Self-regulation not the answer for EMS

Hey there, time traveller!
This article was published 2/12/2016 (936 days ago), so information in it may no longer be current.

The Manitoba government recently announced it is moving forward with a consultation initiative to bring forward paramedic self-regulation to the province. We are grateful to Health Minister Kelvin Goertzen for allowing us to be involved in these discussions. While we will endeavour to participate in the process, we feel it’s important to register our concerns, particularly as the current EMS system in Winnipeg serves as a model for other cities to emulate.

Manitoba is staffed with dual-trained and provincially licensed firefighter-paramedics in Winnipeg, Brandon and Thompson. It is important to emphasize that these firefighter-paramedics are involved in 80 per cent of the total number of emergency medical calls received in Manitoba’s three largest cities every year.

In Brandon and Thompson, the fire departments provide all emergency medical care for their citizens and large surrounding areas. In fact, those departments’ firefighter-paramedics provide every part of the emergency medical response system: from dispatch, to advanced medical care and ambulance transport to the hospital.

Here in Winnipeg, our 40 fire trucks are staffed, in part, by nearly 430 firefighter-paramedics. These crews responded to approximately 48,000 EMS calls last year, of which 12,000 were run by firefighter-paramedics only without an ambulance response. More than half of our licensed paramedics have at some point worked on either rural or city ambulances. These rank-and-file firefighters would be working on these trucks even if we did not attend one EMS call — they are not extra staff. We make use of current resources as a way to allow our system to be financially sustainable. We work closely with the well-trained ambulance-based paramedics, approximately half of whom are trained to the advanced care level, and who subsequently provide transport.

We are proud of our important paramedic role in Manitoba, and as representatives of more than 550 licensed firefighter-paramedics, we respectfully disagree with our ambulance brothers and sisters in the Manitoba Government and General Employees’ Union, and the Paramedic Association of Manitoba on the value and need for self-regulation at this time. Our concerns are based on the fact that we have a tremendously successful EMS system in Winnipeg, Thompson and Brandon, and self-regulation will create another level of bureaucracy. This is needless and costly. It seems the problems in rural EMS delivery are driving this process and self-regulation will not address those issues.

Our EMS system in Winnipeg is looked at by many cities in Canada as a model for patient care and financial sustainability. We continually poll as one of the most respected professions in Winnipeg, and our citizen satisfaction levels are always in the high 90s. We believe we have tremendous leadership and medical oversight in Winnipeg under emergency care specialist and WFPS medical director Dr. Rob Grierson, as well as Fire Paramedic Chief John Lane. Both are highly respected in their fields.

The 2013 Provincial EMS Report states: "The current medical director has been in this position for a decade and during that time has developed a very complete and effective medical oversight system."

We will work with the provincially appointed consultant Reg Toews to look at ways we can move forward with self-regulation while still protecting the systems in Winnipeg, Brandon and Thompson. We need to be perfectly clear that we have nothing but respect for ambulance paramedics in the province and, in fact, are a vocal supporter of our rural counterparts. We have been vocal on the belief that our rural ambulance paramedics have substandard wages and that benefits and their working conditions need to be brought up to the levels we enjoy in Winnipeg. We continuously hear this from the many firefighter-paramedics who have, and continue to work for rural EMS departments.

One thing that’s clear is that self-regulation for paramedics will not help our rural ambulance brothers and sisters in the areas of wages and working conditions. We believe the people responsible for the well-being of our rural paramedics should concentrate on those priorities at this time in light of recent announcements that the provincial government is entering a period of austerity and "wage pauses" for provincial workers.

At the end of the day, our position is clear: we want to continue delivering the best medical care model for the citizens of Manitoba. Self-regulation will not fix the major issues in rural Manitoba EMS delivery and will negatively affect our system by creating another level of needless bureaucracy.

Alex Forrest is the captain of the Winnipeg Fire Department, president of the United Firefighters of Winnipeg and the Canadian trustee of the International Association of Firefighters.