As Ontario marks Paramedic Services Week (May 21-27), CUPE draws attention to recent data showing surging demand and rise in incidents of zero ambulance availability.

As critical ambulance shortages rise across the province, the union representing the majority of paramedics in Ontario is calling on the provincial government to work on a comprehensive staffing strategy for the emergency medical services sector.

“In nearly every region of Ontario, paramedic services are in crisis and unable to meet growing demand for EMS,” says Niko Georgiadis, a frontline paramedic and chair of the CUPE Ambulance Committee of Ontario (CACO). “There are tragic consequences every day – patients in cardiac arrest not getting care in time. Elderly people lying for hours on the floor, suffering as they wait for an ambulance to arrive.”

Georgiadis says paramedic services are unable to retain or recruit staff as chronic understaffing has created a vicious cycle of heavy workloads, high injury rates and further depletion in staffing levels.

The province must step in and play a leadership role to create a long-term, sustainable staffing strategy in consultation with unions, municipalities and other stakeholders, he says.

“It’s not good enough for the province to take a hands-off approach and let municipal employers work it out. The municipalities are competing for the same pool of paramedics and dispatchers,” Georgiadis says. “We need a staffing plan that accounts for population growth and ageing, deficiencies in other parts of the health sector, and the insufficient number of paramedics graduating from college programs to fill vacancies.”

Data collection and disclosure is inconsistent across Ontario, but the information available paints a dire picture. Code Zeros*, occasions when there are no ambulances to respond to 911 calls, are rising across the province.

Ottawa had faced 750 incidents of Code Zeros by July 2022 (matching the number of such incidents in 2021), Waterloo Region witnessed a dramatic four-fold increase in 2022; and Essex County a 185% surge in 2022.

While Code Zeros are often attributed solely to offload delays at hospitals, data shows surging demand is also a major contributing factor.

Across Ontario, demand for paramedic services increased by an average of 4 per cent annually between 2010 and 2019 due to pressures of an underfunded health system and an ageing population. Since then, demand has escalated sharply in multiple regions based on the data available. 

Call volumes jumped by 12.8 per cent and 10 per cent in 2021 in Peterborough County and Waterloo Region, respectively.

CUPE paramedic leaders across Ontario are calling for the provincial government to take the lead in fixing the sector, which must also include a plan to address hospital staffing and capacity to reduce offload delays.

* In Ontario, there isn’t a standardized term for instances of zero ambulance availability. In some regions, these incidents are referred to as Code Blacks or Code Reds.

Quotes from other CUPE paramedic leaders

Natalie Waters, President of CUPE 4911 (Peterborough County paramedics), said:

“The pace of EMS has changed a lot over the years. There are not enough of us to keep up with the increase in call volumes. The understaffing of the hospital prevents us from responding to calls in the community, and the amount of mandatory overtime that is taking me away from my family is unsustainable. It is very stressful knowing that serious calls have been delayed with catastrophic results for the injured/ill person. It’s high time for the provincial government to formulate a comprehensive staffing strategy.”

Nick Desclouds, President of CUPE 5191 (Waterloo Region paramedics) said:

“I think the mental health and wellbeing of our emergency responders after going through an incredibly difficult few years has created an impact that we have yet to fully realize. We desperately need the provincial government to work on a paramedics staffing plan in consultation with unions and all other stakeholders.”

James Jovanovic, President of CUPE 2974 (Windsor-Essex paramedics), said:

“I can now feel the accumulated trauma from years of stress, exacerbated due to lack of resources. We have not been properly investing in staffing levels. Retention and recruitment must be equally prioritized to keep up with the expansion in demand. The province must take ownership here and address the crisis.”

Jon Brunarski, president of CUPE 911 (Niagara Region paramedics) said:

“I worry about our members and the paramedics across Ontario. Call volumes have gone up exponentially, and there are not enough full-time ambulances on the roads.  Our sector is under-resourced and underfunded. Paramedics are leaving their services for better wages and benefits, and going to services that offer full-time employment. This takes a toll on the rest of us trying to carry the load, physically and mentally. Our communities deserve better, we deserve better.”