June 5, 2017

Today, the Minister of Health and Long-Term Care announced proposed changes to emergency health services, including providing alternative options for medical treatment and paramedic services.  We understand there will be a consultation process over the coming weeks with the intent to introduce legislative changes in the fall session.

Firstly, the Ministry is investing in a new medical dispatch system for land ambulance 911 calls expected to roll out across the province over a period of two years starting in March 2018.  The purpose is to better prioritize calls based on patient need and re-directing low acuity patients from emergency rooms, where appropriate and safe to do so.  This initiative is timely and welcome.  AMO has long called for improvements to the dispatch system.

The government is also seeking to expand the scope of paramedics to provide alternate on-scene treatment and to refer patients to destinations other than hospitals as is currently required by law. Further information and analysis on the implications and benefits to patients, municipal governments, and District Social Service Administration Boards is needed.

The Minister also announced that once the Act is changed and a regulation is in place, that two pilot projects could test the use of firefighters certified as paramedics to respond to low-acuity calls  Given the legislative process, it is likely these pilots will not occur until 2018 at the earliest and there are willing municipal governments. There is still time for municipal input into this proposal.
While the two pilots are to be voluntary, determined by the municipal employer, then interest arbitrators must be forbidden in law from replicating this idea.  As happened with 24-hour shift pilots, interest arbitration settlements made it a practice, even in municipalities that did not adopt the policy.  The government must address the labour relations concerns of municipal employers prior to the pilot’s introduction by amending the Fire Protection and Prevention Act, as it amends the Ambulance Act.  If it is truly to be an elective option for municipal governments, then it cannot be imposed without the support of councils.

AMO and others in the paramedic service delivery have no evidence to show improved patient outcomes, yet municipal labour and risk management issues are significant.  If the government proceeds with these pilots, there must be a commitment to conducting a third-party proof of concept evaluation.  AMO will continue to engage the Province about the pilot’s implications and advocate on behalf of municipal governments.

For further information, please see the Ministry news release, Ontario Enhancing Emergency Services across the Province.