December 16, 2017

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Opinion

Politics and paramedics -- a fiery mix?: Paramedics' future is self-regulation

Fire and ambulance crews tend to an accident.

MIKE APORIUS / WINNIPEG FREE PRESS FILES

Fire and ambulance crews tend to an accident.

Hey there, time traveller!
This article was published 13/3/2015 (1009 days ago), so information in it may no longer be current.

During the past few days, the question of what the future may hold for Manitoba paramedics has played out in a very public way. There has been much discussion about the politics surrounding the Paramedic Association of Manitoba application to designate paramedic as a self-regulated profession.

Unfortunately, lost in the political discussion is how the proposal will improve patient care and protect the public.

Self-regulation is important for us all because it ensures that the paramedic who shows up at our door in a medical emergency is qualified and properly trained. It also ensures that when something goes wrong with an emergency call, there is an expert body, independent from the paramedic's employer, to investigate and uphold professional standards of care. During any given shift, paramedics assess patients, provide treatment and administer medications. They should be held to the same standards of accountability and transparency as all other regulated health professions. And this holds true for all paramedics, whether they a ride in an ambulance, helicopter, airplane or fire truck.

Winnipeg operates an integrated fire-paramedic service. The Winnipeg Fire Paramedic Service (WFPS) says this system is the envy of Canada. In fact, other jurisdictions have experimented with this model and backed off. The WFPS wants to pump more money into the current model for things such as overtime. Instead we should invest smarter and be more innovative. Our investments should be focused on ensuring ambulance-based paramedics have the resources to respond as quickly as possible to medical emergencies. That is how patients in medical crisis will get the care they need.

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Hey there, time traveller!
This article was published 13/3/2015 (1009 days ago), so information in it may no longer be current.

During the past few days, the question of what the future may hold for Manitoba paramedics has played out in a very public way. There has been much discussion about the politics surrounding the Paramedic Association of Manitoba application to designate paramedic as a self-regulated profession.

Unfortunately, lost in the political discussion is how the proposal will improve patient care and protect the public.

Self-regulation is important for us all because it ensures that the paramedic who shows up at our door in a medical emergency is qualified and properly trained. It also ensures that when something goes wrong with an emergency call, there is an expert body, independent from the paramedic's employer, to investigate and uphold professional standards of care. During any given shift, paramedics assess patients, provide treatment and administer medications. They should be held to the same standards of accountability and transparency as all other regulated health professions. And this holds true for all paramedics, whether they a ride in an ambulance, helicopter, airplane or fire truck.

Winnipeg operates an integrated fire-paramedic service. The Winnipeg Fire Paramedic Service (WFPS) says this system is the envy of Canada. In fact, other jurisdictions have experimented with this model and backed off. The WFPS wants to pump more money into the current model for things such as overtime. Instead we should invest smarter and be more innovative. Our investments should be focused on ensuring ambulance-based paramedics have the resources to respond as quickly as possible to medical emergencies. That is how patients in medical crisis will get the care they need.

Paramedics believe strongly there should be an independent, third-party review of the WFPS budget to identify service improvements and efficiencies. The city recently undertook such a review with the police service budget, and we believe the time is right to do the same thing with the WFPS budget. The path we're on is unsustainable and the cost will squeeze other city services such as street repair, snow clearing, libraries, community clubs and pools. There is a better way.

Most of us are well aware of ongoing emergency room offload delays. Despite recent efforts, the Winnipeg Regional Health Authority has not been successful in addressing the issue of emergency rooms that are simply too congested to accept patients arriving by ambulance, keeping paramedics and their vehicles off the streets for hours.

Emergency medical services in rural Manitoba face even greater challenges. The situation was recently described in the Winnipeg Free Press as "downright dangerous." We have unacceptably long response times for medical emergencies and communities are being left without ambulances because of ever increasing inter-facility transfers. Staff shortages are forcing fatigued paramedics to work dangerously long hours as they make life-and-death medical decisions and operate vehicles at high speeds. Clearly, despite efforts on their part, this puts patients, motorists and paramedics themselves at risk.

Rural communities cannot keep the paramedics they do have because, despite having the same skills and training, their wages lag behind those paid in Winnipeg by approximately 35 per cent. As a result, experienced, trained paramedics move to the city, leaving rural Manitoba short.

We have poured tens of millions of health-care dollars into the STARS helicopter ambulance program that rarely flies. And we continue to prop up a system in Winnipeg that is the most expensive in Canada, according to national experts.

We're coming up to the two-year anniversary of the release of the provincially mandated EMS review. Precious few of those recommendations have been implemented. These solutions, along with professional self-regulation, aren't about unions or politics — they're about providing the best service to patients, and that's what's missing from this conversation.

Paramedics have been advocating a number of solutions to this for years. Increased use of community paramedicine at personal-care homes. More public awareness campaigns about when it's appropriate to go to the ER in the first place. Avoiding delivery of patients to ERs unless it's absolutely necessary. And last, but certainly not least, providing care directly on-scene whenever appropriate.

All of these innovative and forward-thinking options have the potential to free up ambulances, make health services more cost-effective and ultimately provide better care for patients.


Michelle Gawronsky is the president of the Manitoba Government and General Employees Union.

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