Paramedics, their unions, and other health care workers concerned about the province’s proposed health care overhaul recently took to Queen’s Park to protest the potential changes.
The rally was organized by the Ontario Health Coalition (OHC).
The Ontario Paramedic Association (OPA) has expressed serious concerns about a recently released EMS Vision – Ontario 2050 document, saying the report “indicates the intent of the Ministry of Health – Emergency Health Services Branch to regionalize Ontario’s 52 paramedic services, six First Nations emergency providers and Ornge, as well as its 22 Central Ambulance Communications Centres, into 10 regional health hubs.”
While the Ford government has distanced itself from the EMS Vision document, the Ontario government’s budget confirms that the province plans on altering the way land ambulance dispatch services are delivered by integrating Ontario’s 59 emergency health services operators and 22 dispatch centres.
Union leaders are concerned that the proposed changes will potentially lead to the privatization of some paramedic services, effectively making health care delivery more challenging in the fast-growing region that includes Mississauga, Brampton and Caledon.
“Our main concern is that the residents of the Region of Peel have spent the past 19 years developing a world-class paramedic service. Now, this bill could give those resources to private companies,” says Dave Wakely, Union President of the Peel Paramedic Union (OPSEU 277).
“We’ve seen in the past that central delivery doesn’t work,” he says.
Wakely and OPSEU 277 aren’t alone when it comes to concerns about potential privatization in the province’s health care sector overall.
On the rally’s official page, the OHC says the Doug Ford government is proposing massive restructuring to hospitals, long-term care, home care, community care, mental health, and more. The organization says the new legislation could sell vital health care services to private for-profit corporations, impose costly mega-mergers that put local services and hospitals at risk and privatize the health care system.
The province has denied that the health care overhaul-—which will see the creation of a superagency called Ontario Health—will harm or eliminate Ontario’s current public and universal healthcare system.
The new Ontario Health super agency will be formed over a period of time by dissolving the 14 Local Health Integration Networks (LHINS) and merging them with several other provincial agencies that already exist.
As far as paramedic services go, Wakely told insauga.com that the province intends to amalgamate 59 services into just 10.
“It’s going to be catastrophic to the care we deliver. Amalgamating 50-plus services into 10 is damaging to the type of care we provide and the accountability of care we provide. Our risk management team is looking at this, and the goal is to increase safety for the patient. We’re a leader in pre-hospital research, and that will go away.”
Wakely is concerned that changes could merge paramedic services from Peel to Niagara.
“We serve one-tenth of Ontario’s population. We’ll still do great work, but the policies and procedures that allow us to do things within our community will be eroded. We’re concerned it’ll hurt our patients and our jobs.”
As of now, Peel paramedics work with the Region of Peel to deliver hyper-local services.
“We work with the regional council, and the needs are really catered to the community. We go directly into the operating room with patients who are having heart attacks. We’re able to bridge a gap and provide a more efficient service.”
According to the OPA, the current model of care–one that allows paramedic services to work directly with the municipalities they serve–was established in 2000 under the Progressive Conservative government.
When the provincial government downloaded the costs associated with ambulances to the municipalities, local areas amalgamated several local services into a larger regional model.
Wakely says the current model allows paramedics to form close and productive relationships with local hospitals and healthcare providers, effectively creating a more streamlined and patient-focus service that saves time and public money.
“A group of providers who work together every day can address issues that come up. Having authority close to the local level makes it easier.
Wakely says Peel paramedics participate in what’s known as a Lean process with local hospitals to help reduce off-road delay.
“It started at an upper management level. We participate in processes to save money and get patients seen faster. It saves about $7 million a year in cost [for paramedic services].”
Wakely says people who are trained in Lean go step-by-step to learn what the patient journey entails.
“They go through and figure out if there are spots where efficiencies can be gained or where there are delays where they don’t need to be. We work directly with hospital partners. It all starts with personal relationships with the hospital. The changes are going to hurt paramedics, and they’re going to hurt patients.”
Wakely says that while there is no official proposal to privatize paramedic services right now, he is concerned that some aspects of the system could be sold off to private bidders in the future.
“There’s no proposal to privatize right now; it’s to change 52 services into 10–59 if you include First Nations. It’s hard to privatize 52 services, but by uploading it to the province and changing it to 10, the private provider only needs to do 10 proposals, and the government can do all 10.”
Wakely says he believes this is the first step towards privatization, suggesting that it’s possible that scheduling or payroll services could be privatized in the future.
“Tax dollars should be invested in the care of people. They shouldn’t be sent to an American or Canadian company. We need to keep private interests out of health care.”
Wakely says it’s been challenging to engage the provincial government in conversation but is hopeful the rally will compel the province to listen to paramedics’ concerns.
“Even the paramedic chiefs have had an extremely hard time getting a meeting with the government. We’re trying to get them to listen.”
Cover photo courtesy of Durham Paramedics CUPE