People with serious injuries are waiting longer for ambulances, Tri-City mayors say, and in some cases their family members are resorting to driving them to hospital.
The concerns are being raised by Port Moody, Coquitlam and Port Coquitlam mayors and councillors after a number of medical calls were downgraded by BC Emergency Health Services (BCEHS) in a reallocation of ambulance services last fall.
The mayors are concerned too, that the decision to downgrade 39 medical calls from Code 3 - that's when ambulances travel above the speed limit with lights and sirens - to Code 2 - when they drive at posted speeds - is tying up fire department resources.
"My main challenge with BC Ambulance is [the change] constitutes a downloading of service, such as the cost to the taxpayer is going up but its delivery of service is not," said Coquitlam Mayor Richard Stewart, who said he has had personal experience with long waits for ambulances. "I don't think the public is well served by that."
BCEHS says since the reallocation of BC Ambulance Services in October, calls to urgent emergencies are a minute faster and public safety has increased because fewer ambulances are responding to calls at speeds above the posted limit, resulting in 800,000 fewer kilometres of light-and-siren driving for ambulances each year.
EXPERT REVIEW
Dr. William Dick, vice-president of medical programs at BC Emergency Health Services, said an expert review panel studied 868 types of calls and 600,000 total calls over two years and made the changes after looking at patient outcomes and the risk of driving at high speeds.
Calls that were downgraded were those that were less medically urgent, he said, and didn't require critical intervention because the patients' vital signs, such as blood pressure, were good, although they still needed an ambulance to transport them to hospital.
"These were not calls where people are in danger, it's not calls where people are sick. Calls where we know people are sick, we are going to as fast as possible," Dick said, adding that everybody who calls 911 for an ambulance will get one.
But for the cities, the change from Code 3 to Code 2 for medical conditions such as falls, broken bones or other serious injuries simply downloads the costs of medical care to municipalities because firefighters have to wait at the scene longer for ambulance paramedics to arrive. In some situations, overtime might be required when call volumes are high and ambulances are not immediately available.
50 MINUTE WAITS
"We are very concerned with the BC Ambulance changes. It's resulted in firefighters on the scene waiting for an ambulance to come for an average of 20 minutes to sometimes as long as 50 minutes," said Port Coquitlam Mayor Greg Moore.
In some cases, he said, the ambulance doesn't even show up. "And in fact, sometimes the patient's family has driven someone to the hospital, which is just not appropriate."
Coquitlam has reported similar wait times and Port Moody council wants a report from its fire chief on the issue.
"I want some questions answered, I want to know specifically how it's affecting Port Moody residents," said PoMo Coun. Gerry Nuttall after he raised his concerns at Tuesday's council meeting.
PoMo Fire Chief Remo Faedo, who has already presented a preliminary report to PoMo council and plans a follow up, said wait times have increased by as much as 28 minutes for about 10% of calls, and though he acknowledged the thoroughness of data BCEHS used to make its decision, says in some cases, calls dispatched as Code 2 turn into Code 3 emergencies.
In those cases, dispatchers respond to firefighter assessments by sending an ambulance with lights and sirens but it can still result in delays. He's also concerned about the lack of consultation before the decision was made.
"They went and released the study and made changes without consultation with the public or the first responders," Faedo said.
The Port Coquitlam and Coquitlam mayors say they are also concerned about what they see as a lack of consultation, although BCEHS is about to conduct a review of the reallocation of services.
MORE DOWNLOADING
Mayor Stewart said firefighters with whom he has spoken are frustrated and some have suggested that a higher level of training would enable them to respond to calls now handled by paramedics.
But he said none of these issues would be a concern if there were enough ambulances available to take the calls.
"This is the ultimate question," he said. "Do we local governments pick up the slack? And it will be much more expensive to society to do it that way," He equated the situation to the way mental health concerns have been downloaded by the province on to municipal police forces.
PoCo's Moore raised a similar issue. "Instead of BC Ambulance getting more money to provide the same level of service that they have been, they are reducing quality of service," Moore said.
BCEHS meanwhile, maintains that the changes were not a money saving measure and some kinds of calls were upgraded. Dick said services are now being delivered more efficiently, although he acknowledged that his information shows waits for less medically urgent calls have increased by an average of six minutes.
He said other jurisdictions have made similar changes to ambulance services based on rigorous data analysis and he pointed out that dispatchers use internationally validated tools to match response to patient need. Still, he said he's willing to take a closer look at changes if cities can provide the data to back up their concerns.
"I am happy to review them, I've told the fire chiefs, 'If you've got issues, send them to me,'" Dick said.
