'What's going to happen when I call 911?' Ambulance merger proposal raises questions

The provincial government is thinking about consolidating 59 local ambulance services in Ontario into just 10. The restructuring is alluded to but not fully explained in the budget tabled last week by Finance Minister Vic Fedeli. leaving cities, paramedic and emergency services hungry for details. And the bottom line is: what does it mean for patients?

As it currently stands, individual municipalities operate their own ambulance services. But municipalities could lose their autonomy if the services are merged by the Ford government. Jason Fraser, a Peterborough paramedic and chair of the CUPE Ambulance Committee of Ontario, worries that ambulance response times could increase as a result of the restructuring. He talked with the CBC's Adam Carter about the impact the changes could have on paramedics and patients.

Adam Carter: So Jason, what details do we know about the merger so far?

Jason Fraser: Currently, we don't really know a whole lot other than what's been released in the media. There's been no transparency from the government. They haven't had any conversations with the stakeholders. So, you know, we're waiting to have that conversation. We're trying to obtain a meeting so we can find out what the plan is.

AC: Did you have any knowledge that this change was coming?

JF: We were very surprised when we heard about this and I think the other stakeholders involved were equally as surprised when this came out.

AC: What's the current operating model and how does it work?

JF: The current model is the upper tier municipality operates the paramedic service or the ambulance service. They provide 50 percent of the funding, they set the staffing levels, they set ambulance response time standards. And then the province of Ontario kicks in the other 50 percent of the funding to operate the paramedic service.

AC: Moving forward with this restructuring, what's at stake for patients and paramedics?

JF: Our big concern is that we need to ensure that there's an adequate number of vehicles on the road to answer calls in a timely manner. Call volumes are continuing to escalate now at a greater rate than the increase of ambulances and staff. So with the restructuring going to a larger geographic area, there's going to be more difficulty reaching those 911 callers in a timely manner. So with all this restructuring, there's potential that all this will get worse.

AC: Are the issues and scenarios that you're describing going to affect rural and northern areas differently than bigger cities and areas in the south?

JF: I think that since we haven't seen a plan, it's really hard to know what the delivery service will look like.

Because there has been no transparency. I think right now each municipality that operates a paramedic service, you know, they get to look and see what their call volume is, what there demographics are, what there geography is. And they set their service levels based on that. So going to a larger system — are those municipalities going to be able to have that same input into the larger, restructured service?

That's a question that hasn't been answered. It hasn't even been consulted on. So I think people should be concerned about what's going to happen with restructuring. What's going to happen when I call 911? Where's that ambulance coming from? These are all concerns that people in Ontario should have.

AC: You just touched on it a little bit, and I know a lot is still unknown about how this system is going to operate — what are some of the other big questions you have about how the new system is going to work?

JF: There are just so many questions that it's really hard to figure out where to start. But the biggest question is what does the service remodel look like? Right now we know what it looks like.

We know each individual municipality has that autonomy, that control over what services they provide. Going to the larger system, is that all going to be lost? And that's a big question.

AC: Alright, appreciate your time this morning. Thanks very much.

JF: Thanks a lot.