A correspondent wrote and said:
I would appreciate you addressing the transport of patients to public hospitals by privately operated ambulances from mine sites on your blog if you have time and consider it appropriate.
I am an Intensive Care Paramedic with the ASNSW with mixed rural/urban experience. I currently work in a rural area where mines rescue personal transport patients (their employees) to public hospitals in ambulances. I have been informed that they are able to do this under the Mines Rescue Act. Recently a certain mine has transported critically ill patients and delivered sub standard care. Where does the government ambulance service (ASNSW) stand here? When the patient leaves the mine site and is traveling to a nearby public hospital are they still acting under the Mines Rescue Act?
As you have previously cited; in NSW it is an offence to:
(a) directly or indirectly provide or take part in the provision of transport of sick or injured persons for fee or reward, or
(b) conduct for fee or reward any operations similar to the operations carried on by the Director-General under this Chapter,
without the consent of the Director-General… (Health Services Act 1997 (NSW) s 67E).
Is this practice allowed because they are not charging a fee to their employees?
The reference to s 67E is only a reference to half the section. Sub-section 3 goes on to say:
(3) This section does not apply to:
(a) the St John Ambulance Australia (NSW) in respect of operations similar to the operations lawfully carried on by that body immediately before the day on which this section commences, or
(b) the Royal Flying Doctor Service of Australia (NSW Section), or
(c) the mines rescue company, within the meaning of the Coal Industry Act 2001, (or a member, director or employee of that company) in the exercise of mines rescue functions under Division 3 of Part 3, or Part 4, of that Act, or
(d) a member of the New South Wales Mines Rescue Brigade established under the Coal Industry Act 2001 , or
(e) any person (or class of persons) prescribed by the regulations.
The Mines Rescue Act 1994 (NSW) was repealed by the Coal Industry Act 2001 (NSW) s 54. The 2001 Act provides that the minister may approve a company or companies to operate Mine Rescue Brigades (s 10(k)). The functions of a Mines Rescue Company are set out in the Act (ss 14-17). ‘Rescue’ is not defined, but an approved rescue company is to operate subject to the State Emergency and Rescue Management Ac t 1989 (NSW). Rescue is defined in the State Emergency and Rescue Management Ac t 1989 (NSW) s 3, as ‘the safe removal of persons or domestic animals from actual or threatened danger of physical harm’. The Mines Rescue Brigade is established to provide rescue services under the direction and control of the approved Mines Rescue Company. Each Brigade is made up of members of the various mines who agree to be part of the Brigade.
There is nothing in the Act that refers to first aid or the transport of people to medical care. The obligation to ensure that there are first aid or emergency medical procedures in place does however arise under the Work Health and Safety Act 2011 (NSW) and the Coal Mine and Safety Act 2002 (NSW). A coal mine operator must have health and safety and an emergency management systems in place (Coal Mine and Safety Act 2002 (NSW) Division 2; Subdivisions 1 and 5). An emergency management system must include:
- ‘provisions for the treatment and transport of sick or injured people’;
- ‘procedures to be adopted when emergency services external to the mine are required’ to attend the underground parts of the mine;
- ‘first aid arrangements, including the provision of appropriate facilities, competent people and procedures …’; and
- ‘arrangements for the treatment of electric shock and fluid injection injuries together with the effective training of people providing such treatment’ (Coal Mine Health and Safety Regulation 2006 (NSW) s 45).
Coal mine operators are required to contribute to the running cost of the Mines Rescue service (Coal Industry Act 2001 (NSW) ss 19, 20) but there are no fees charged for rescue unless the rescue takes longer than 8 hours or such other prescribed time (Coal Industry Act 2001 (NSW) s 22).
It should be noted that the Mines Rescue Company is not the same as the coal miner so the rescue company is not transporting its employees but the employees of the coal mine (and members of the Brigade, when acting in that capacity, are deemed employees of the Mines Rescue Company, not the coal mine (Coal Industry Act 2001 (NSW) s 35).
It must have been thought that the activities of the Mines Rescue service could constitute an ambulance service, hence the need to specifically exempt them from the operation of s 67E. What follows is that the Mines Rescue Service is entitled to conduct its operations, and even if they are providing a service like that provided by NSW Ambulance they commit no offence.
It follows that neither the Mines Rescue Brigade nor the mine commit any offence by not calling the ambulance service. If there is sub-standard care, that is a matter between the injured worker, the Mines Rescue Brigade and the coal mine should the worker seek any remedy, but a worker injured at work is entitled to no-fault workers compensation so is unlikely, except in the most extreme cases, to want to sue anyone. If there has been some failure to ensure health and safety that would be a matter for Workcover as the agency charged with enforcing the Work Health and Safety Act.
So ‘where does the government ambulance service (ASNSW) stand here?’ and the answer is ‘nowhere’. The ASNSW is ‘an’ ambulance service provided by NSW Health but it is not the ambulance police or regulator. If the ambulance service is not called to assist they have no interest in the matter, it is not their job to see that adequate care is provided, that is up to the Department of Health or the patient if he or she suffers injury or damage. If paramedics were members of a registered health profession they could be subject to professional discipline but that is not currently the case. The Health Care Complaints Commission may have some jurisdiction to investigate the treatment by an unregistered health professional but that will, again, only arise if someone chooses to make a complaint. The most appropriate complainant would be the patient or their treating doctor if they thought the substandard care was going to have significant adverse outcomes.
Michael Eburn
21 July 2012
Updated 21 September 2012.
Australian Emergency Law 
In WA, most of the mines have either thier own ambulances, utilise private contractor ambulances or hire them from St John Ambulance (WA).
Under the WA Department of Transport Warning lights guildlines a “Priority one” vehicle is defined as urgent duty with immediate threat to life and property. This allows red/white/blue and audible warning device. This does refer to dedicated ambulances. A “Priority Two” vehicle is for “serious threat to life or property. This refers to ambulances, SES, some DEC, Railway Patrol.
All mining company and industrial ambulances are fitted as P1 although I am of the opinion that they do not qaulify for that status and should only be P2 as its for mine use only. I am of the belief also, that if showing defined coloured lenses when not in operation the device must be covered when on public roads. The revised guildlines refer to clear lenses that show the approporiate colur when in operation only
However in saying that, there is an issue with private/industrial/mining/contractor ambulances are often seen driving with uncovered lenses on public roads. A further issue is when these “ambulances” are operating in priority one/urgent duty mode on public roads. A senior WA police officer commented to me on this in a discussion that the mining town she lives in has an issue with a certian mining company ambulance driving high speed and on the wrong side of the road lights and sirens. When the police took action against the driver, the matter was quashed from ranks higher up. The police concerned were of the impression that the vehicle in question is not an ambulance on public roads. Private fire fighting vehicles are classed differently as the mining companies are registered with FESA as a “private brigade”.
I see the issue here, as the pseudo/erataz “ambulance” whilst operation in urgent duty mode if involved in an accident with another vehicle, may not be classed as an emergency vehicle., what would be the legal outcome for all parties concerned?
Personally, I would not give a non authorised vehicle the right of way on the road as it is not regonised or authorised. My experiance in mining towns is that ost of these vehicle have the siren on for play.
However, the WA Police, FESA and St John Ambulance in regional areas have called on the use of these vehicles in times of an civil emergency ie a motor vehicle accident where no state services are located.
This post has only the tip of the iceberg on this matter
Dear Michael, in the example given above, would the patient, should they have complaints about the “sub standard” care provided by the “parmedics” on the mines rescue unit who transported them to a hospital bypassing the public paramedic service, be entitled (and come under the juristiction) of the NSW health care complaints commission (or similar body in other states)? Would the recipient of substandard care have any recourse other than a civil claim?
We have to be careful about the use of ‘sub standard care’. The care may be below the standard expected from an intensive care paramedic but it may not be below the standard of reasonable care from a mines rescue officer. Putting that aside, the avenue of complaint would be as you say the Health Care Complaints Commission in NSW which can investigate ‘unregistered health professionals’ but in other states the only complaint would be to the employer. Given they are a mine service there would also be an opportunity to complaint to the work safety inspectorate – WorkCover in NSW. If the person has suffered a loss as a result of that care (difficult to prove at the best of times) they would be entitled to workers compensation or would have to resort to a civil claim.
Michael Eburn
I ommitted by accident what devices a Priority Two vehicle is fitted with being red lights and siren. Priority Three is government enforcement (ie Transport, DEC, Fisheries) which are fitted out with magenta lenses and optional sirens, Priority 4 are “community interest” or “Special purpose” vehicles and shire rangers which have amber. Shire rangers on fire control duties may have fitted a red lamp as well subject to approval. All P1,2,3 vehicle drivers have to complete successfully an approved course.
Peter, dont you mean state ambulance service rather than public paramedic service?
Geoff, thanks for that information; I found the WA guidelines at http://www.transport.wa.gov.au/mediaFiles/LBU_VS_B_WarningLamps.pdf.
The Australian Road Rules provide that an emergency vehicle is exempt from the road rules provided they have the appropriate flashing lights and/or siren activated and it is reasonable in the circumstances – Road Traffic Code 2000 (WA) s 281. An emergency vehicle includes ‘… an ambulance, answering an urgent call or conveying any injured or sick person to any place for the provision of urgent treatment’ and a vehicle ‘duly authorised as an emergency vehicle for the purposes of these regulations, by the Director General’ (Road Traffic Code 2000 (WA) s 3). It follows that if the vehicle is an ‘ambulance’ (however defined) and is on urgent duty then it is an emergency vehicle and is entitled to the exception. I can’t see why, even if it’s a mining company ambulance, it would not or should not get the exemption when responding to an urgent call or transporting a person for urgent treatment. There is certainly nothing in the Road Traffic Code (and subject to any conditions imposed by the DG) that would support the view that ‘the vehicle in question is not an ambulance on public roads’. It either is an ambulance, or it isn’t.
Thank you Micheal, however the issue is where or not the “ambulance” styled vehicle is duly authorised or not. Many years ago the Road Traffic Code in WA stated that an ambulance had to be of the registered colours and livery., being white and black markings. This was clearly aimed at St John Ambulance Association ambulances being the only ambulance provider in the state. In saying this, ambulances across Australia have opted for more corporate graphics style. The days of “registered colours” are long gone. Puchasing an ex police vehile of the 70s being dark blue with a white roof had to be “decomissioned” and colour changed or altered in order that a member of the public couldnt regonise it as a police vehicle.
A mining company or an industrial ambulance is not an authorised emergency vehicle on state funded roads unless approved by the Minister of Transport (WA) thru the delegated authority by the department. There is a Warning Devices Advisory Commitee chaired by DoT (WA). Fire vehicles approval is through the FESA representation. There is no “Ambulance Act” (as in Victoria) in WA. If the vehicle is authorised it must carry a certified copy of the letter of authorisation. It should be noted that security company vehicles are not permitted to have strobe, LED or rotational warning lamps but a lightbar with flashing lights connected to the hazard lights and sign. Privitised first aid providers have fitted thier vehicles as P1 where SJAA (WA) first aiders and patient transport vehicles either have no warning devices or only amber ones fitted.
Mining copanies use a varitey of coloured lenses to depict various operational requirements on site. Green and blue are often used. P & O Ports use blue lights on vehicles on portside operations for tendering to refrigerated containers. Red is often used for on site emergency response by “Emergency Service Officers” which are securtity guards with advanced first aid quailifations. These lights have to have lenses covered when the vehicle is on gazzetted roads, but in my own personal observations this is not the case. A mining company Toyota Hi Lux ute with no stretcher transport capibilities fitted with a red/white/blue lights and audible warning device is not an ambulance.
I recall in Victoria in 1986 when the ambulance act was reviewed, there was restrictions put on the usage of the word “AMBULANCE” on vehicles. SJAA had to remove the word from vehicle headboards and private companies were not allowed access to same wording, this restricted the use of PRIVATE AMBULANCE as well. Animal Ambulance and St John Ambulance were allowed but under strict guildlines.
As you correctly stated, there is no clear defination under the RTRs let alone usage of certian words to describe occupations. This issue is much bigger than it apperars prima facie.
An “Ambulance” might be a wolf in sheeps clothing
Geoff, your knowledge of the WA road rules is truly encyclopaedic and I wont try to comment further on the particulars. You may be interested in the decision in POLICE v ZAMMITT [2007] SASC 37. The defendant provided an industrial paramedic service. He was ‘charged with 20 counts, namely one count of providing an ambulance service without a licence, one count of holding out as providing an ambulance service, five counts of providing a record that is misleading, two counts of attempting to pervert the course of justice, three counts of driving a vehicle fitted with a siren and three counts of driving a vehicle that is fitted with flashing lights’. A magistrate said that, even taken at its highest, the police could not prove their case and the accused was acquitted of all charges. The police appealed to the Supreme Court. After reviewing the provisions of the Ambulance Services Act 1992 (SA) (now repealed) he said:
Although the vehicles were equipped and staffed to provide medical care, they were not modified to facilitate that service; a witness
Although they were not providing an ambulance service, on the basis that their cars were not ‘ambulances’ they could be guilty of holding themselves out as providing an ambulance service:
That charge and others relating to making misleading statements to the vehicle registration authorities regarding the registration of the vehicles as an ambulance and representations made to police to waive traffic infringements were returned to the Magistrate for rehearing on the basis that the evidence presented could establish the police case.
Michael
Thank you Micheal, your compliament made me smile. However you might be tad disappointed that you are not the first to say that in relation to my “working knowledge to interperat and apply legislation”.
I will have a read of the case law you posted. My background is police and emergency services and of the last 5 years being a shire/council ranger specialising in regional animal and bushfire control.
Whilst working gatehouse security on a chemical site,a few years back in Victoria, I came across a private company that conducts fire awareness training and industrial firefighting. I noticed the fire appliance they used (ex SAMFS) had red/blues lights fitted and a siren speaker. During my conversation with the driver I asked how did they get approval for the lights and “whoopee switch”. The driver said “I have 28 years fire fighting experiance and ex MFB station officer” I replied, “So does that mean because I’ an ex copper and now a security guard i can do the same?” I dont think I made a friend that day.
Another Victorian story that may be one of interest to you is that a recipient recieving a disability pension who calls himself a “trained paramedic” runs an animal ambulance service using ex ambulance service vehicles. His vehicles are marked “Emergency Animal Ambulance” and wears uniforms that are not unlike the state ambulance service with “Star of Life” badges. Recently on Facebook he asked in a poll “Should Emergency Animal Abulances be fitted with red/blue lights and sirens”. What would be interesting if this animal related service was involed in an accident when responding to a call or flagged down by a member of the community for assistance in a human matter rather than a humane matter? I do recall serveral years beforehand a similar fee-for-service animal ambulance was using a stationwagon with the same font signage as the former Victorian Civil Ambulance Service and was charged for impersonation and traffic matters. The same operator would send around “media statements” in later years offering his animal ambulance for human transport in a declared emergency. This same person has a patient transport service as well.
It would seem that not only registration and classification of persons referring to themselves as “paramedics” but regulation and licensing of the “prehospital emergency care and transport” providers both state and national level is required.
I took a look at that case law study and noted a couple of items of interest that you could have added. The Ambulance Services Act (SA) 1993 although repealed has been absorbed into the Heath Services Act. The act only recognises the South Australian Ambulance Service (being a joint venture between the Order of St John of Jerusulam and the state of SA) as the provider of emergency ambulance services. However it does make allowances by a licencing agreement of “private non emergency ambulance services”
There is an offence of holding out as an ambulance service provisions with a max penality of $20,000.00 as well as an offence of the use of the wording “EMERGENCY AMBULANCE” on any vehicle. It should be noted the word “EMERGENCY” has been added, not just an offence for use of the word “AMBULANCE”
A member of the community driving along in his or her car going about thier daily business hearing the wailing of a 100w siren behind them and looking in the rear veiw mirror seeing red and blue lights and the reversed word “AMBULANCE” rapidly approaching behind them, requesting “expediant passage” and “right of way” is not going to look to see if another word is preceeding it. Mr/Mrs/Ms Citizen is going to try thier best to assist in this matter. Citizen isn’t going to notice that the official looking vehicle is a “real” or “psudeo/erataz” emergency vehicle or not. After all it is not an offence to purchase red/blue devices and sirens. We have eBay to thank for that increase.
This whole situation is a 44 gal drum of worms that has not been sealed correctly.
Another question I would pose. I have an extensive first aid kit in my vehicle. It carries authorsed medications such as an epi pen, paracetamol, ventolin (all over the counter as per WA Heath Act) a resuscitator and collars plus other items that are carried in an “ambulance”. I also have detachable visual warning device as well. I use this kit for my work as well as I travel and work in remote areas. I am a holder of a current “senior” first aid certificate as well as a remote area first aid certificate. I do not have the word “AMBULANCE” affixed to my black jeep. I also carry an “animal welfare kit” that is similar but with a stethoscope for euthansia (I put down animals in my line of work) animal body bags and various humane restraints. Am I holding out to be an ambulance service provider as well? I do wear a distinctive uniform for my work and a vest with a sillitoe/batternberg markings
To further this quandry, the Scouts have thier own service known as “The Scouting Association First Aid Service” that provide first aid and welfare services at official functions. Motorsport courses often have thier own ambulances and fire rescue crews and equipement, Charity car rallies and 4WD clubs often have a purpose equiped vehicle or allocate that duty to one car for events, Aboriginal trusts and heath organisations do the same in remote areas. Community Nursing posts use thier 4WD vehicles as ambulances where no ambulance service is statiioned. Marble Bar and Nulligine in WA are prime examples of that (got a pub, a police stn, a fire brigade but no ambulance). There are several “little” first aid and alike services being operational in our wide brown land. Swiftwater Rescue groups and other sporting clubs extend their expertise out the same way for the benefit of our community in hope of the greater good. Then there is the roadhouse operator that has an old stationwagon with “all the good gear in” that gets the missus to bring out to an accident when he has been awoken in the middle of the night for a muliple car accident that his tow truck is needed. Are they committing an offence as well?
Food for thought isnt it?
I personally think the whole “Emergency Medical Response” industry needs to be regulated and overhaulled, with clear and simple classifications both State/Terrority and Nation wide.
Hopefully common sense will prevail
Geoff
I think common sense does, on the whole, prevail which is why all the people you’ve mentioned are not prosecuted. They are not holding themselves out as providing an ambulance service, but it is indeed debatable. It is commonly said, of organisations that provide event first aid, that they can provide ambulance type services as long as they don’t transport patients to public hospitals on public streets, but that argument was rejected in Paramedical Services v Ambulance Service of NSW [1999] FCA 548, interpreting the Ambulance Services Act 1990 (NSW) s 23 (now repealed and replaced by the Health Services Act (NSW) s 67E).
As I discuss in the paper I wrote with Jason Bendall (see ‘The provision of Ambulance Services in Australia: a legal argument for the national registration of paramedics’ (2010) 8(4) Australian Journal of Emergency Primary Health Care; Article Number: 990414) the definition of what is an ambulance service is neither clear nor consistent; but I think to be ‘holding yourself out’ as providing an ambulance service you have to do much more than just provide first aid even on a regular basis. As you say common sense hopefully will, and generally does, prevail.
Michael.
My take on this (and no I do not have a legal background) is if a mining company meets the required design and legislative rules, and the vehicle is so equipped to be used as an ambulance, and the people who crew the ambulance have some formalised training recieved the required driver training. Then they would be entitled to opeate an ambulance
It is a well established fact that the driver of an emergency vehicle does not get blanket exemptions when responding to an emergency and will be held responsible if it is judged that they have acted unreasonably, one only has to recall the recent events involving the death of a woman during a police chase here in Western Australia which resulted in the police officer being charged.
Also in the Dept of Transport document refered to in the list for P2 vehicles it stipulates “ambulance vehicles” my take on this would be an ambulance comand vehicle and not an ambulance per sei. But regardless if a mining company sort and obtained authorisation for a priority 1 classification and they complied with their obligations (ie; driver training). Then they would be entitled to operate that ambulance on public roads.
On the question of mining vehicles the publication states (Mine vehicles categorised as special use vehicles under the WA government gazetted notice No 113 on Friday, 30 June 2006 are allowed to be use on public roads with warning lamps fitted. However these special use vehicles are not allowed to operate warning lamps on public roads). My take on this is that are referring to the use of amber beacons and not emergency lights.
To say “Personally, I would not give a non authorised vehicle the right of way on the road as it is not regonised or authorised” shows a callous disregard to the patient being conveyed in a mine ambulance. And is in fact an offence under r 60 Road Traffic Code 2000 (W.A.). The fact that an ambulance is signed as such should be all the proof that is required to say the vehicle is an ambulance and that the mining company concerned has recieved the relevant authorisation to operate the ambulance.
But back to the original question how would it be sub-standard care if the care deliverd was provided to the level of training that the attendant has attained. It would seem sub-standard when compared against someone with a higher skill level but in reality it is not
Thanks Dodge, it’s interesting that the WA rules define an emergency vehicle as an ambulance or a vehicle ‘duly authorised as an emergency vehicle for the purposes of these regulations, by the Director General’. If it is an ambulance then it does not need the DGs approval, but as we’ve noted it’s not clear what an ambulance is. In Police v Zammit they said (in SA) it had to be modified for patient transport under the terms of the Ambulance Services Act, but it only had to be used for patient transport under the road rules. Is a motorcycle used by an ambulance service ‘an ambulance’? Yes, in NSW where an emergency vehicle is a vehicle used by an emergency worker and an emergency worker includes ‘a member of the Ambulance Service rendering or providing transport for sick or injured persons’ but arguably not in SA (at least given the law as it was in 2007) and arguably not in WA in which case, in WA, they would need the DGs approval to operate as an emergency vehicle.
I agree that no driver should fail to give way to a vehcile with lights and sirens on as they cannot know whether it has the DGs approval (in WA) or whatever other approval is required in the other jurisdictions. Under the WA Road Traffic Code ‘A driver shall give way to, and make every reasonable effort to give a clear and uninterrupted passage to, every police or emergency vehicle that is displaying a flashing blue or red light (whether or not it is also displaying other lights) or sounding an alarm.’ You may want to argue if you get a ticket that for whatever reason the vehicle did not meet the definition of an emergency vehicle, but that’s pretty high risk behaviour when the alternative is to pull over and let it go.
Michael.
I note that initial comment claimed that mines rescue personal (sic) were used to transport patients to public hospitals in private ambulances. The discussion then went on to reference the Coal Industry Act 2001 and by inference conclude that Mines Rescue Pty Ltd provided that service.
That is incorrect. Mines Rescue does not provide transport off site. That is a matter for the mine and other emergency providers.
So many problems with providers parading themselves in whatever guise no wonder over the years there has been a strong sense of horror to private sector providers. However there are a large number of providers who are authorised and strive to ensure that (at the risk of having their approvals withdrawn and loss of their entire business and livelihood) they comply to the acts and regulations which govern them. I am one such operator. We have had to give very defined undertakings as part of our initial and ongoing renewals of approval to operate as an ‘Ambulance Service provider’ So I can only implore that during these posts offering examples of bad or even worse offenders, that there are others who are going to be affected.
Paul and James, I accept all that you say. I certainly answer the questions on the assumption that the facts reported are true. You could imply a sentence ‘Assuming that’s a correct understanding of the facts…’ before my commentary, so my commentary is ‘If that’s correct then …’ Hopefully discussing the law as it apples to the ‘given’ facts improves understanding of the law, even if the factual situations vary across place and time.
And Paul, just beecause Mines Rescue personnel aren’t meant to transport, you can’t be sure they haven’t and perhaps that is what my correspondent observed hence the question.
Michael
I know this is a late entry to the conversations but ill throw my two cents worth in. I suppose at the end of the day it all comes down to patient care. all the arguments of who provides what and how, in reality gets lost in the fight of who gets to be the part of the paramedic state service elite. All the legal arguments pail in insignificance when you’ve got your young apprentice in your arms bleeding to death. I became a paramedic because I wanted to be able to take care of my own. I never wanted to enter a state service and never will. I currently work in the mining industry and maintain my skills working on the rodeo/camp draft circuit. I have and still work in the construction industry. I’ve seen more trauma than I care to revisit. I am completely accountable for my treatment and actions. If I have to transport I will and I don’t care about acts and regs. If I lose my house over a a legal definition I really don’t care because in reality if my patient has a good outcome and reduced rehabilitation time then I’ve done my job. I actually call my self a first responder who happens to be qualified and authorised to treat at an ALS level. I can write a prose on the world of the private paramedic but in summery it’s one of the hardest jobs. Long distances for little reward and constant suspicion. I welcome registration but I know for a fact that its not the answer. At least it’s a start. I hope I’ve introduced the human factor into the argument and that some of us private providers are in it because we actually care. We personally risk everything to care for our patients.
In a simple word- no. NSW Mines Rescue does not transport patients in any way other than from underground to the surface. If the atmosphere is not irrespirable, the actually take the paramedics with them. The primary duty of mines rescue personnel is to go into atmospheres and situations where other services are unable.