Ontario service agencies and municipal governments are still waiting see how Premier Doug Ford’s Progressive Conservative (PC) government is going to consolidate the province’s 59 local paramedic services into just 10. The planned merger comes on the heels of other cuts in Ontario’s health sector, including reducing the number of public health authorities from 35 local units to 10 regional bodies. Mergers are also planned for the province’s 22 dispatch centers; it’s all part of an across-the-government campaign to save tax dollars.
“Our government will streamline the way land ambulance dispatch services are delivered by better integrating Ontario’s emergency health services operators and dispatch centers,” says Hayley Chazan, spokesperson for Minister of Health and Long-Term Care Christine Elliott, in an e-mail interview. “These changes will ensure our frontline paramedics and emergency response teams have the right tools and technology when responding to 9-1-1 calls and more options to treat patients during an emergency. No frontline paramedic will lose their job as a result of consolidation. Just the opposite: We are empowering frontline paramedics to improve the already-great service they provide in communities each and every day.”
The province’s April announcement that it would consolidate paramedic services caught Ontario paramedic and municipal officials off guard, coming with no previous warning.
“It’s really something,” said Jamie Ramage, chair of the Ontario Public Service Employees Union’s ambulance division, which represents paramedics in 22 Ontario agencies. Speaking to the London Free Press newspaper, Ramage added that the announcement “really did take people by surprise.”
The same was expressed by the Association of Municipalities of Ontario: “AMO is shocked with today’s news and deeply concerned,” wrote Executive Director Pat Vanini in an e-mail to provincial paramedic chiefs. “There is no ready information on the government’s plan to do this restructuring, how it was determined, let alone what happens to cost sharing and say for pay among other governance and funding matters.”
For Darryl Wilton, president of the Ontario Paramedic Association (OPA), “The Ford government’s cuts pick up where the last PC government left off before being voted out 17 years ago,” he says. “Their 2019 budget that vaguely alluded to these cuts was full of buzzwords and short on specifics. Now we have to wait and see how this will all play out.”
Wilton believes “Premier Ford is ultimately looking at regionalization followed by privatization.” To understand what this could mean for Ontario paramedics, the OPA has “reached out to colleagues in Nova Scotia, New Brunswick, and Prince Edward Island…who have worked both systems (Ontario’s public model and the east coast’s private model),” he says. “We also spoke to paramedics in Chatham-Kent who work for Medavie (a private EMS provider). Based on our landscape survey, nobody has anything good to say about privatization.”
Beyond the possibility of privatization, a key concern for Ontario’s paramedics is that the consolidation will lead to job losses. Ford has publicly denied front-line staff will be cut under his plan. “There’s always going to be the same number of paramedics, 100%, that’s a guarantee,” Ford told reporters after the consolidation was announced.
However, Ford also promised during the 2018 election that “not one single person will lose their job” under his other proposed program cuts. Once in power he made changes to education policy and classroom sizes that will cut 3,475 full-time teaching positions over the next four years, according to an Education Ministry memo leaked to the Toronto Star newspaper. The cuts will save the province $851 million by increasing class sizes.
The OPA is certainly skeptical about Ford’s promise. “His statement is purposely ambiguous and does not at all speak to our current system design,” says Wilton. “Any cuts could cripple high-quality and economically efficient care that taxpayers are currently able to pay for at a mere fraction of the costs of police services or fire services.”
What remains to be seen is how Ontario’s paramedic services consolidation plays out in the months to come. According to the Ontario government, “Conversations with municipal partners and unions will be ongoing over the coming months, with further details to follow throughout the spring and summer,” says Chazan. “As the province begins this work, Ontarians can be confident that they can continue to call for the emergency medical care they need.”
According to Wilton, “Formal consultations have definitely not started. The only thing that has occurred is a panicked attempt to put out this fire that was started by Premier Ford’s office.”
James Careless is a freelance writer and frequent contributor to EMS World.