least, an oxygen cylinder, saline, multi-purpose stretcher, a driver and an assistant trained in first aid service. These ambulances meant to carry normal patients ferry serious patients on a stretcher for hundreds of kilometres, often posing serious threat to the patients' lives.

Dr Bishnu Nepali of Manipal Hospital said the risk could be minimised if patients receive primary care in the ambulance while being ferried to a hospital. "Most patients are brought to hospital in taxis and even the ambulances do not provide more than oxygen," he said.

Meanwhile, most hospitals are found to be using ambulances to ferry doctors, staffers and even goods. DPHO chief Ramesh Prasad Adhikari admitted that they failed to carry out inspections on a regular basis. Adhikari said the last inspection was carried out before the Constituent Assembly elections. "We can take action against those found flouting regulations if we receive a complaint," he said, emphasising locals' cooperation.

Meanwhile, Prakash Silwal, chairperson of the Ambulance Drivers' Care Fund in the district, said drivers alone should not be held responsible and added that misuse of ambulances could be minimised if drivers' needs were taken into consideration.

Stating that ambulances are misused during strikes, Khemraj Sapkota, administrative officer at the Red Cross Society, said the authorities concerned should initiate efforts to curb such practices.