Over the past several years, the Manitoba Government and General Employees’ Union (MGEU) has been vocal about the challenges and issues facing paramedics in our Province. We believe paramedics have been undervalued and under-resourced for far too long whether they are delivering service in the city of Winnipeg or in communities across this province. Our hope is that paramedics’ issues will be front and centre in the days and weeks to follow. We welcome the focus and coverage on these issues. Our position has been clear for some time: paramedics can and should play a more active and integrated role in health care delivery in our province.

We have met with Minister of Health Theresa Oswald and with City of Winnipeg officials to share our concerns about paramedics’ role in health care and we will continue to do so at every opportunity. We have been campaigning around issues like ambulance shortages and ER backlogs in the paid media and in self-generated media stories. That work will continue until we feel paramedics have been given their rightful place, based on their training, expertise and experience, within our health care delivery system.

We have encouraged the Province to undertake a comprehensive review of Manitoba’s emergency medical system. One of the most important aspects of an emergency medical services systems review will be to examine the benefits and challenges inherent within an integrated services model in both urban and rural settings. Put simply, we must be sure to carefully examine the roles and responsibilities of all who provide services within our communities, including nurses, nurse practitioners, paramedics, and fire fighters. Then, we must clearly and honestly evaluate their contributions in three important areas: efficacy, efficiency, and cost effectiveness. The ultimate goal is to provide the very best patient care possible.

We believe that such a review will ultimately come to the same conclusion our members have come to based on working in the current system: the time has come to move away from a regionally based system of delivering emergency medical services in Manitoba to a single, province-wide system under Manitoba Health.

Our emergency medical system as it currently exists lacks consistency in service delivery. In rural Manitoba, Different regions must simply do things differently, and patients deserve consistent care. In addition, the practice of duplicating administrative tasks across several health authorities can be better done under a single umbrella to both make better use of precious health care dollars and improve efficiency, but also to ensure a standard of care across regions that is more consistently applied and enforced.

In Winnipeg, MGEU has been extremely vocal about the lack of ambulances and available resources to move to emergency situations in a timely manner. We have voiced quite clearly that we believe patient safety has been put at risk, and that wait times for ambulances to transport patients to hospital are too lengthy. In fairness, improvements have been made in the recent past. For example, the City’s insistence on charging the RHAs for unacceptable offload delays in emergency rooms places additional (and welcome) accountability into the system. The Province has funded new ambulances, and the decision to utilize the Misericordia Urgent Care Centre for non-emergency cases to relieve backlogs at emergency rooms was a step in the right direction. Paramedics will be the first to tell you there’s a lot more work to do.
Our past advocacy efforts have been targeted mainly to the City of Winnipeg because within the city, they act as the direct employers of those who work as paramedics and as the entity in charge of operational service delivery. The Province of Manitoba and the Winnipeg RHA, however, bear responsibility for funding (along with patient fees) and standards. The challenge for those looking for accountability within the system as it stands is that with no less than three entities in a position of authority, it has become common practice for each entity to blame the other for service shortfalls and gaps in service. We need to stop the finger pointing and buck passing.

There are positive and proactive ways to move forward in the direction of a province-wide system that are not without precedent in Manitoba. For example, the Diagnostic Services Manitoba model is one example of how we can move forward together to provide better service to health care recipients in our province. And it is certainly worth noting that in many cases we are already on the way to a provincial delivery model when you consider our provincial fleet of ambulances are delivered and serviced by the province, treatment guidelines and protocols within the system are becoming more standardized (but applied differently), and the Manitoba Transportation Coordination Centre in Brandon already organizes EMS transfers within all jurisdictions aside from Winnipeg.

Another significant recommendation from paramedics: the Province of Manitoba should adopt a community paramedicine model. In practice, community paramedicine means giving appropriately trained paramedics, in conjunction with other health care providers and community involvement, the ability to asses and treat patients that do not need to be transported to hospital. The most obvious benefit of this model is that it assists in alleviating backlogs at emergency rooms but it also makes better use of non-critical care resources within health care. This would be beneficial also in communities in rural Manitoba that don’t have an emergency room and have very limited access to health care. Not only has this model been tried successfully in other Canadian and European centres, but there is a successful example of community paramedicine right here in Manitoba at the Main Street Project in Winnipeg.

As part of moving toward community paramedicine, the Province must provide improved training opportunities for paramedics across Manitoba. Currently, only paramedics in the Winnipeg Fire Paramedic Service can access advanced care paramedic (ACP) training. As a result, there are only a handful of ACPs in rural Manitoba. The same level of service should be available to residents of rural communities in our province. Therefore, we encourage ACP training to be available to all current and prospective medics regardless of where they live or work.

In conclusion, we’ve stated quite clearly that paramedics want to be part of the solution in improving health care services for Manitobans. Paramedics believe they’ve been under-utilized in the current system, and want to take on a more active role in health care delivery. As the candidates and parties continue to prepare health care announcements on a go-forward basis, it is our sincere hope that they will consider our positions on the issues stated above and incorporate some of the ideas into their platforms. Paramedics, like all public employees, have both a right and responsibility to get involved in the electoral process, to get educated about the issues that affect them and their families, and to ask questions of candidates in the upcoming election.

Lois Wales
MGEU President

Wayne Chacun,
Director, Technical Professional Paramedical Component

Chris Broughton
President, Paramedics of Winnipeg, MGEU Local 911