Paramedics like Tony Camara, left, and Garry McLeish, right, will be affected by the decision to make ambulance service a public or private affair. Sarnia this week photo by Dave Paul
By Angela Crich
Sarnia this week
While we hope we may never have to use the ambulance, it's comforting
to know it's there for our safety. On March 8, Lambton County Council
will decide whether to operate the ambulance service on
its own or let a private company take the wheel. In the past,
the land ambulance service has been controlled by the province and managed
in the city by Sarnia General Hospital and in the county by two private
operators, Gilpin and Steadman. Due to provincial downloading, the cost
for land ambulance was delegated to the county on Jan. 1, 1998. However,
the province continued to operate the service on behalf of the county for
a transition period, which will end on Jan. 1, 2001. By Sept. 3, 2000,
the countymust notify the Ministry of Health and Long Term Care of its
choice for a service provider.
Steve Van Valkenburg was hired on contract as the county's ambulance
co-ordinator. He compiled a report on the Land Ambulance Service, detailing
the pros and cons of each option as well as the status of the existing
service.
The report states the total estimated cost of the status quo ambulance
service would be $3,673,156.37 if run by the county and $3,923,486.44 if
contracted out. "The only figures we have to work on are the Ministry
of Health figures from 1999. I agree we're kind of shooting in the dark,
but we're shooting the best we can," says County Warden Pat Davidson.
The report lists four pros and 16 cons to a private system. Among the pros
are flexibility and cost efficiencies. Among the cons are lack of control
and instability for the employees. For the public sector service,
the report details 15 pros and three cons. Among the pros are full accountability
and career stability for the paramedics. Among the cons are potential for
political interference and potential for higher costing up-front.
The county's Health and Senior Services committee motion which will
come before council on March 8 favors the public option. Anne Khan, a city-county
councilor, made the motion as a starting point. Since then, she has vacillated
between options. "I'm pretty sure I'm going to go ahead and support
the county-run option, but I will be comfortable either way," says Khan.
"This isn't an absolutely right or absolutely wrong issue. This is
a difficult decision - a real dilemma. It's not a business decision, but
it's about emergency medical care." She's leaning towards the county because
she says it is patient focused and offers stability for the Paramedic Level
2 personnel. "Certainly in the city we have valued the P-2 expertise
on the ambulance. We know it does save lives. There is uncertainty about
what would happen to the P-2s if we went to an RFP (request for proposals).
(Under the private option), there may not be the same commitment to have
the P-2s." One concern she has about this public option is the opportunity
for political interference. "If you have politicians representing
an area, they are going to fight for their particular area. I see that
as a huge negative. That's a huge red flag." City-county councilor
Rod Brown favors an RFP process. "To me, the RFP would give us more
information, more factual information and I would feel more comfortable
making a decision," says Brown. Rick Furnish, director of ambulance
services, says the city's 30 full and part time paramedics would like to
see the county take over the ambulance service. They believe this would
offer better continuity of pension plans and health plans. "They
don't want to have to go through an RFP every three years - having a new
employer come in every three years. They've seen what has happened with
the Community Care Access
Center workers and they don't want to see that happen with the ambulance."
There is a shortage of paramedic staff and it is expected to get worse
as the Ambulance and Emergency Care program has been changed from a one
year to a two year program. There will be no graduates from the program
until next year. Furnish says certain areas such as London and the County
of Durham are in dire need of paramedics and are offering large incentives
to entice employees. Furnish believes SGH could provide "an excellent
ambulance service for the whole county." David Vigar, president and
CEO of Lambton Hospitals Group, says the SGH commission is interested in
submitting a proposal. "We feel one of our advantages is that hospital
employees cannot strike right now. Although there is legislation in the
works right now for ambulance workers, that hasn't passed." At one
point, the hospital had dismissed the idea of bidding on the service, but
has since discussed the issue with other hospitals successful in the process.
"There are issues no matter what way this goes. I just hope it's a good
quality ambulance
system," says Vigar, adding the hospital is willing to work with whichever
operator the county selects to ensure a smooth transition. Malcolm
Gilpin and Andy Steadman, owner/operators of the county systems, say the
report "is clearly biased toward a direct delivery of Ambulance Service
by the County of Lambton and is simply designing a full-time position for
the new Land Ambulance Transition
Co-ordinator." "The report fails to address the reality that
already a number of municipalities, namely
Muskoka, Niagara, Middlesex, City of London and Chatham-Kent have either
chosen the RFP process as a delivery option or chosen the provider already
and many of the issues identified in the report as cons have been addressed,"
say Gilpin and Steadman. The operators say the low staff job security
is a fact of life in today's job market and all qualified paramedics will
be offered jobs.
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