Duelling 'firemedics' polls in Sudbury

Duelling 'firemedics' polls in Sudbury
By Mary Katherine Keown
Sudbury Star
Link to article: Duelling 'firemedics' polls in Sudbury

A new poll released Thursday shows that Sudburians want to maintain access to their paramedic services and disagree with a recent Liberal proposal that would redirect medical calls away from paramedics to fire departments.

"If they had to call for medical assistance for themselves or a family member, nearly 88 per cent of Sudburians who responded to a poll about provincial changes to 911 delivery said they prefer a response by an ambulance service," CUPE said in a release Thursday. "Only eight per cent said they preferred a response by a fire department."

Provincially, more than 83 per cent of the 2,500 Ontarians surveyed said they prefer a response by an ambulance service. Only 6.8 per cent said they would prefer the fire department respond.

The poll was conducted late in 2017, immediately following the passing of changes to the Ambulance Act that could allow fundamental changes to 911 responses and pre-hospital care, say paramedics with CUPE. These changes include allowing pilot projects in willing municipalities to experiment with using firefighters who also have a paramedic designation to respond to emergency medical calls.

"As one of the few municipalities that provide both ambulance and fire services, this sort of experiment is much more likely to happen in Sudbury than elsewhere," Jason Fraser, chair of CUPE Ontario's Ambulance Committee, said. "Just because the government or fire are more likely to target Sudbury doesn't mean Sudbury should experiment with a pilot. There is no evidence that there are better patient outcomes and it costs much more to send a paramedic on a fire truck than to send medics on an ambulance."

CUPE represents more than 5,500 paramedics at ambulance services province-wide. There are about 8,000 paramedics in Ontario.

In fact, CUPE said it costs significantly more to use firemedics. An hour of fire service costs 55 per cent more than an hour of ambulance service. Municipalities pay 100 per cent for fire services through the local tax base while the province pays 50 per cent of ambulance-based paramedic services.

The other issue, Fraser said, is that paramedics are highly regulated - they must certify every year - but no similar oversights exist within fire services.

"Currently they do not exist within the fire service," he said.

He does not know why the province is considering introducing firemedics.

"The only people in favour of it are the Ontario Professional Firefighters," he said. "The Liberal government is facilitating it. All the other stakeholders involved are against it."

Darryl Taylor, president of CUPE Local 4705, which represents paramedics in Sudbury, does not want to see Sudbury used as a guinea pig. In Sudbury, paramedics respond to more than 30,000 calls for service per year.

Taylor is encouraging city council to "steer away from using Sudbury as a pilot guinea pig. Instead, council should look rationally at available funding resources and put dollars into what saves lives and costs less. And that's ambulance-based paramedic services, not some new system that will cost more for the municipality."

Taylor said implementing a pilot project in Sudbury is simply part of a political agenda.

"Sudbury's ambulance service is second to none," Taylor said. "Our personnel provide a very high level of service; there is a lot of oversight and medical control. In a large, upper-tier municipality such as Sudbury it would burden the city with extra and unnecessary costs. Once the pilot project ends, the city will be left holding the bag. The people of Sudbury deserve much better than to be guinea pigs in some pilot project."

Taylor, who has worked as a paramedic for nearly 30 years, said he doubts the pilot project would be successful.

"It's no more than smoke and mirrors; it's simply duplication, creating a second system and it's not dealing with the issues of putting the money where it's needed," he said. "The provincial government should be putting resources into enhancing the existing ambulance service, not promoting fire experiments. North Bay city council recently passed a motion demonstrating their concerns about the possibility of a pilot project. I think it's incumbent on the City of Greater Sudbury and our councillors to follow suit and do the responsible thing and say no to a haphazard pilot project such as this."

The Ontario Professional Fire Fighters Association said the poll commissioned by CUPE is not credible. They commissioned their own poll through Mainstreet Research - it took place last July and reached 4,600 Ontario residents via telephone - which found the majority of Ontario residents actually favour the use of firemedics.

"There's all kinds of evidence to support that the status quo as it relates to pre-hospital care is not working," Rob Hyndman, president of the OPFFA and a local firefighter, said. He does not believe Sudbury will be chosen as one of the pilot sites.

According to a release issued by the OPFFA last November, "when asked about changing regulations to allow firefighters who are trained paramedics to administer care at the scene of an emergency, almost nine in 10 Ontarians (88 per cent) said they would support allowing them to use their medical training. Included in that number is almost two thirds of Ontarians who strongly agree with making the necessary changes."

Hyndman said there will be two pilot sites, which will be fully funded by the provincial government. The project could go live in May, but there are still many details through which to work.

Hyndman said currently, the province is at a crossroads.

"The costs of pre-hospital care are exponentially outpacing the number of patients," he said.

Hyndman said auditor-general's reports have shown that costs have increased by 200 per cent, whereas the number of patients has only gone up by about 17 per cent.

"You're seeing this exorbitant amount of money being spent without the corresponding number of patient involvement being there," he said. "Over the course of the last three years, you've seen a drive of patients from our elderly population and our repeat callers."

Since 2011, repeat calls - more than 12 calls and hospital admissions per year - increased by 50 per cent.

"To use a certified paramedic firefighter in the community through treat-and-release/diversion strategies, it's going to free up those ambulances for those more high acuity calls," Hyndman said. "It's about increasing your capacity in your existing resources, versus new money for new ambulances and paramedics."

Firefighters could be trained to insert IVs into patients in long-term care facilities, for example, and Hyndman said keeping people out of hospitals unnecessarily will reduce their chances of contracting nosocomial infections, which can be fatal.

Hyndman said ultimately, all that matters is that people in distress get the best medical care possible.

"When emergency services arrive at a scene, people deserve the best and fastest care possible," he said. "They should not have to worry about whether the medically trained professional arrived in a white truck or a red truck, just that they or their loved ones will be taken care of."

Studies confirm that emergency medical calls are increasing, while the number of fires is declining. According to the CUPE poll, nearly 62 per cent of people polled said they agree the provincial government should study the public health and economic potential for moving resources from services that have a declining need, such as fire calls, to services that have an increasing need, such as ambulance-based paramedic calls.

"We need rational planning for our emergency services, not politically driven decisions. It appears the only supporters of this model are the firefighters' association that proposed it and the provincial Liberals that are facilitating it," Fraser said.

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