Fire-paramedic review urged

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This article was published 17/04/2015 (3307 days ago), so information in it may no longer be current.

The union for Winnipeg paramedics wants an independent audit to compare costs and operations of the Winnipeg Fire Paramedic Service and examine the integrated paramedic/firefighter service model unique to this city.

Michelle Gawronsky, president of the Manitoba Government and General Employees’ Union (MGEU), said the union questions the efficiency and costs associated with operating a paramedic department relying on paramedics and firefighters trained as paramedics.

“The fact the fire paramedic service budget is escalating at a rate that is just not sustainable, I believe taxpayers and health-care clients should be asking why,” Gawronsky said.

“We know no other city in Canada uses the system we have here. There must be a reason for it if we take a look at it.”

The service in Winnipeg is unique in Canada.

In addition to a team of two paramedics in an ambulance, two firefighters on every fire truck at every station for every shift are also trained as paramedics. They respond when an ambulance crew is not available.

If patients require transport to hospital, the firefighter/paramedics wait for an ambulance crew, which takes the patient to hospital and provides further medical assistance.

The WFPS and the firefighters union boast that the model has resulted in the lowest ambulance costs and the best patient outcomes of any comparable major Canadian city.

An Ontario agency did a comparison study that found Winnipeg’s integrated model resulted in substantially lower costs, but its conclusions on response times were different.

It found that, for ambulance calls, response times were the worst, and for fire vehicles, response times were in the middle of the pack.

The City of Winnipeg refused to make Fire Paramedic Chief John Lane available for an interview.

Instead, Lane provided a lengthy email statement.

“There is already ample external, independent, and third-party review and surveillance of the WFPS performance and finances,” Lane stated in his email.

“Additional review will add unnecessary cost to the citizens of Winnipeg.”

Lane added the WFPS participates in the annual Ontario Municipal Benchmarking Initiative, and has won two awards in the last three years from the Paramedic Chiefs of Canada that recognizes “their excellence in emergency medical services provision.”

The WFPS provides emergency medical services (EMS) through an agreement with the Winnipeg Regional Health Authority, Lane said, adding the WRHA is undergoing an accreditation review in 2016, and the WFPS will be included in it.

Firefighters union president Alex Forrest said he wouldn’t comment on MGEU’s call for an audit but said he is confident the integrated model provides the best outcomes for Winnipeg.

“We know our system is one of the most cost-effective EMS systems in Canada, with the best patient outcomes and response capabilities of any large city in Canada for paramedic response. Our system saves lives,” said Forrest, president of the United Fire Fighters of Winnipeg.

“We are also working on increasing our fire response as well for the citizens of Winnipeg.”

Lane has commissioned an independent review of firefighting capabilities.

The Fire Underwriters’ Survey (FUS), which grades a municipality’s firefighting capabilities and issues a score from one to 10, with one being the best, is expected to be presented to the protection and community services committee next month.

The last FUS was conducted 26 years ago. At that time, Winnipeg had a grade of 2.

The FUS review examines a variety of factors to determine a municipality’s ability to fight industrial, institutional, commercial and multi-family residential fires, assessing the water-supply system and the fire service’s administration and operations, communications system and inspection programs.

Gawronsky said she questions how cost-effective is it to have four firefighters and a fire truck respond to an EMS call, saying it would be cheaper to have two paramedics in an ambulance handle the same call.

“We should be expanding on the ambulance services,” Gawronsky said, adding a two-year-old provincial review of EMS services questioned the city’s reliance on firefighters and fire trucks as first responders and recommended that model be examined to determine cost-effectiveness.

She said it’s never been done.

“How much would we save by sending two paramedics in an ambulance rather than four fire personnel on a pumper truck?” she asked.

Gawronsky said an impartial, third-party review of the Winnipeg Police Service was done two years ago, and a similar review should be conducted for the WFPS.

She said the union plans to lobby city councillors for an independent review.

One councillor who agrees with the MGEU is Jeff Browaty, chairman of protection and community services.

Browaty met with MGEU representatives recently and said an independent review, similar to one done on the police service, makes sense.

“I am in no way endorsing (the MGEU) opinion that the current model of fire/paramedic service is ineffective, but I don’t think there is any harm and only upside to quantify that along with many other aspects of this very important service,” Browaty said.

The MGEU concerns are viewed by some as part of the dispute between the paramedics union and the firefighters union over the establishment of a self-regulating body for paramedics, similar to the College of Physicians and Surgeons.

Gawronsky said the MGEU call for a review has nothing to do with the self-regulation issue or the perception of a dispute with the firefighters union.

“We respect the job the firefighters do, but this is EMS, the ambulance service. It’s our paramedics that can transport the patients,” Gawronsky said.

 

aldo.santin@freepress.mb.ca