City of Thompson turns ambulance service over to Shared Health after government funding dries up

The City of Thompson says it is handing over ambulance services to Shared Health, after provincial underfunding and staffing shortages stretched resources to the point where it's decided to focus its funding on firefighting and emergency services.

The provincial health-care agency is expected to assume full responsibility for ambulance service in the northern Manitoba city starting Feb. 1, 2025, the city has told CBC News.

"Without adequate funding for ambulance service, staffing and additional infrastructure that's needed, it doesn't make sense for the City of Thompson to continue running a paramedic service," a spokesperson for the city said in a statement. 

Ambulance and emergency medical services in the city have been provided by Thompson Fire & Emergency Services, including local firefighter-paramedics and cross-trained first-responders who also respond to fire calls. 

Shared Health, Manitoba's provincial health authority, assumed delivery of emergency medical services in 2019.

However, in cities such as Thompson, Brandon and Winnipeg, these services have been run by municipalities in exchange of Shared Health funding under a contract known as a service purchase agreement.

However, Mayor Colleen Smook said the city's agreement with Shared Health expired in 2019, and for the last five years the city has been working with the provincial agency to strike a new deal that "just hasn't happened." 

"We have still provided the ambulance service according to the past agreement," she said. "We have struggled in a few areas.… Hiring and retention, ever since COVID, that is definitely not picked up as much. It's been a challenge." 

'We've reached a breaking point': union

Eric Campbell, acting president for the Thompson Professional Firefighters Association, the union representing the emergency department's first responders, says that without an agreement, the city is receiving the same government resources to run emergency medical services it did in 2019, despite an annual increase of seven to 10 per cent in call volume.

"That blows back on to the city. They're going to have to come up with extra money out of the coffers," he said. "That comes back to our membership.… With no increase in staffing, our workload is going up seven to 10 per cent." 

So far this year, firefighter-paramedics have logged about 11,000 hours of overtime cumulatively, the union's acting president said, leading to burnout, physical fatigue and a steady number of vacancies. 

"We have turned over in the last five years approximately 55 staff," he said. "That's 11 people a year, which is about 50 per cent of our operational capacity … being replaced every year."  

Smook says the local department employs a crew of 24 first responders, a number that has remained unchanged since the late 1970s. Nine of those positions are currently vacant, the city says.

"We do need more personnel, more ambulances, but the capacity of our fire hall won't allow us to bring in any more equipment," Smook said. 

The city says relinquishing the responsibility for operating ambulance services will make it possible for the emergency department to focus on local fire protection and wildfire preparedness.

"We've reached a breaking point where we are unable to do both — we have to pick and choose," Campbell said. "That essentially will take away 8,500 ambulance calls that we have to respond to every year."

Thompson has dealt with at least three major fires over the last couple years, including a blaze that ravaged classrooms at a local elementary school in the summer, the mayor says, adding it is important crews keep up to date with fire inspections and training to respond to wildfires in a city surrounded by boreal forest.

Transition details being worked out 

A spokesperson for Shared Health told CBC News the "vast majority" of just over 9,000 calls answered by the city's emergency department in the 2023-24 fiscal year were for medical support and inter-facility transport between Thompson's airport and the hospital.

"We want to reassure all residents that health services will continue to be available," the spokesperson said, adding discussions on the delivery of emergency response are underway. 

While details on a transition plan are still being worked out, the city says firefighter-paramedics will remain city employees "throughout and after the transition, unless they resign."

However, Campbell says the department's unionized staff were "majority in favour" of the transition when they were told about it two weeks ago. 

"I do not see anybody leaving our … [fire] service to go work for Shared Health on the ambulance," he said. "I don't think there will be one of us that will do that."

Rebecca Clifton, administrative director with the Paramedic Association of Manitoba — a voluntary professional association for paramedics and emergency medical responders — told CBC News it is still unclear how Shared Health will staff ambulance and emergency medical services in Thompson. 

But she said there are already more than 100 paramedic vacancies within the organization, and that number could potentially swell if the provincial health-care organization absorbs any shortage of first-responders in Thompson.

"A lot of paramedics across this province are contemplating whether they want to do this anymore," Clifton said. 

"They haven't seen anything change over the last several years, and for this to now potentially be something that is going to increase vacancies … it's not going to help. They're going to be even more frustrated."

The association is hoping the transition will include a plan to retain paramedics who are already on the job and attract new ones. 

"Manitobans deserve better," Clifton said. "They do need to be able to call 911 and have paramedics arrive in a reasonable time frame."