Category Archives: Ambulance

Ornge: What the auditor couldn’t find out

Yesterday’s special report by the Office of the Auditor General of Ontario tells us much about the web of for-profit companies established by Ornge and the failure of oversight by the Minister of Health and Long Term Care.

What’s not in the report is likely of even more interest and raises questions about the relationship with other for-profit providers in the health system.

The McGuinty government subscribes heavily to the concept of steering not rowing, but clearly with Ornge there was no steering and the rowing left much to be desired.

The auditor notes: “having an arm’s-length corporation deliver air ambulance services was … consistent with the Ministry’s long-term objective of moving away from direct service delivery, with health care services being provided by external entities accountable to the Ministry.”

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NDP says they’ll scrap $45 ambulance fee

The Ontario NDP say they would scrap the $45 fee paid by patients for ambulance services.

Leader Andrea Horwath said patients shouldn’t have to think twice about dialing 911 during an emergency.

More than two-thirds ofOntario’s ambulance trips require a user co-pay of $45. Ontario Works recipients, long term care home residents, individuals with disabilities or who are receiving home care are presently exempt from paying the fee.

Horwath says her own mother has thought twice about calling for a ride when she needed one.

“We have an aging population, there’s more and more seniors who are going to be in need of that kind of service,” she told the Canadian Press. “I think it’s something that’s going to take a load off their mind.”

The NDP say scrapping the fees will cost $30 million per year, something Dalton McGuinty has already dismissed, saying families have other health care priorities.

Prince Edward Island removed the fee in 2009 and New Brunswick is in the process of removing their ambulance charges.

Jamie Ramage, Chair of OPSEU’s ambulance sector, says he supports the idea, noting the $45 fee means the most marginalized individuals may be reluctant to call when they need assistance.

The NDP plan to reveal their full election platform June 24. Ontarians go the polls October 6.

McGuinty promises to regulate private patient transfer

You might call it the McGuinty Liberals first campaign promise on health care. June 10 the government announced that it would regulate private non-emergency transportation that moves patients between hospitals and other facilities.

The private patient transfer service came under the microscope of the ombudsman’s office in January after Andre Marin said he received more than 60 complaints about the service.

Marin said that patients would be better off calling a cab rather than take one of these unregulated ambulances.

Ontario is the only province not to have regulated these transfers.

It’s allowed private companies to charge hundreds of dollars per patient for transports in old, beat-up ambulances operated by “kids” with no medical training, Marin told the Canadian Press.

“Our investigation uncovered serious issues, from a lack of infection control to unsafe vehicles and poorly trained staff,” Marin stated in a release last week. “These vehicles look like ambulances and are often transporting vulnerable patients. People need to know they can trust these services.”

The New Democrats were critical the Liberals for having waited so long to act. “Anybody who had the health file knew about this, and they did nothing for the eight years that they were in power,” NDP health critic France Gelinas told CP.

The McGuinty government said they would introduce legislation at the earliest possible moment – which at this point will be after the October 6, 2011 election.

Ontario Ombudsman to investigate private non-emergency patient transfers

Ombudsman Andre Marin is going to investigate whether the Ministry of Health and Long Term Care and the Ministry of Transportation are ensuring adequate measures are in place to protect the public amidst concerns raised about private non-emergency transportation services. These transfers take place in vehicles that are not ambulances, but resemble them.

“We have received dozens of complaints from upset patients, their families, and from whistleblowers with the medical transportation industry who feel that patient safety is being compromised and that the government’s response to these issues has been inadequate,” Marin stated in a press release Tuesday. “Anyone who has had experience with these services is invited to call our office.”

The Ombudsman’s office says concerns raised so far include allegations of patients being injured, unsafe vehicles, a lack of infection control, insufficiently trained staff and a lack of official regulation or oversight.

“It’s about time,” says OPSEU Ambulance Division Chair Jamie Ramage. “The government has given these companies the authority to transfer these patients, however these companies are not held accountable or to a standard when it comes to equipment, patient comfort and care.”

He says while these patients may not necessarily need the services of a paramedic, they should not be denied the basic right of quality, care and comfort.

The special investigation will be completed in 90 days. Those with complaints can do so online at http://www.ombudsman.on.ca or by calling 1-800-263-1830.

Smitherman resurrects firemedic idea despite disastrous response in Owen Sound

In an emergency situation, would you prefer a paramedic who has had two years of appropriate training, or a firefighter with several weeks of medical first aid training?

Former Health Minister and Toronto Mayoral candidate George Smitherman is advocating an amalgamation of the city’s ambulance and fire services.

He claims that such a merger would save money and improve services, but he has no evidence to back up these claims. Instead Smitherman is relying on a paper long in rhetoric and short on data to make his case.

The paper, put together by Ontario’s Fire Chiefs and unions, is advocating for dual-trained and licensed firefighter-paramedics, with fire trucks often attending an emergency instead of ambulances.

Several questions come to mind:

Are all fire fighters to receive the same degree of training as paramedics, and who will pick up the cost? Similarly, are trained paramedics expected to go out and fight fires? These are very different functions with very different training requirements.

Regardless of who is the first responder, an ambulance is still required to transfer the patient to hospital and the paramedic is required to treat and care for the patient according to provincial protocols and standards. It is the paramedic who is responsible for all patient care on the scene.

Unlike many new ideas that have saved lives – including the widespread distribution of defibrillators in the community, citizen CPR, improved dispatch protocols that assist at the scene prior to the arrival of ambulance – this idea is more about saving money.

Ever since the firefighters produced their paper, OPSEU’s paramedics have been trying to arrange a meeting with Rick Bartolucci, Minister of Community Safety and Correctional Services. It seems the Minister, having been promised savings from the Fire Chiefs, would rather not hear about the down side of this proposal.

There is no question that paramedics are stressed by years of underfunding and underresourcing. The answer is in providing more crews and resources, not having lesser trained firefighters do the job.

In 2000-01 the idea of the firemedic was raised in Owen Sound. When the facts were assessed, the public overwhelmingly objected to the plan. The Mayor subsequently lost the next election – something George Smitherman should keep in mind.

Deputy Fire chief encourages residents to exaggerate medical conditions to get help faster

The Deputy Fire Chief of Erin, a community 30 km northeast of Guelph, told the Guelph Mercury that residents know reporting certain maladies will get the fire department dispatched faster than an ambulance. “We teach people around here to say you’re having trouble breathing … which will trigger us to come,” said Deputy Fire Chief Ken Keeler.

Town officials have complained about slow response times from the Guelph-run ambulance service. Graham Smith, manager of Erin’s community centre, said “If I had someone down here I would definitely say they were having trouble breathing because you just get a better response time.”

Guelph-Wellington EMS has an agreement with the fire fighters over what kinds of calls are appropriate for the fire department to respond to.

The issue gained public attention after a woman waited for more than an hour for ambulance service after falling and injuring her knee outside the Erin Community Centre. Shawn Armstrong, regional director of EMS, told the newspaper “that type of situation happens in the City of Guelph and County of Wellington every day.” He said the delay was a combination of bad weather and prioritizing of calls.

OPSEU represents members at the Guelph-Wellington EMS.