This profile provides CUPE members with information about the sector they work in from a national perspective.

Overview

The Emergency and Security Services (ESS) sector is made up of paramedic emergency communication, fire service, police, correctional, and security workers. Within CUPE, most ESS workers are emergency medical service workers – paramedics, communication officers, administrative, maintenance and support staff.

CUPE is the largest union of paramedic or emergency medical staff in Canada, representing 9,400 workers. Our members include all paramedic staff in British Columbia and Prince Edward Island, most paramedic staff in Ontario, and some EMS staff in Alberta, Saskatchewan, and Newfoundland and Labrador. In Quebec, nearly a thousand paramedics have joined CUPE since 2020. CUPE represents emergency communication staff in Ontario, BC, Quebec, and New Brunswick. 

CUPE also represents close to 5,600 employees in fire and police operations, including approximately 1,000 administrative and dispatch employees in Quebec and several hundred more in British Columbia. In May of 2021, Quebec’s firefighter union, the Syndicat des pompiers et pompières du Québec (SPQ), voted to join forces with CUPE. Some police officers, firefighters, and correctional officers are CUPE members in New Brunswick and Prince Edward Island. CUPE 104 represents 1,200 RCMP communication specialists across Canada, including 9-1-1 call takers and dispatchers, telecom operators and intercept monitor analysts. Finally, several hundred members in Quebec work in the field of secure transportation.

In Ontario, CUPE’s growth in the EMS sector continues. The Oneida Nation of the Thames paramedic service voted to join CUPE, making them the first CUPE First Nations paramedic group. In June of 2020, they achieved their first collective agreement.

The public understands that reliable and well-funded emergency and security services are vital for their health. The positive public opinion of ESS workers helps command media attention and public support. A recent Maru Public Opinion poll finds that — out of 29 measured occupations — Canadians rank paramedics as the most respected job with firefighters coming in at number two.

Issues

Funding and governance

While police and fire services are typically under municipal jurisdiction, EMS services tend to fall under provincial control. In Ontario, however, municipal governments are responsible for delivering and funding EMS, and the province plays a key role, strictly regulating EMS, providing funding for 50 % of the approved land ambulance costs, and paying 100 % of the approved costs for air ambulance, dispatch, base hospital oversight and EMS services in Indigenous communities.

Police, correctional and fire services

Police, correctional and fire services are coping with growing demands. Police are facing increased scrutiny, including independent police reviews, higher policing standards, better ways to deal with mentally ill persons and calls for defunding and reform. While changes are coming, governments are not always prepared to fund the training required to meet these new standards, leaving police officers and staff in some jeopardy. In fire services, increased standards can be difficult to deal with because they are sometimes unevenly applied, partially because of the mix of permanent and volunteer firefighting services.

Delivery and privatization

Like police, correctional and fire services, paramedic services are predominantly publicly provided in Canada, but corporations have made some inroads.

Most notable is Medavie, a large private corporation that provides a range of health care services in several provinces. Medavie manages EMS on behalf of Ambulance New Brunswick, a provincial crown corporation. It operates and employs EMS staff on Prince Edward Island and in Nova Scotia through contracts with the provincial governments, and it operates Guardian EMS and Prairie EMS in Alberta. It also runs two services in Ontario (Chatham-Kent and nearby Elgin County) and manages Perth County Paramedic Services.

In Alberta, land ambulance services have been the responsibility of the provincial health authority, Alberta Health Services (AHS) since April 2009. AHS delivers most EMS but contracts out some work to a handful of for-profit or municipal EMS operators.

Ontario air ambulance services are provided by ORNGE, a provincial crown corporation that was badly entangled in scandals due to the partial privatization of its operations.

In Quebec, Urgences-santé, a non-profit organization with a board appointed by the provincial government, provides EMS to Montreal and Laval and responds to 40 to 50%  the calls. Outside of Montreal and Laval, EMS is often provided by private companies and cooperatives. The need for significant investments to adapt to new information technologies has increased financial pressure on municipalities and provinces, with some considering privatization as a solution.

Health and safety

Paramedic health and safety concerns have skyrocketed in recent years, even before the arrival of COVID-19, with psychological injury a major factor. In several provinces we have secured access to workers’ compensation for paramedics, dispatchers, police officers, and firefighters suffering from post-traumatic stress disorder. Other significant health and safety concerns stem from vehicle design, equipment failure, violence, lifting, traffic, road-side safety, fatigue, and inadequate personal protective equipment. Many of these issues are common with fire and police services. In some cases, workers compensation numbers are up, encouraging employers to work with unions to find solutions.

Oversight

With increasing responsibilities comes increasing oversight of paramedic services. The many levels of oversight of paramedic staff are causing significant concern to workers. Some paramedic staff now face double or even triple jeopardy with various levels of paramedic oversight having the ability to stop them from working.

Private patient transfers

Health care restructuring has increased inter-facility patient transfers, encouraging rapid growth in the private, for-profit patient transfer business. Public oversight of the private transfer companies is often lacking, and the service provided by these companies is often inadequate. The workers in this industry are often non-unionized and poorly paid. In Ontario, CUPE’s paramedics have successfully secured title protection for the word “paramedic” ensuring that other types of services cannot be called paramedic services.

Staffing shortages

In many areas call volumes are increasing without a corresponding increase in staff. An aging and growing population is driving increased demand for paramedic services. Offload delays, during which paramedics must remain at emergency rooms while they wait to hand over patients to hospital staff, are common due to hospital underfunding. This causes ER overflows and long waits for EMS.  

In jails, high inmate-to-correctional officer ratios adversely affects oversight. Chronic short staffing in RCMP Operational Communications Centers across the country is also putting public safety at risk. New Brunswick EMS communications staff report sometimes being short-staffed by as much as two-thirds, leading to burnout and a high staff turn-over.

At times, ambulance services are so overloaded that few, if any, are available to respond to 9-1-1 calls, with many lined up outside of local hospitals. This takes a toll on patients and EMS staff as services are not always able to respond in a timely way.  Compounding the problem, some services are now struggling to hire sufficient staff. Needed vacations are sometimes hard to book.

CUPE Quebec’s ad hoc 9-1-1 committee is concerned with staff shortages in many municipalities. It has led a campaign to bring to light the value of the work done by 9-1-1 dispatch officers as well as the effects of cuts and technological changes to a workforce that was already stretched thin. The need for specific measures to prevent psychological distress of 9-1-1 dispatch officers after particularly difficult calls has also been recognized.

CUPE 8911 has recently launched its Seconds Count campaign: B.C.’s 9-1-1 service is unsustainably short-staffed and underfunded and must be “right-sized” to run properly. The local was even informed late in 2021 that 9-1-1 Operators would no longer wait on the line with the caller until ambulance dispatchers pick up – a wait that can be as long as 20 minutes due to under-staffing. This change was a measure to deal with more calls but caused the abandonment of callers in distress.

With the overlapping crises of underfunding, staffing shortages, the opioid crisis, and COVID, the stress of emergency service work has gotten worse.

Community paramedicine

There is increasing interest in using paramedics in non-emergency situations, notably by making home visits to patients such as frail seniors to prevent illnesses, ensure correct medication use, provide education about chronic disease management, connect patients to local supports, and prevent accidents. While there remains significant variation in the use of community paramedicine, key goals are to prevent emergency calls and hospital admission. These programs also allow paramedics to apply their skills beyond the traditional role of emergency response.

Bargaining

Right to bargain and Interest arbitration

The number of ESS staff allowed by law to strike is often tightly restricted, reducing their bargaining power. Changes in New Brunswick have brought in interest arbitration for CUPE correctional officers in the province.

A very limited right to strike exists for municipal paramedics in Ontario, but some unions and municipalities have agreed to use interest arbitration voluntarily. The few remaining hospital-based paramedics in Ontario are required to use interest arbitration.

CUPE paramedics on PEI have also been deemed “essential” with no right to strike since 2010. In BC, paramedics represented by CUPE 873 had bargained under a larger provincial group, but freely negotiated their own collective agreement in 2019.

In Quebec, after Bill 15 was passed, the government continued to attack the rights of workers by launching Bill 110. This legislation, passed by the Quebec National Assembly, affects the municipal and land transport sector including police, firefighters, 9-1-1 emergency dispatchers and administrative support workers. Bill 110 changes the negotiating framework to favour employers and allows the government to more easily legislate working conditions, especially for firefighters and police officers. Other workers are concerned because it may be applied more broadly if it is successfully implemented. CUPE is currently challenging Bill 110 in court.

COVID-19

CUPE’s EMS members have been at the frontlines of the COVID-19 pandemic. CUPE members have been vocal about the need for adequate Personal Protective Equipment and other measures, such as increased training, to ensure the safety of paramedics and patients during the pandemic.

Pensions

CUPE paramedics helped win changes to the federal Income Tax Act to extend the definition of “public safety occupations” to include paramedics, making them eligible for a normal retirement age of 60 (NRA 60), rather than the more common 65.

In BC, CUPE 873 negotiated a provision in the BC Public Service Pension Plan in 1995 that confers enhanced early retirement benefits on members of the British Columbia Ambulance Service. The provision allows paramedics to retire as early as 55 without penalty or reduction in cases where the member has age plus years of contributory service equal to 80.

In Quebec, Bill 15 attacked defined benefit pensions for firefighters, police officers, police administrative staff and municipal employees. The bill has cut pension benefits, forced members to pay half the pension deficit, capped contributions and legislated a negotiating framework. All affected unions challenged this law as unconstitutional. Following the challenge to Bill 15, the Superior Court of Quebec declared that sections 16 and 17 of the law relating to the suspension of indexation for retirees were unconstitutional, while rejecting the other demands CUPE brought forward.

CUPE Quebec filed an appeal against the Superior Court decision in August of 2020. The arbitration process set up in Bill 15 does not alleviate the obstacles contained in the bill to the right to collective bargaining, a right recognized by the Quebec and Canadian Charters of Rights and Freedoms.