If they had to call for medical assistance for themselves or a family member, nearly 88 per cent of Sudburians who responded to a poll about provincial changes to 911 delivery, said they prefer a response by an ambulance service. Only 8 per cent said they preferred a response by a fire department.
The Sudbury results are similar, but considerably higher, than a provincial poll released this past January that shows that Ontarians aren’t on board for recent Liberal government changes that would redirect 911 medical calls away from paramedic ambulance services to fire departments.
Both the Sudbury and provincial polling took place late in 2017, immediately following the passing of changes to the Ambulance Act that could allow fundamental changes to 911 emergency medical response and pre-hospital care, say paramedics with the Canadian Union of Public Employees (CUPE). These changes include allowing pilot projects in “willing” municipalities to experiment with using firefighters who also have a paramedic designation to respond to pre-hospital emergency medical calls.
“As one of the few municipalities that provide both ambulance and fire services, this sort of experiment is much more likely to happen in Sudbury than elsewhere. But just because the government or fire are more likely to target Sudbury doesn’t mean Sudbury should experiment with a pilot. There is no evidence that there are better patient outcomes and it costs much more to send a paramedic on a firetruck than send medics on an ambulance,” says Jason Fraser, chair of CUPE Ontario’s Ambulance Committee (CACO). CUPE represents more than 5,500 paramedics at ambulance services province-wide. There are about 8,000 paramedics in Ontario.
When asked directly whether they would support government replacing an ambulance service response to some 911 medical calls with a fire department response, more than 74 per cent of Sudbury respondents said they were against the change.
Polling in Sudbury and province-wide shows “that the provincial government really doesn’t have Ontarians’ support to alter 911 medical response to redirect medical response to fire departments. Our findings show there is really no appetite for this. Ontarians understand both the patient care implications and the higher costs that will be incurred by municipalities if the province goes through with this model.
“The paramedics, whom CUPE represents, are strongly urging this government to put resources into enhancing ambulance paramedic response, not these fire experiments,” says Fraser.
To date, no municipality has volunteered to run a pilot. Although the province wanted trials in place before the election, the province now seems to recognize that it will have to wait until after the election. In fact, municipalities, through their provincial umbrella group, have come out against moving to a medical response through fire departments. Neighboring North Bay council recently also voted against the proposal. A paramedic fire model would increase costs for municipalities as an hour of fire service is 55 per cent higher in cost than an hour of ambulance service. Compounding the extra costs, municipalities pay 100 per cent for fire services through the local tax base, while the province pays 50 per cent of ambulance-based paramedic services.
CUPE 4705 represents Sudbury-based paramedics, and local president Darryl Taylor is encouraging Greater Sudbury city council to “steer away using Sudbury as a pilot guinea pig. Instead, council should look rationally at available funding resources and put dollars into what saves lives and costs less. And that’s ambulance-based paramedic services, not some new system that will cost more for the municipality.”
CUPE believes governments need to study the potential for rational planning – moving resources from firefighting services, that have declining need, to services, like ambulance, that have growing need. Studies confirm that emergency medical calls are increasing, while the number of fires is declining. Just over 62 per cent polled in Sudbury said they agree that the provincial government should study the public health and economic potential for moving resources from services that have a declining need, such as fire calls, to services that have an increasing need, such as ambulance-based paramedic calls.