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North Westside Road BC Ambulance Service

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Blue Divider Line

The population of B.C. is growing steadily each year, with the elderly (65+) population increasing even more rapidly. This growth is reflected in large increases in ambulance call volumes and emergency room visits annually in all areas of the province. Even during this time of increased demand we have seen continued downsizing of rural ambulance stations.

http://www.apbc.ca/home/node/86

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BC Ambulance Statistics
on their Home page at the bottom of the page.

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Please speak to your MLA about the lack in BC's Air Ambulance System

MLA Finder http://www.leg.bc.ca/mla/3-1-1.htm

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Thank you Hans Dysarsz for informing us of everything you know. 

Our Ambulance Service needs its own Ambulance by the looks of it eh!!!

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Better ambulance service for all of BC including the OK valley

Hans Dysarsz is involved in placing a rapid response EMS helicopter in Kelowna.

Please see www.helicoptercontract.info for more information.

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British Columbia Ambulance Services are managed by BC Emergency Health Services http://www.health.gov.bc.ca/ehsc/

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Ambulance waits under fire at UBCM
piquenewsmagazine.com - By Alison Taylor - Sept 18, 2014

In Whistler and beyond, communities rally for ambulance response review at annual convention

BIG CONCERNS The Lower Mainland Local Government Association is using the UBCM conference in Whistler to highlight the negative impacts of long ambulance response times.
On a summer Saturday evening, in the heart of Whistler Village, a man lay at the entrance to a busy restaurant, suffering seizures and fading in and out of consciousness for a full 40 minutes before BC Ambulance arrived on scene.

"He lost consciousness multiple times during that time," said RCMP Sgt. Rob Knapton, adding that police, who were flagged down to provide assistance, were on scene at 9:45 p.m. and paramedics arrived at 10:25 p.m.

It is not clear if this incident was called in as a Code 3 — a top priority, lights-and-siren response.

But concern is growing in Whistler, and beyond, about ambulance wait times, as evidenced by resolutions at the Union of British Columbia Municipalities (UBCM) conference this week, which will likely serve as a lightning rod for the issue province-wide.

The pressing question in this corner of B.C., which is becoming increasingly busier from one end of the corridor to the other, is whether the ambulance service is keeping up with growing demand? The Aug. 9 incident is not an isolated one.

At 3 a.m. on Saturday, July 5, it took BC Ambulance 14 minutes to respond to a cyclist struck by a taxi in the village; he had a broken femur, two broken eye sockets, and bleeding on the brain as local firefighters waited anxiously by his side, rendered almost ineffectual by law.

This call came into ambulance dispatch at 2:33 a.m. Paramedics arrived at 2:47 a.m. The station is less than one kilometre away.

The 14-minute wait is almost double the eight-minute city standard elsewhere for urgent calls.

"Other ambulances in the area were assigned to other calls," said Kelsie Carwithen, manager of media relations with BC Emergency Health Services and BC Ambulance Service via email.

Further down the road in Squamish, Sue Lawther was walking her son's dogs on a rainy May evening on a residential road in the Highlands. She fell on the cement and broke her femur. Her yells alerted the neighbours, who called an ambulance.

"It was pouring rain. It was freezing cold," said Lawther, who lives in Whistler. "It was 22 minutes before the ambulance got there."

She was taken to Squamish General Hospital where she had to spend the night because there was no ambulance available to transport her to the city where she needed surgery.

"It was an incredible wake up call (about) the services that I took for granted because I lived in Canada, and thought that we had these services," said Lawther. " I don't think I would have anticipated waiting for 22 minutes in the pouring rain in the dark relying on my neighbours to try and get me through those 22 minutes before an ambulance came. I would have anticipated that help would have arrived much sooner.

"It was an eye-opener for everybody that it took so long for the ambulance to arrive."

Said Whistler Mayor Nancy Wilhelm-Morden's upon hearing of the incidents: "It's just not acceptable."

She's not alone in her concerns.

These same stories are playing out in communities across B.C., particularly in the last year after sweeping changes to ambulance responses.

It appears, however, to be coming to a head in Whistler at the upcoming UBCM convention (Sept. 22-26).

Several resolutions at UBCM this year are calling for change.

B.C. communities, large and small, urban and rural, are calling for the government to review its one-year-old Resource Allocation Plan (RAP) that has changed the way ambulances respond to calls, essentially downgrading Code 3 calls, "lights and sirens" calls to Code 2 for a full 39 types of calls. The change was implemented in part to help ambulances respond faster to the most urgent calls.

A third-party review of the RAP changes found that they are consistent with contemporary best practices nationally and internationally.

"The methodology has a strong foundation in robust clinical evidence of the actual medical needs of British Columbia's EMS patients, and is superior to the processes used in many major EMS systems," said Alan Craig in his external review report.

The reality on the ground, however, is reports of longer wait times for everyone else.

The fallout lands on the firefighters who rush to the scene to help, but cannot transport a patient.

The Lower Mainland Local Government Association Executive (LMLGA), which includes 33 local governments from Pemberton to Hope, including Whistler, is using UBCM to highlight the negative impact on response time and patient safety and is calling for the province to "develop an effective, well integrated, patient-centred emergency response service for our citizens provided by fire and rescue service and BC Ambulance Service working together."

Councillor Chuck Puchmayr, of New Westminster, is the president of the LMLGA executive.

He calls the government's roll out of the resource allocation plan "a red herring."

"They delays aren't because ambulances are moving at Code 2," said Puchmayr. "The delays are because there are just not enough paramedics."

He said there are even cases where people are calling taxis, or using alternative transportation, to get to the hospital.

Last winter in Whistler, firefighters responded to a call after an American tourist fell down several steps in the village, blowing out his knee, and suffering lacerations to his face.

After 35 minutes waiting for an ambulance, the visitor's family put their father into their own car and drove him to the health care centre.

Puchmayr calls these incidents "deplorable."

"We want them (the government) to come clean and just admit that they have a shortage of paramedics, and they have a backlog in emergency wards and that's why they're not able to dispatch ambulances," said Puchmayr. "It has nothing to do with whether to go on lights and sirens or not. It has everything to do with the fact that they just do not have the paramedics to go to the calls, and as a government they're obligated to do that."

The District of Squamish is spearheading its own resolution on the issue. It is highlighting that "the delayed response leaves an expectation that first responders will attend patients until the British Columbia Ambulance service arrives, which downloads an additional cost for pre-hospital medical care to the community."

Squamish is asking that the UBCM work with the province to develop a funding mechanism that will compensate local governments providing pre-hospital medical assistance through the first-responder program for the additional costs of delayed response by BCAS.

Squamish Mayor Rob Kirkham said the ambulance situation is something that Squamish has been experiencing for a while, particularly with the upgraded highway through town.

"It's one more downloading from other levels of government to us in delaying their response times," he said. "What ends up (happening), of course, is we're left picking up the slack with our firefighters having to be on site, and be on site for longer periods of time and therefore not being available for other concerns that come up in our community."

It has a rippling effect he said — more resources, more volunteers, more recruitment campaigns, more training.

"All of that comes at the expense of the District of Squamish."

Kirkham could not say just how much it has cost the DOS this past year.

"I'm delighted to hear about it (coming up on the UBCM agenda)," said Lawther, who praised the professionalism and the care from the paramedics who did help her.

Last year in Whistler, the average response time to urgent calls was 13.37 minutes. BCAS responded to 739 urgent calls.

During the ski season, there is an average 303 emergencies and transfers per month from Whistler. During July and August that drops to 219 per month with the shoulder seasons averaging 138 per month.

During the five-month period from Oct. 2012 to March 2013, an ambulance based in Pemberton performed calls in the Whistler area (including transfers to the city), an average of 21 times per month, and from Squamish in that time period, an average of five times per month.

The current configuration during the day is one full-time unit and one on-call unit. At night, there is one crew on standby in the station and one on-call crew.

"Call volumes and trends are reviewed on a regular basis," said Carwithen.

But with the resort breaking room night records month after month, there is escalating concern that there are not enough paramedics to serve the area, and that wait times are deepening.

"It really does seem like unilateral decisions have been made by the province without consultation and they're having a downloading effect on urban communities and are putting rural communities at risk," said Wilhelm-Morden. "The ambulance service is just calling out for a review."

Blue Divider Line

Madame Premier,

The story below recently ran in a UK paper. It shows that (one of the 11) ambulance service providers in the UK is being fined over $2,000,000 CDN for NOT meeting the required ambulance response time of under 8 minutes 75% of the time!!!

FYI, the vast majority of BC has ambulance response times (if calculated in 90th percentile) of well over double that. Not even Metro Vancouver has 90th percentile response times of less than 8 minutes. The service provider being fined has over 4,000 full time staff with an additional 1,500 volunteers. They deal with over 910,000 call per year and handle more than 1,000,000 (one million) non-emergency patient journeys to and from routine hospital appointments. More info at http://www.eastamb.nhs.uk/about-us/area-profile.htm

This story highlights that other jurisdictions would never tolerate the kind of ambulance response times we have had for decades in BC!

Point-of-fact; and regardless of what anyone in the Ministry of Health / PHSA tells you, the Ministry of Health does NOT have to be in the EMS service provision business to provide a safe and efficient ambulance service here in BC (although all associated stakeholders in Victoria will insist that, that it is the only ‘safe way’ to provide such a service, that simply not true).

FYI, the vast majority of EMS service provision in North America and around the world is provided by non-government EMS service providers. In these jurisdictions, their state health authorities or separate Colleges , i.e. College of Paramedics etc. ensure proper ambulance personnel training, licensing and regulations. The proof of what I state is supported by the fact that you don’t hear CNN report horror stories each night on how US Fire Rescue Department provided EMS systems are causing people to die due to medical screw-ups etc. Point of fact, efficiency obsessed Germany, has virtually their entire prehospital care system provided by non profit service providers, i.e. like the Red Cross. Here in BC NOT allowing local Fire Rescue Departments to once again provide EMS service is absurd into the extreme and is directly contributing to the unnecessary deaths of hundreds of urgent care needs patients each year here.

BC has over 3,800 career fire fighters working for over 50 full time municipal fire departments, most of these firefighters are already ‘partially EMS trained’ and licensed (but only to first responder level). Furthermore, their salaries are already paid for by their local municipal employers, meaning they are an already paid for EMS resource, which, by the way, already response to most urgent code 3 EMS calls! At no additional cost to the provincial government / provincial taxpayers.

If the BC government were to do away with the stupid and deadly law that still prevents Fire Rescue Departments from both transporting patients and practicing beyond ‘first responder’ level of care, and; allowed them, once again, to hire and or train their personnel to (even just) at least ‘Basic life Support level’ (like 95% of all BCEHS ambulance attendants) and or simply allow them to hire some of the 2,000 plus part-time BCEHS attendants (to work full time for them), it would result in BC ‘starting to move toward best-possible-patient- outcome-EMS-system’ rather maintaining the ‘lowest-cost-per-patient-transported-system’ which we still have. BTW, our current system costs us all far more than we realized as it directly contributes, in many cases actually causes long term and permanent injury to patients.

Our ‘standalone EMS/ambulance system’ has proven (for decades now) to have inherent longer responses and transport to hospital times. By choosing NOT to allow Fire Rescue Departments to treat and transport patients we have a giant ‘duplication of resources’ in our communities and this is not only an unnecessary cost to British Columbians, it is directly contributing to unnecessary deaths of many completely salvageable / completely treatable condition patients in BC !!

If the BC government were to allow those municipal Fire Departments wishing to once again provide full spectrum EMS (and patient transport) back into the full spectrum EMS service provision field what that would mean for urban BC EMS response times; it would mean ambulance response in half the time currently seen! What’s more, it would also free up a significant number of BCEHS personnel which could be transferred to the most urgently ‘in-need rural BCEHS stations’, in other words, all areas of BC would benefit – which ironically, was and remains (apparently) the Raison d’être for our single service provider / province-wide ambulance service (which came as a result of the Dr Richard Foulkes recommendations to the royal commission back in 1974 under the Dave Barrett NDP government).

The facts are as follows:

1.) It was never a realistic (or even remotely achievable goal) “.... to provide a uniformly high standard of EMS care across for all British Columbians ...” as laid out by the Foulkes Commission Report and adopted by the Barrett NDP government in 1974. BC’s topography, extreme distances and low population densities (in areas) make such a goal impossible to achieve regardless of how much money is put into the ambulance service.

2.) Today, BC’s prehospital care/EMS system is grossly under-staffed, grossly under trained, and grossly underfunded and there is absolutely no question that many people in BC are dying from treatable but time sensitive conditions each year.

3.) The BC government must act immediately to amend the 40 year old (stupid and deadly) law to finally allow all able and willing EMS service providers to augment existing BCEHS crews wherever they can, this, to finally be able to meet North American benchmark ambulance response time of under 9 minutes for 90% of BC’s population.

The story below will give you (much needed) on what your bureaucrats tell you about how ‘no other ambulance services are meeting their benchmark response times’; the EU benchmark ambulance response time of 7 minutes, 59 seconds is federal law there! In fact, in countries like Holland and Germany, if it federal law that urgent care patients must be seen by a doctor (!) within 8 minutes, 75% of the time and within 15 minutes within 90% of the time. Again, that is federal law and you can see from the attached story below, they take this law seriously there. In parts of BC, the time it takes for an urgent care needs patient to be seen by a doctor can be measured in hours!

Sincerely, Hans Dysarsz


North Essex
Ambulance service fined after failing to reach life-threatening emergencies

First published Sunday 7 September 2014 in North Essex

The East of England Ambulance Service has been fined £1.2million over failures to reach three quarters of life-threatening emergencies within eight minutes.

The trust handles more than 900,000 emergency 999 calls a year in Essex, Suffolk, Norfolk, Cambridgeshire, Hertfordshire and Bedfordshire.

It has also been fined £300,000 over turnaround times at hospitals.

The new fines totalling £1.5million have built up over three months from April to July this year.

The ambulance trust must pay the £300,000 fine now and the £1.2million at the end of the financial year.

It serves 19 clinical commissioning groups (CCGs), the GP-led organisations in charge of local NHS budgets.

The fines will be distributed among the CCGs, according to the percentage of their payment to the ambulance service contract.

The lead commissioners are the Ipswich and East and West Suffolk Clinical Commissioning Group.

Dr Anthony Marsh took on the role of chief executive of East of England Ambulance Service in January.

A spokesman for the East of England Ambulance Service said it was working hard to turn around the ambulance service, such as recruiting hundreds of new frontline staff, bringing in new emergency ambulances and upskilling staff, while making £10million of savings.

Blue Divider Line

Is there enough mental health support for first responders?
Global News - July 17, 2014 - By Carmen Chai

TORONTO – As a paramedic responding to emergency calls, Jim Harris says he often saw people going through the “worst day of their life.”

The former frontline paramedic was on the job for two decades. First responders – police, paramedics, firefighters – come across violence, substance abuse, and severe health emergencies on a day-to-day basis.

“You have to go into situations that often times are some of the worst days of the individuals we’re treating. [First responders] are asked to do this daily, it can’t help but affect you over time,” Harris, now a manager of paramedic training programs at Lakeridge Health, told Global News.

In the past 10 weeks, 13 Canadian first responders reportedly killed themselves, according to Tema Conter Memorial Trust, an organization that promotes mental health awareness among Canada’s emergency workers.

Those who took their lives were a mix of police officers, paramedics and federal corrections officers.

Now, former frontline emergency responders and the organizations they represent say they aren’t surprised by these reports on the recent string of deaths.

They say that training in recognizing mental health issues is bare bones, and the resources aren’t sufficient.

Mental health support for first responders varies depending on where you live, according to Dwayne Forsman, who represents the Paramedic Association of Canada.

Toronto Emergency Medical Services – the largest EMS service in the country – is the only service that provides its frontline workers with a dedicated staff psychologist, for example.

Other health authorities filter their first responders in need to the regional mental health professionals, but they may not understand the intricacies involved with their line of work, Forsman said.

“You might go to a psychologist who really doesn’t understand what it is that you do. In our view, there needs to be dedicated staff – not simply on retainer – but attached to the service, who appreciates what goes on and is talking to people whether they need the help or not,” Forsman said.

He’s a former Winnipeg paramedic with over 37 years of experience in the field. During his training on the job, educators quickly skimmed over mental health issues that may come up. Pamphlets, business cards and counselling information was doled out. It wasn’t revisited again throughout Forsman’s tenure.

“It becomes one big glob of information, so these things tend to get lost in the conversation as you’re wide-eyed trying to take it all in. Then the expectation is that you just know where to go if something happens,” he said.

Even if education on mental health and coping mechanisms were built into the training curriculum, the experts wonder if new frontline workers would be interested in the information.

There are also EAPs (employee assistance programs), debrief teams and peer support groups, according to Harris.

With EAPs, employers enlist the help of a third party service so first responders can speak to counsellors anonymously about issues they may be dealing with. It doesn’t have to be about mental health either – staff can call about financial woes, marital issues or discuss a trauma they encountered that day.

With debrief teams, colleagues from various sectors are deployed to speak to you following an extreme incident.

That’s Harris’ concern – while there’s emphasis on care following a major shooting, a colleague’s death or injury or large emergency events, the daily buildup of stress is overlooked.

“There’s very little in place in most organizations to provide support or even acknowledge the cumulative stress issues. It’s that stress that’s affecting more people,” Harris said.

Dr. Jeff Morley, a registered psychologist and Tema mental health officer, says that in his practice, he typically comes across three issues first responders present with.

Some patients deal with primary trauma – when they’ve been physically assaulted or threatened, secondary trauma – when they’ve had to deal with unfixable trauma, and organizational stressors, which has to do with workplace harassment, bullying or feelings of betrayal.

Depression is the most common diagnosis for first responders, according to Morley. Addiction issues and sleep disorders follow.

Morley is a veteran RCMP officer with 23 years in the field in B.C. before he became a psychologist. Being acquainted with both worlds offers him a leg up when he’s treating patients.

“First responders are a very mistrusting group, and they’re hyper vigilant so they need to find a psychologist they can trust and know the culture,” he said.

What’s critical is resources that are delivered in a timely manner, he suggests.

Emotional responses are doled out in the moment, Morley explained. When your son scores a goal at the soccer game, you cheer. When your grandmother passes away, you cry. But first responders on the job at the most grisly scenes have to keep their composure.

“They have to go into work mode, which is fine, but to keep these folks healthy, you have to get that emotion out as soon as they leave that scene,” Morley suggested.

Instead, they’re whisked off to respond to the next call, and the trauma they encountered isn’t fully processed and addressed.

In Morley’s case, psychologists were readily available but his superiors knew who was going for treatment. He said that employees feared the stigma, wondered if their jobs were in jeopardy or if they’d have to take time off.

Toronto EMS says that it has “open conversations” with employees about their mental and physical health. It also provides support based on the latest, best practices, including access to a full-time psychologist, a service physician, peer support teams on call 24/7 and debrief teams.

“Toronto EMS takes a proactive, and therefore preventive approach, to health and wellness in all areas of our service, including the maintenance of mental health,” its superintendent of public information said in an email.

Durham Region police did not yet respond to comment.

There may be room for improvement, but the experts are certain first responders’ employers are on the right track.

When Harris began his career as a paramedic 30 years ago, there were expectations of being stoic.

“Nothing bothers you and we don’t talk about things, we make jokes about them and that’s how we deal with it. Many paramedics struggled throughout their career with issues because of stress buildup,” he told Global News.

Now, with mental health thrust into the forefront, it’s an issue organizations are forced to address. He suggests a cultural shift needs to happen in the profession, the same way mental health stigma needs to be shed in other parts of society.

carmen.chai "at" globalnews.ca

Blue Divider Line

Teen critically injured tubing
Castanet.net - by Bill Everitt | Story: 118222 - Jun 30, 2014


Photo: CTV - Vancouver - File photo

A teenager was transported to Kelowna General Hospital after suffering extensive injuries in a tubing accident on the weekend.

A teenager is in critical condition after a tubing accident on Okanagan Lake Saturday.

RCMP said a family and other friends were boating and tubing on Okanagan Lake when a teenage male fell off the tube.

The woman who was driving the boat circled to pick him up, but struck the teen in the water. The boy suffered multiple life-threatening injuries to his head, arms and legs from being hit by the propeller.

BC Ambulance confirmed that at 6:10 p.m. Saturday evening, air ambulance was called to transport a youth injured in a boating accident.

The helicopter landed near the intersection of Mary Anns Road and Westside Road near Vernon. The youth was transported to Kelowna General Hospital. He was listed as being in critical condition.

A witness who happened to be in the hospital at the time for a CT scan said she saw a boy on a blood-covered stretcher being wheeled past her. She was told that the boy had been boating with his father on Okanagan Lake when he was hit by the boat.

She said the boy had tourniquets on both arms to staunch heavy bleeding and was also wearing a cervical collar. A team of six emergency personnel were with him, including two that were carrying red coolers.

The boy was considered to be insufficiently stable for a CT scan and was being transferred back to emergency while she was there.

RCMP said that alcohol was not a factor in the incident.

More details to follow.

Blue Divider Line

May 30, 2014

The attachments speak for themselves. How many more stakeholders need to speak out on our broken ambulance system before our MLAs act on our behalf, before the minister decides to take control and finally fixes (this very fix-able) problem?

.pdf icon FCABC Pre-hospital Care Statement of Principles Final

.pdf icon FCABC Briefing Note Pre-hospital Care


Hans

PS: As you know, the 5 year old little Abbotsford girl did finally die of her injuries. FYI, in a state of the art EMS system, an EMS rescue helicopter would have had a ‘dual specialty’ doctor on the scene, within 7 to 9 minutes and depending on their ‘on-scene’ triage of the patient, would have had this little girl in (the only) level one pediatric trauma center in the province, BC Children’s, in under 30 minutes from the time the original 911 call was answered by E-Comm! BTW, that is also how it’s done in Alberta and has been for the last 28 years! How much longer will it take before the people of BC will finally get a system like theirs? Funny thing, it costs less to society than our chosen substandard EMS system as well!


PPS:

The BC Fire Chief Association and the Lower Mainland Local Government Association seem to be on the same page; that BC has a substandard EMS system and the provincial government is NOT acting to fix it.

From this year’s LMLGA meeting in Whistler a few weeks ago.

Where as the provincial Health Services Authority (PHSA) within the Ministry of Health made the unilateral decision to change service delivery for BC Ambulance Service (BCAS) has created an unprecedented downloading of costs and risk onto local government first responders;

And where as the October 2013 changes by BCAS to the Resource Allocation Plan (RAP) has created a negative impact on response time and patient safety:

Therefore be it resolved that the Province of BC develop an effective, well-integrated, patient-centered emergency response service for our citizens provided by fire and rescue services and BC Ambulance Service working together.

Blue Divider Line

Coroner’s report cites fatigue as factor in 2010 deaths of two paramedics
By Justin McElroy Global News

A coroner’s report cites fatigue as a “contributing factor” in the deaths of two paramedics whose ambulance fell off a cliff near Tofino in 2010.

Fifty nine-year-old Jo-Ann Fuller and 65-year-old Ivan Polivka died four years ago when their ambulance plunged into Kennedy Lake.

Cornorer Lyn Blenkinsop concluded that Fuller, who was driving at the time, was likely asleep at the wheel, while Polivka was likely sleeping on the gurney.

They were returning to Tofino after transferring a sedated psychiatric patient from Tofino General Hospital to West Coast General Hospital in Port Alberni.

The trip was an unscheduled shift in the middle of the night, and began five hours after they had finished a 8.5 hour-long shift.

Since the incident, BC Ambulance Services has committed to review scheduling issues arising from workers having long shifts with short breaks.

Blenkinsop makes no recommendations in her report.

Blue Divider Line

What you are about to read will show you what current ‘state of the art’ prehospital care is all about – and to be clear - BC has nothing even remotely close, consequently, prehospital critical care needs patients in BC continue to die from treatable conditions, including patients in our most densely populated areas.

I urge you to read every word of this story, this, so you too can come to understand what true first class EMS / prehospital care is all about – no matter what anyone associated with BCAS or PHSA tells you.

BTW, the population density (and total population numbers) of the Lower Mainland / southern Vancouver Island, more than justify several programs like featured in the story below. FYI, there are over 430 such HEMS programs operating all over Europe – some for over 45 years!! Many of their catchment areas have ‘population numbers’ as low as 500,000 (within 15 minutes flying time). The take away message is this: BC’s Lower mainland should have at least 4 similar programs to cover the south-western corner of the province. There should be at least three such programs strategically situated in the remaining areas of BC – where time from definitive care is a known and common killer (for far too many critical care needs patients).

The LAA model described below, could easily be amended / adapted to a BC application – just like in Alberta (where a similar program has been in constant operation for the last 28 years).

If you think there are insufficient critical care needs patients in BC to justify such programs, guess again, BCAS’ own numbers indicate 2% of all transports they do yearly are ‘urgent or critical care needs’, the actual numbers are likely more like other western jurisdictions, i.e. something between 5% and 7%. Given that the BCAS does over 400,000 transports each year, of which 235,000 used to be Code 3 (now reduced to 168,000, after the implementation last fall of the Resource Allocation Plan, RAP). It means that we are talking about a critical care needs patient number range of between 8,000 and 25,000 patients each year in BC. FYI, over 31,000 people die in BC each year, of that, over 7,500 die ‘outside of hospital’ (source: BC Coroner Service); as you can see, this is not a ‘small’ problem in BC.

Hans Dysarsz

=================

From the Spring 2014 issue of Vertical 911 magazine.

London Calling

Blue Divider Line

The LMLGA (Lower Mainland Local Government Assoc) passed the following May 2014 resolution:

Where as the provincial Health Services Authority (PHSA) within the Ministry of Health made the unilateral decision to change service delivery for BC Ambulance Service (BCAS) has created an unprecedented downloading of costs and risk onto local government first responders;

And where as the October 2013 changes by BCAS to the Resource Allocation Plan (RAP) has created a negative impact on response time and patient safety:

Therefore be it resolved that the Province of BC develop an effective, well-integrated, patient-centred emergency response service for our citizens provided by fire and rescue services and BC Ambulance Service working together.

Blue Divider Line

Ambulance response change ups costs, reduces safety: LMLGA
The Canadian Press - May 11, 2014

Surrey and Vancouver fire chiefs say patients are waiting too long for ambulances to arrive

Last October, the BCAS changed more than 70 services from Code 3 — requiring a lights and sirens response — to routine Code 2 responses so it can reach critical calls faster. Some of those services include fainting, falls, hemorrhage or miscarriage, and trauma injury. (CBC)

A group that represents 33 British Columbia local governments has passed resolution saying changes made by the B.C. Ambulance Service have created a negative impact on response time and patient safety.

The Lower Mainland Local Government Association, which represents local governments from Hope to Squamish passed the resolution critical of the unilateral decision to make the changes.

The resolution says the changes created an unprecedented downloading of costs and risks onto local government first responders.

The motion calls on the province to develop a patient-centred emergency response service for citizens provided by fire, rescue services and the B.C. Ambulance Service.

The B.C. Ambulance Service downgraded dozens of its response for dozens of calls last October, and has recently defended the changes saying patients' needs are being met.

But fire chiefs in both Surrey and Vancouver have complained that both patients and firefighters are waiting too long for ambulances to show up since the changes took effect.

Blue Divider Line

There has been much concern about BC’s prehospital care system of late; I feel it’s high time someone provided the actual facts of the matter.

No matter what any PHSA official tells us all, understand this fact: BC does not have a ‘best possible patient outcome prehospital care EMS system, BC has a ‘lowest cost per patient transported system’. We do not have a ‘patient first’ system we have a ‘service provider first’ EMS system.

‘Truth be known, BC has nothing even remotely close to a ‘first class’ EMS system, we have something between a 3rd and 4th class system. Here’s why: ‘first class’ EMS systems make widespread use of specially trained doctors in the prehospital setting. ‘Second class’ EMS systems make widespread use of Advanced Life Support paramedics (ALS). ‘Third class’ systems make widespread use of ‘full time’ Basic Life Support (BLS) ambulance attendants. ‘Fourth class’ EMS systems make-wide spread use of part-time and full-time BLS attendants. BC currently has 3,650 ambulance attendants, of that, over 2,000 are part-timer BLS attendants and only 5% of all BC ambulance attendants are ALS certified. BCAS does NOT use any doctors prehospital. First class international EMS systems report their ‘lights and Sirens’ (life and limb saving) responses in ‘90th percentile’ times, BC reports in 50th percentile (or average response times). While the layperson may not immediately see the difference between the two reporting systems, it is significant; 90th percentile times show the lapse time for the ambulance to ‘arrive’ on scene for 90% of the time, BC’s chosen reporting process shows the ‘average’ it took for an ambulance to arrive on scene, meaning BC ambulance code 3 times show the time it took for an ambulance to arrive on scene for only half the calls, meaning half the responses were longer than indicated.

Another fact that British Columbians will not be told by any PHSA officials is that in BC, prehospital care patients continue to die from highly treatable conditions, ones that have not routinely caused death in other first class EMS systems in literally decades. Most people don’t know that many heart attack deaths start as ‘time sensitive conditions’ and only result in death due to ‘excessive time delay to definitive treatment’. Same holds true for trauma, stroke, anaphylaxis, accidental drug overdose deaths. In fact, most trauma deaths are from blood loss; a highly treatable condition. Whereas other first class EMS systems have (either) doctors or (a very ratio of) ALS paramedics in the prehospital setting, we in BC have neither, so when anyone from PHSA tries to tell me that we have a ‘high level of EMS care’ in BC, ask them by what comparison! Fact is we have a ‘low level of prehospital care’ in BC (in comparison to international first class EMS jurisdictions).

Then you add in all the ‘turf protection laws’ we have in BC to protect our 40 year year-old ‘single service provider’ approach to EMS; did you know that it is illegal for the world’s largest ambulance service provider, the Red Cross, to operate even one ambulance in BC? Did you know it is illegal for any municipality in BC to operate even one ambulance in BC? Did you know that it is not possible for a working firefighter to practice beyond ‘first responder level’ (50 hours of training) when on the job, even if they hold a valid BC-issued ‘ALS licence’ (issued by the BC EMS Licensing Board, the same licensing board that licenses BCAS personnel)? Did you know that no elected official makes direct EMS service level decisions? Did you know that bureaucrats make life and death policy decisions in this regard? Did you know that not one ambulance in BC carries universal whole blood to treat (highly treatable) bleeding injuries? Did you know that only a handful of BCAS’ 500 ground ambulances carry clot busting drugs to better treat heart attacks and strokes? Did you know that BC does not have an independent prehospital care patient advocacy group? Did you know the there is no independent ‘critical incident investigation system’ in place to investigate ‘in care’ death at the BCAS? Did you know that the BC Coroner Service is not allowed to assign blame or to indicate that ‘cause of death’ was from a highly treatable condition or that ‘time delay to definitive treatment’ was the actual cause of death? I can go on but you get the picture.

Whenever I hear anyone from within the system tell me what a world class EMS system we BC, all I can think about is why we need laws to prohibit other (even proven and existing) emergency service providers from providing even an additional layer basic life support in their own communities in BC; why is it still illegal for firefighter to provide anything beyond first responder care, where in the US, the Fire Rescue provided EMS model is by far the largest / most effective EMS system used there (and they have over 315 million people in the US. Why are we reinventing the wheel in BC in this matter? So please Mr PHSA, tell me how our vastly inferior EMS system is better for our loved ones in their time of need? How does our chosen EMS system even save us all money? How does it result in shorter patient hospital stays, less long-term care, lower insurance payouts, less lost work time? Fact is, it doesn’t, fact is, our system needs a complete overhaul, fact is, ‘clinically salvageable patients’ die all the time in BC from highly treatable conditions, and the recently announced Resource Allocation Plan has take any remaining ‘erring on the side of caution’ out of our EMS system, and there is no question that it will cost lives. At the very least, patient pain management has taken a major cut due to the new time deals directly caused by the new RAP. BTW, did you know that shock can be trigged by relatively simple conditions, did you know that shock is known killer (for some patients)?

Finally, if you think this is only a small problem, one that only affects a small number of people in BC, guess again: on average over 31,000 people die each year here, of that, almost 8,000 patients die outside of hospital (each year), many hundreds, possibly thousands, die within minutes (or hours) of finally making it to a hospital. Think about that for a moment, then think about this: Trauma Services BC, a branch of the PHSA, estimates that trauma related deaths and injuries cost BC society circa $5 Billion (yes ‘Billion’) each year! Then understand this fact; there is no other sector of modern medicine in which more lives can be saved, more permanent injury can be prevented, than in the prehospital sector, yet in BC, prehospital care remains grossly underfunded, grossly understaffed and hugely misunderstood, not only by the public but by the very people we trust to look out for our best interests, our politicians.

WRT, the new RAP, ambulance response times will increase (considerably) for over 70,000 patients in BC per year, this, so that BCAS can cut ‘code 3’ ambulance response times, to the remaining 160,000 or so remaining Code 3 patients by an average 29 seconds! While I welcome any shorter response times, the fact of the matter is BCAS should have hired/trained additional staff to achieve better response times and not ‘Robbed Peter to pay Paul’. And this mess was initial launched under the guise or enhanced road safety and when the didn’t fly, the BCAS switched their approach to highly faster response times; sound to me like a desperate organization grasping at straws to make themselves look better without actually doing the right thing and spend more money.

How about fixing our ultra slow ambulance response time by making every single part-time ambulance attendant in BC FULL TIME! How about paying all ambulance attendants what they are worth, how about making it MUCH easier to for them to upgrade their medical qualifications, how about putting MORE ambulance stations into our communities, how about putting actual studded snow tires on ALL BC ambulances (instead of all season tire for most), how about having more than just 6, 4x4 ambulances province wide! (yes, BC only has 6, 4x4 ambulances out of 500!). How about allowing all those willing municipalities to cross utilize their existing firefighter resources to provide sooner, better care to their residents and ratepayers!?

The finally straw for me is that persons at PHSA are now trying to convince municipal councils to cut their existing code 3 response by their Fire Rescue departments to match the ‘cut responses’ by BCAS as well (!!) this because they (PHSA) officials feel that they (Fire Rescue) only really provide ‘comfort care’ anyway, and that (such a further cut) in EMS responses will NOT change patient outcomes! How would anyone at PHSA or BCAS know about patient outcomes, they don’t track patient outcomes in BC! They track patient outcomes in true first class EMS systems but not here in BC.

The above is only a short list of the many shortcomings of the BCAS ambulance service and BC prehospital care in general. Even a layperson can tell from the above that our EMS system is long outdated, grossly inadequate and highly dysfunctional, and it not difficult to see that our loved ones are paying a high price as a result.

If the above does not convince you of the fact that BC is decades behind other EMS systems, consider this; in Europe they perform emergency surgery right on the scene, including open heart surgery !! (but patients must be ‘pronounced / declared dead’ by the attending physicians before they open the chest – and they have a 17% revival rate with this procedure! See London’s Air Ambulance on the net for more details). This level of care has been common in Europe for over 40 years, but not here.

Finally, consider this; if they came up with a cure for cancer (etc) in Europe, how long do you think it would take for that knowhow to be adopted here, months, perhaps a year, two years tops, well the Europeans developed a prehospital care system over 40 years ago that yields vastly lower mortality and morbidity rates; and get this; European heath care systems have over all better patient outcomes for lower patient cost that we do! So why are we still doing what we are doing, why is our chosen, proven outdated, EMS system being so zealously guarded by a handful of PHSA officials? Someone please tell me how our chosen EMS system is better for my loved ones!

I know better, having lived and worked in Europe.

Hans Dysarsz

Blue Divider Line

Below is a Hansard transcript copy of a recent Public Affairs Committee meeting on the state of air ambulance in BC; it is less than flattering. If the BCAS can’t properly manage their only 10 aircraft around the province or track patient outcomes for these 10 aircraft transported patients, I can only imagine the state of affairs for BC’s 550 ground vehicles, 500 of which are ambulances.

As a caring and informed MLA, I suggest you take the time to read the attached transcript.

One of the (many) things I found disturbing when reading the transcript was the fact that neither the Chair of the PHSA, Wynne Powell, nor the Chair of the BCEHS, could find the time to appear before this most important Public Affairs committee, this, to directly answers questions to the ‘committee of elected officials’.

As it stand still today, BC has unelected officials making life and death ‘policy decisions’ in BC; that is utterly unacceptable in my view. Even municipal councillors have a say in how many police and firefighters they have in their communities yet they have NO say in how many ambulances they have (or the level of training of ambulance attendants they have) for their residents, constituents, friends and family. In fact, even you as an elected MLA, have direct NO say in the level of prehospital care your constituents get; I also find that unacceptable. WE the (provincial) taxpayers (and municipal rate payers) pay for these emergency service, yet we do not have a direct say in the level of EMS care we get via our elected officials, which could be held accountable if necessary.

H Dysarsz



72 minutes
Alaska Highway News - March 20, 2014

Ambulance wait in Feb. incident the last straw for Northern Rockies

Photo Caption: Ambulances are shown in Fort Nelson. The Northern Rockies region is larger than Austria, with a population of about 5,300, served by two on-call ambulances, with one on-duty and 13 on-call paramedic staff.
Courtesy photo Matt Lamers

Seventy-two minutes. That’s how long it took BC Ambulance Service to arrive on the scene of a three-vehicle crash that closed the Alaska Highway near Fort Nelson on Feb. 19, and left one of the drivers seriously injured.

The Northern Rockies Regional Municipality calls the lengthy delay “unacceptable.” Mayor Bill Streeper claims that it is not an isolated incident.

“It is strictly a pattern of neglect,” he said. “We’re going back to the ministers on this to tell them that it is unacceptable, that we would like [them] to investigate this and let us know ... what the B.C. government plans to do with our ambulance service.”

But that’s not enough for some in the NRRM, who want to take matters into their own hands.

At a recent council meeting, Kim Eglinski and Danny Soles put a motion forward to advise Premier Christy Clark that the municipality “is seeking innovative solutions to years of unacceptable service levels with BC Ambulance,” and proposing to amalgamate emergency ambulance response within the municipality’s fire department.

That letter was delivered this week to Clark, Minister of Health Terry Lake, Peace River North MLA Pat Pimm, the municipality's MP Bob Zimmer and BC Ambulance Service.

Heather Cobbett, the municipality’s deputy chief administration officer, said the letter reiterates the same information that has been relayed to the province and BC Ambulance over the past decade, “and the countless numbers of times that their services has been unacceptable for the citizens.”

Their complaint does have an extended history, and not just for the Northern Rockies. The issue was raised with the province at least as recently as September 2013’s Union of B.C. Municipalities Convention.

However, this time, Streeper said he hopes the letter illustrates the fact that changes have to be made to accommodate better ambulance service in the north of the province.

“We will not just sit around and keep accepting this below-standard service that they keep giving to us, and it goes right up to the highest management,” he added. “They seem to not care at all about the north.”

Northern Rockies Regional Municipality is an enormous, 85,000 square-kilometre piece of land that covers 10 per cent of the province. It’s larger than Austria or the United Arab Emirates, or closer to home, about 40 times the area of metro Vancouver.

According to government records, BC Ambulance is supposed to service the area with two on-call ambulances, 13 staff on pagers and one full-time paramedic.

“It’s not just about the people of Fort Nelson,” said Eglinski. “It’s about the NRRM as a whole, which includes Toad River, Muncho Lake, our First Nations communities and so on.

“It’s also about the travelling public on the Alaska Highway. BCAS has an enormous area to cover – they need to provide adequate resources to their paramedics in order to get the job done.

"Delays in BCAS response times could be the difference between life and death for some patients, and that is unacceptable.”

When the call mentioned at the beginning of this story went out at 8:44 a.m. on Feb. 19, only one ambulance was available, BCAS confirmed, but it was already involved in another transport.

Fort Nelson Fire Rescue personnel were at the scene 18 minutes after the call went out to provide treatment for a patient. However, liability issues meant they were not permitted to transport the patient. The ambulance arrived on the scene 54 minutes after that.

BCAS said “staffing challenges” prevented its other ambulance from entering service that day, adding that a fixed-wing airplane was immediately launched to Fort Nelson.

“BCAS regrets that we were unable to staff both ambulances in Fort Nelson on Feb. 19,” said a spokesperson.

BCAS said it has recruited three staff in Fort Nelson, one a paramedic unit chief, within the last month. “This unit chief will continue targeted recruitment efforts to identify other potential staff from within the community,” the spokesperson added.

At issue, said Eglinski, is the system, not the ambulance attendants, for whose service she expressed gratitude.

“The status quo is not good enough. BCAS has failed to recognize that their paramedics are not paid fairly, they are overworked and they can't survive by simply being a paramedic alone,” she said. “This is the biggest factor in their failed attempts to recruit and retain paramedics to this community.

Streeper agrees that pay is part of the problem.

“Some of the plans they’ve sent us have been completely ridiculous. At one point, they said they would hire first aid people from the oil patch to work for BC Ambulance when they’re on their time off,” he said. “You want them to work for one-third what they’re making in the oil patch? They’re not going to do it. Nobody would work for their terms.”

So calls are growing within the municipality for the BCAS to contract out its services to the local fire department. The city envisions a combined ambulance and fire service, similar to a model already in place in Kitimat, officials said.

“Essentially, we want improved services for the region, and we see amalgamation as one way to achieve that,” Cobbett said. “The service [currently] provided is marginal at best.”

Combining the roles of BC Ambulance with the fire department is not a new idea for this part of the province. Cobbett said the town has made the request at least a dozen times.

When reached by the Alaska Highway News, Kitimat fire chief Trent Bossence couldn’t comment on whether or not his system would work in Northeast B.C. as well as it does in Kitimat.

It’s always nice to have one agency under one roof. We receive a call and we go there. It’s not going to multiple agencies,” he said. “So a 911 call comes to us, whether it’s fire or ambulance, it’s coming to the same place. It simplifies the response in that sense.”

For decades, Bossence said, the fire department has been contracted by BC Ambulance to provide the service.

“For us, it’s a matter of having fire and ambulance on the scene at the same time, doing the same work. We’re under the same roof, so we do the same training,” Bossence added. “There is no separation from who’s who. We’re all one. We’re all paramedic trained.”

Eglinski said it simply is not efficient for communities like NRRM to have separate fire and ambulance services, where standby costs are high and secondary jobs for paramedics are harder to come by. She said she wants paramedics and firefighters working side by side.

“I envision paramedics actually being paid what they are worth,” she added.

“We are home to the largest shale gas reserves in Canada – citizens, business, and industry in our community deserve a reasonable level of ambulance service, and we are not getting that now.

Streeper said he feels like BC Ambulance is turning its back to his community.

“We keep getting reassured by the ambulance people in Victoria that they’re going to fix the situation, but at no avail. We fully believe that they’re turning their back to us, and think it’s going to fix itself, but it keeps getting worse,” he said.

“You can’t say, ‘We’re looking for people.’ – are people supposed to die because of an accident when you’re looking? You have a problem and somebody should fix it. They’ve been told this long enough.”

=======================

REPORT OF PROCEEDINGS
(Hansard Blues)

Select Standing Committee on
PUBLIC ACCOUNTS

WEDNESDAY, MARCH 12, 2014

http://www.leg.bc.ca/cmt/40thparl/session-2/pac/hansard/20140312am-PublicAccounts-Blues.htm

Blue Divider Line

FYI, The issues outlined in this story are happening in every community in BC, and BC patients are paying the price.
Sincerely, H Dysarsz

Fire chief, council irked by ambulance service impact on Burnaby
Stefania Seccia / Burnaby Now - March 12, 2014

The Burnaby Fire Department's fire chief says it's experienced longer waiting periods since the B.C. Ambulance Service changed 74 services from code three to code two last October. It switched the services from a lights and sirens response to a routine call. Photograph by: File/BURNABY NOW

A pregnant woman in her first or second trimester who is hemorrhaging or having just miscarried and called 911 is one of the 74 services that has been downgraded from a "hot" to "cold" response by the B.C. Ambulance Service.

The Burnaby Fire Department recently released a report outlining how the changes impacted its work for the first three-and-a-half months, which overall led to longer wait times for ambulances by firefighters.

Last October, the B.C. Ambulance Service changed 74 services from code three to code two in its resource allocation plan. The switch changes the response from lights and sirens to routine calls.

"Firsthand experience of (fire department) personnel has shown that the new (resource allocation plan) has resulted in delayed ambulance response to medical incidents in Burnaby," Doug McDonald, Burnaby's fire chief, said in his report.

For the first three months, firefighters experienced an average nine-minute wait for an ambulance to arrive, the number of incidents where firefighters had to wait more than 30 minutes doubled, and in six incidents they had to wait more than one hour.

"Staff are of the opinion that the changes made on the basis of clinical and statistical data have ignored the important needs of immediate scene assessment and stabilization, as well as patient conditions and status updates at the scene if the event is escalated to more serious than reported or as classified by a call taker," McDonald said. "The delayed ambulance response also requires the (department's) resources to stay at the scene longer and potentially could impact the (department's) ability to respond to other emergencies in a timely manner."

Despite the fire chief's findings, Kelsie Carwithen, spokesperson for the B.C. Emergency Health Services, said since the plan was implemented, paramedics are getting to urgent calls faster and the response time to routine calls is about six minutes longer.

"We found that the six additional minutes for routine calls did not have a negative impact on the patient's condition," she told the NOW.

Carwithen said the changes are not about reducing costs, but using resources "smarter."

"It's important that we make the best use of taxpayer funds while continuing to provide quality care," she said. "It's important that we provide the best patient care we can on each and every call. Resources are being used as effectively as possible and emergency vehicles aren't driving with lights and siren if it isn't required."

In a letter to council, Wynne Powell, board chair of B.C. Emergency Health Services, wrote that most B.C. fire departments decided to match the ambulance service's response.

However, the B.C. Fire Chiefs Association polled its membership regarding matching the ambulance service's plan, and 78 per cent reported they had not changed their level of response for incident types from code three to two.

"In addition, about 48 per cent of the cities polled had experienced increased wait times for an ambulance's arrival," McDonald said.

Councillors expressed their frustrations to the service change's impacts at the council meeting on March 10 as outlined in McDonald's report.

Coun. Paul McDonell said it's another example of the province downloading service to municipalities.

"This is the start of privatizing some of the ambulance service," he added. "This is just the government's way of saying there's more balance in the books and more balance in the budget, and down the torpedoes."

Jordan said the city will not be receiving the report in which the basis of the changes were made it had asked for last fall because "there isn't one."

"Let's face it, this is a mess, and it's a very serious mess," she said. "It's impacted people's lives.

"I'm disgusted by what's being done ... . Those resource decisions are being made in the interests of the bottom line and not in the interests of the citizens, and we're not going to go in that direction."

Mayor Derek Corrigan said Burnaby has chosen not to reduce its responses in line with ambulance service.

Council requested a meeting with Powell to discuss the changes to the ambulance service.

Snapshot of ambulance services downgraded to level two:

- Pregnancy: first and second trimester hemorrhage or miscarriage

- Fainting: female with abdominal pain

- Falls and Trauma injury: serious hemorrhage

- Hemorrhage: possibly dangerous hemorrhage

- Electrocution: unknown status, lightning

- Falls: serious hemorrhage, jumper

- Allergy/sting: unknown status

Blue Divider Line

FYI, this letter to the editor, by someone that identifies themselves as a ‘working BC Ambulance Service paramedic’ speaks volumes.

There is no question that BC ambulance attendants are over-worked / under paid and significantly undertrained and have far too many part-timers. Allowing, once again, all (interested / willing) municipal fire rescue departments to either augment or take over entirely, ambulance services in their communities, would mean British Columbians would get better patient outcomes and at lower cost to both our health care system as well as to our society as a whole. Why; because fire rescue personnel almost always get to patients (much) sooner than BCAS personnel, and in critical care needs patients cases, seconds can make the difference between not only permanent injury / long hospital stays / long term care, but indeed life and death.

H. Dysarsz

==============================

Paramedics need help to help patients
Comox Valley Record - Mar 3, 2014

Dear editor,

I am a paramedic working for the BC Ambulance Service.

For fear of disciplinary action I must remain anonymous, as our employer has gag orders on us to not speak to the media about the state of the ambulance service.

I, like most paramedics, am passionate about my work. We have to be, due to lack of respect from our employer and the government.

One does not do this job for the money you do it because you love the work. It's because of this that our employer takes advantage of us daily.

People in B.C. need to know the state which their ambulance service is in. Currently, our upper management is embroiled in a sex scandal, which involves the promotion of some employees.

Our lower-level management have no proper training, care little about the paramedics on the street and manage through threat and intimidation.

We work under constant threat from fire departments wanting to take us over so they can justify their enormous budgets, as their budget is based on call volume and due to fire safety, their calls have dropped. A provincial ambulance has been proven to be the most cost-effective.

Our resources are at an abysmal level. Daily there are no ambulances available to respond to calls and people are forced to wait long periods of time for one to show up.

We get told by our management to just do more with less. Well, we can't do anymore.

We work 12-hour shifts and with our call volume rising by thousands every year, we have no down time. We start our shifts, leave the station and rarely ever get back till the end of the shift.

We do not get any breaks due to us being an emergency service. As long as there are calls holding we work and there are always calls holding.

Our resources on the street have remained at an almost stagnant level for the past 10 to 12 years, call volume goes up by thousands every year, and the only thing that has really changed is our ranks in management almost being tripled.

Our management has done nothing but create an atmosphere of fear as well as created a very hostile and unsafe work environment. Our employer is concerned with nothing but budget and liability, NOT patient care

At all hours of the day and night we respond to your (the public) calls, whether it be your home, work, the streets and all places in between. We do show up, we do care, but we are also tired and burning out at an alarming rate.

Do not think that while you wait for an ambulance that is taking a long time to show that we are having lunch or coffee or on a break of any kind, it's just that there no ambulances available to respond.

We come to your aid daily, we are now asking for your help. We need more resources, not more managers.

I ask you, the public, to get on social media, write letters to your city council, your MLA, to the premier. This is your ambulance service. You deserve better service and should not have to wait when you or a loved one is in need of help.

If this letter is printed, my employers' response will be one of denial, of course. It's embarrassing to them and to admit there is a problem means they must fix it.

We, the paramedics, have no power to make a change. Our hands and mouths are tied and gagged and the power is yours to make a difference. We have come to your aid in your time of need for years, now we are asking for your help.

Please, help us in order for us to better help you.

A concerned paramedic

Blue Divider Line

FYI,

Starting this March, Haiti, the poorest country in the Americas and one of the poorest countries in the world, is getting two, dedicated, Bell 407 EMS (HEMS) helicopters!

Yet BC, one of the richest provinces, in one of the richest countries, still doesn’t have any ‘dedicated EMS helicopters’ for the vast majority of our province.

Shame on BC Health, shame on the Provincial Health Services Authority, shame on the BC Ambulance Service!

===============

Haiti: Poverty Profile

Overview

According to the Haiti Living Conditions Survey[1] conducted in 2001 by L’Institut Haïtien de Statistique et d’Informatique (IHSI), three quarters of the Haitian population are poor and over half, or approximately four and a half million people, are extremely poor. Poor is defined as living on less than $2 USD per day per person; extremely poor is defined as living on less that $1 USD per day per person. Haiti is infamously known as the poorest country in Latin America, and its socio-economic indicators are comparable to some of the poorest African countries. Haiti is far from alone in its struggle. Approximately 1.2 billion people around the world live on less than $1 USD per day (New Global Agenda, 2001).


click page for a larger copy

Blue Divider Line

There were 235,000 ‘code 3’ responses last year in 2012.  By cutting them by 29%, it will mean 68,000 patients will get slower responses.

http://globalnews.ca/news/939329/a-look-at-changes-made-to-bc-ambulance-response-to-some-emergencies/

Many will die as a result, and many will sustain permanent injury.

Blue Divider Line

Burnaby council outraged over ambulance service change
Stefania Seccia / Burnaby Now - November 12, 2013

B.C. Emergency Health Services spokesperson says the changes will increase routine calls made by ambulances

Burnaby council is concerned over changes made to the B.C. Ambulance Service's resource allocation plan that would put firefighters out. Photograph by: File

City council is concerned what the backlash will be following an ambulance service shift in responding to different emergency calls.

At its last meeting, Burnaby council rang the alarm over protocol changes to B.C. Ambulance Service's resource allocation plan announced in late October.

The major change is that more calls have been designated as routine and medically do not require a lights-and-siren response or first responder assistance. But ambulances will still attend every call.

"Seventy different services that were previously code three, that's lights and sirens and ambulance get there right now, have now been downgraded to code two, which is referred to as a cold response," said Coun. Colleen Jordan.

Calls for a suspected aortic aneurysm and abdominal pain are now considered code two, according to a report from Burnaby's fire chief Doug McDonald.

"So 75 of those (services) have been downgraded, and so the ambulance service doesn't have to go there, zoom, fast, lights and sirens, but the fire still does," she noted. "Our people have to go. In speaking with the (fire) chief ... we already have some of our fire (services) sitting at a call waiting for an ambulance for more than an hour."

Jordan noted that while the firefighters are waiting for an ambulance they may be missing other important emergency calls.

"This is a horrible mess," she added. "We'll have to start tracking and making sure we have a log of what implications this is causing for the fire service, if it's already starting to impact us and then have some kind of report from staff on what the implication can be.

"I'm really frightened what it means for us as a city, but also what it means for people who want care."

Coun. Paul McDonell, a former deputy fire chief, said the decision "came out of the blue." He agreed that it will impact the city's fire service.

"There's also a statement made by the B.C. Ambulance Service that this will save them 30 per cent on their budget," he added. "So, follow the money. What they're doing is they're going to balance this budget, the provincial budget, and the cuts are coming. This is just the first wave of them in health care."

With the flu season coming up, McDonell said ambulance calls will heavily increase in the next few months and that will "compound" the issue.

"They'll balance the budget on the back of the people," he added. "You can see the impact it'll have on us for providing the other service, which is firefighting. That's why they're firefighters."

Mayor Derek Corrigan said he was also concerned over the potential for people in crisis to be left waiting.

"If the provincial government wants to talk about efficiency and wants to work with us ... the door is always open," he said. "But this isn't a matter of anyone having a discussion with us."

But the changes are meant to increase the number of routine calls, according to B.C. Emergency Health Services spokesperson Kelsie Carwithen.

"It is very important to note that we will not be making changes to first responder notification ... without further consultation with first responders over the next month," she said in an email to the NOW.

The decision to change the resource allocation plan came out of a review that happens regularly, and changes are based on medical evidence. In this case, physicians and a working group reviewed 630,000 patient records.

"The review showed that it is not medically necessary (and therefore not an effective use of their resources and portion of the municipal budget) for first responders to attend some calls as in the past," she said. "However, they will still be providing other non-medical services like extraction and jaws of life, etc."

Carwithen stressed that the decision is not a cost-saving measure because an ambulance will still attend every call.

"This is simply a way to ensure that we are keeping the public, patients, paramedics safe by reducing the mode of the response. (For example), code three response (driving fast) versus routine (driving the speed limit)."

Any further changes to the plan will not be done without consultation, Carwithen noted.

"Some local governments only wish to provide assistance to paramedics when clinically required, while others wish to respond to a greater number of calls (even if not medically required)," she said. "I understand Burnaby may be one of these municipalities. Is this a good use of their budget, to attend when it is not medically necessary?"

In the coming months, the B.C. Ambulance Service is expected to change the first responder component to the resource allocation plan "in order to ensure first responder resources are being used appropriately as part of B.C.'s emergency medical service system," Carwithen added.

Blue Divider Line

From: Westsider
Sent: October 24, 2013 1:43 PM
To: BC Minister of Health Terry Lake and Minister of Transportation Todd Stone and Interior Health
Subject: Contact Us

To BC Minister of Health Terry Lake and Minister of Transportation Todd Stone and Interior Health:

I have four questions:

1). How is our chosen prehospital care system better for our critical care needs loved ones, than the (widely) internationally used Franco-German EMS system? (in use worldwide for over 60 years)

2). Has a ‘universal cost benefit analysis’, of our chosen prehospital care system, ever been carried out in order to ensure BC taxpayers are actually getting maximum value for our limited healthcare dollars?

3). Is the BCAS’ mission to provide: ‘best possible patient outcomes’, or; achieve ‘lowest cost per patient transported’?

4). Do the ambulances serving my area have these automatic chains, if not then why not?

I believe that the Minister of Transportation and Minister of Health should do what they can to keep the roads safe for all people and especially the ambulances and other emergency vehicles, because it is imperative that a stroke patient or heart attack victim arrive at hospital in a timely manner.

A few years ago an ambulance got stuck in my subdivision due to deep snow, and so a helicopter had to be brought in to transport a stroke patient living 45 minutes drive either to Kelowna or Vernon out Westside Road near Fintry Provincial Park. I live there too and I hope that if I have a heart attack one day, that it won't take hours to get to the hospital. I have heard about automatic chains on ambulances, do the ambulances serving my area have these automatic chains? Why did the ambulance get stuck to begin with?

From what I understand there are people dying because of slow response times to emergencies. Did Taylor Van Diest from Armstrong die due to a slow response time? If this is true like I think it is, then please fix the system to work like other successful systems in the world better than ours.... ours looks like one of the worst to me.

I wanted to attach two photos of the ambulance on Firwood Road after people pushed the ambulance to get it unstuck from the snow, with the helicopter at my subdivision landed waiting for transportation of the patient but I couldn't find your email address and could only use this form email which I dislike. The fire rescue guys carried the patient on a stretcher to the helicopter.

Thank you
Westsider

==================

Dear Westsider,

Thank you for your email of October 24th enquiring about the pre-hospital care system and advocating for ambulance services within the province.

Interior Health strives to provide timely and high quality care, and feedback such as yours is important to us. Although Interior Health does not have decision making authority over provincial services, we appreciate you copying us on your correspondence. British Columbia Ambulance Services are managed by BC Emergency Health Services http://www.health.gov.bc.ca/ehsc/

Regards,
Norman Embree, Board Chair
Interior Health

Marlis Gauvin • Board Resource Officer • Board of Directors • Interior Health Authority
Kirschner Plaza, 220 - 1815 Kirschner Road, Kelowna, BC V1Y 4N7
Office: 250.862.4005 • IH Quick Dial: 8+100+4005 • Fax: 250.862.4201 • marlis.gauvin "at" interiorhealth.ca

Blue Divider Line

WRT, the state of our prehospital care system in BC; can you please ask someone in charge at the BCAS / PHSA / BC Health / Terry Lake, Minister, these three questions:

1). How is our chosen prehospital care system better for our critical care needs loved ones, than the (widely) internationally used Franco-German EMS system? (in use worldwide for over 60 years)

2). Has a ‘universal cost benefit analysis’, of our chosen prehospital care system, ever been carried out in order to ensure BC taxpayers are actually getting maximum value for our limited healthcare dollars?

3). Is the BCAS’ mission to provide: ‘best possible patient outcomes’, or; achieve ‘lowest cost per patient transported’?

Surely someone at BC health should be able to give you three straight answers to these three simple questions.

H. Dysarsz

==========

BC Health
Minister's Office
Honourable Terry Lake
Minister of Health
Room 337, Parliament Buildings
Victoria, BC V8V 1X4
Phone: 250 953-3547
Fax: 250 356-9587
E-mail: hlth.minister@gov.bc.ca

Minister of Health Terry Lake - hlth.minister@gov.bc.ca
PO Box 9050
Stn Prov. Gov.
Victoria, BC
V8W-9E2
Telephone: 250 953-3547
Fax: 250 356-9587

MLA Terry Lake - terry.lake.mla@leg.bc.ca

BC Ambulance Service

Provincial Health Authority is Interior Health for those in the Interior

Interior Health Authority 220 - 1815 Kirschner Road
Kelowna, B.C. V1Y 4N7
Phone: (250) 862-4200
Fax: (250) 862-4201
Board Chair: Norman Embree
President and Chief Executive Officer: Dr. Robert Halpenny

Minister of Transportation
Honourable Todd Stone
PO Box 9055 Stn Prov Govt
Victoria BC V8W 9E2
Telephone: 250 387-1978
Fax: 250 356-2290
Minister.Transportation@gov.bc.ca

Blue Divider Line

BC's Air Ambulance Service:

The contents are in German, but you can use ‘Google Translate’ to get the gist of the message.

The many pictures will speak volumes to you. All indicated programs that are NOT ‘military’ supplied/operated air ambulances, are ‘non profit service provider’ operated.

http://www.rth.info/stationen.db/stationen.php


Once at the site, simply click on the helicopter ‘call sign’ (Rufname) and you will be taken to that aircraft’s operating base.

At each ‘Aircraft Base site’, you will see base-specific data including pictures (at least 4 pics per base per location) and these pictures speak volumes on their own.

Only Germany, Austria, France, Holland and Luxembourg bases are shown but understand that there are many more in this system than shown, in fact, there are literally hundreds more in Western Europe (just like the ones shown) – all are doctor-staffed and not one of these programs operate S76 helicopters (any model) like we do in BC. Care to guess why?


Please note:

All helicopters which bear the ‘DRF Luftrettung’ name belong to a nonprofit organization which was started over 40 years ago by an average German family; Siegfried and Ute Steiger, started both the German equivalent of our 911 system as well as the indicated air ambulance system due to the tragic and preventable death of their 8 year-old, Bjorn. Bjorn Steiger was hit by a car on his way home from a local swimming pool, he sustained only a broken leg (and lost tooth) but due to the low EMS service level (like in rural BC) provided by the German EMS of the day (in 1969) it took the ambulance an hour to respond; Bjorn consequently died from Shock (!!) - a 100% treatable condition. This sort of unnecessary death still occurs in BC on a regular basis throughout the province but nowhere more so that in rural BC.

Over 40 years later, DRF Luftrettung (alone) have flown 700,000 missions flown to-date (out of the circa 2,000,000 or about 1/3 of all EMS helicopter flights in Germany since 1970). DRF today operates 50 state-of-the-art EMS helicopters operating from 28 bases in three countries; quite literally, the Steiger family’s involvement in this issue directly resulted in the saving of hundreds of thousands of lives, as well as prevented (or mitigated) hundreds of thousands of permanent injuries in this time. Today, DRF Luftrettung is one of the two largest nonprofit EMS air ambulance operations in Germany (and the world, the other one in Germany is even larger: the ADAC). For more information on the Bjorn Steiger Foundation which helps to pay for the DRF air ambulance system, please click on the link: http://de.wikipedia.org/wiki/Björn-Steiger-Stiftung (you can use ‘Google translate’ to get the gist of the information).

Again, and to be crystal clear: there is no other sector of BC medicine whereby just moving our EMS system to use ‘proven best (EMS) practices’ could, would make such a profound difference in saving so many additional lives in BC each year.

If you still don’t believe me of the merits of using nonprofit operated, doctor-staffed, rapid response EMS helicopters, please contact Premier Brad Wall’s office and ask them why he personally initiated bringing nonprofit air ambulance EMS to Saskatchewan – it was certainly NOT at the ongoing insistence of Sask Health bureaucrats! Same goes for Premier Greg Salinger of Manitoba and of course Premier Redford of Alberta.

If the BC Liberal government were to embrace this initiative, you would reap significant benefits in the next election, again, nowhere more so than rural BC, the traditional NDP base lands.

‘Notarzt’ means emergency doctor in German, you will see that on the EMS helicopters as they all carry emergency doctors, most in Germany operate with ‘dual specialty’ emergency doctors.

Here is a 5 minute video (in English) on a UK rendition of what they do in Europe; London’s air ambulance has been providing this high level of service for over 25 years. There are over 25 such programs in the UK

http://www.londonsairambulance.co.uk/about-us


Air ambulance service lacks goals, monitoring: B.C. auditor general

Major problems in air ambulance service: report

http://bc.ctvnews.ca/polopoly_fs/1.1206305!/httpImage/image.jpg_gen/derivatives/landscape_150/image.jpg

B.C.’s Auditor General has found problems in planning and service records in the province’s air ambulance service.
Cara McKenna, The Canadian Press
Published Thursday, Mar. 21, 2013

VICTORIA -- British Columbia's air ambulance provider seems to have its head in the clouds when it comes to tracking its own performance and looking for ways to improve, findings the auditor general warns could be putting patients at risk.

John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.

"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.
Photos

Air ambulance

An air ambulance lands down in this CTV News file photo.

Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.

It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.

It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.

"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."

The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.

After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."

It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.

Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.

"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.

He said it aims to develop concrete service standards and improve data collection.

During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.


Air ambulances not doing enough to improve service, says B.C. auditor general
globaltvbc.com - Thursday, March 21, 2013

British Columbia's air ambulance provider seems to have its head in the clouds when it comes to tracking its own performance and looking for ways to improve, findings the auditor general warns could be putting patients at risk.

John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.

"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.

Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.

It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.

It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.

"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."

The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.

After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."

It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.

Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.

"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.

He said it aims to develop concrete service standards and improve data collection.

During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.

— By Cara McKenna in Vancouver

© The Canadian Press, 2013


Read it on Global News: Global BC | Air ambulances not doing enough to improve service, says B.C. auditor general

Blue Divider Line

Please speak to your MLA about the lack in BC's Air Ambulance System

MLA Finder http://www.leg.bc.ca/mla/3-1-1.htm

Blue Divider Line

Approx. Feb. 2008 during a time when Firwood Road at Valley of the Sun was not plowed and the snow was piled high, someone had a stroke.  The ambulance got stuck in the unplowed paved road and people were out trying to push the ambulance to get it unstuck.  A helicopter was brought in to rescue the stoke patient.  This was at Valley of the Sun along Westside Road, Kelowna B.C.  These are the same photos that were posted on the North Westside Fire Rescue's website at one time.  The air ambulance helicopter is not an air ambulance Hans Dysarsz told us.

Did you know there is such a thing as automatic chains now?  There was no reason this ambulance would have gotten stuck if it was 4 wheel drive and/or had automatic chains.

A reporter is going to do some stories about our Ambulance Service.  If there is anyone that has a story please send us your name and contact information using this form, and we will pass your name and contact information on to the unnamed reporter.

September 20, 2013


North Westside Road Fire Rescue transporting the patient from the Ambulance to the helicopter, which by the way was NOT an air ambulance helicopter.

 

Blue Divider Line

Kootenay’s fastest ambulances found in Creston
By Greg Nesteroff - Nelson Star - September 30, 2013

Nelson lagged behind Creston, Cranbrook, and Castlegar in ambulance response times in 2012, but was still faster than Trail.

If you have a medical emergency in the Kootenays, it’s best to be in Creston, judging by statistics from the BC Ambulance Service.

In 2012, Creston’s average response time to Code 3 calls — requiring lights and sirens — was nine minutes and 20 seconds, better than Cranbrook (10:01), Nelson (11:06), Castlegar (10:42), Trail (11:16), or Grand Forks (12:30).

However, all were slower than the nine-minute standard suggested by the US Commission on Accreditation of Ambulance Services, a benchmark reached by only ten communities in the province last year.

Creston also posted the fastest times in the region in 2010 and 2011. The slowest response times in West Kootenay/Boundary last year were in Christina Lake (27:05), Rock Creek (26:27), and Kaslo (24:05). The former two don't have ambulance stations, contributing to the delay, but the latter does.

The figures, obtained through a freedom of information request by former air ambulance pilot Hans Dysarsz (see related story below), surprised rural Creston regional district director Larry Binks, a retired BC Ambulance administrator.

“Under ten minutes is good,” he said. “It comes down to staffing: if a station isn’t staffed properly, response time is going to be poor. We recognize we live in rural areas and won’t get the same response times [as in urban centres] but certainly deserve better than what is happening in some cases.”

Creston achieved its response times despite only having one full-time paramedic and 13 part-timers. By comparison, Nelson has seven full-timers and 33 part-timers, Trail four full-timers and 27 part-timers, Castlegar one full-timer and 27 part-timers, and Grand Forks one full-timer and 14 part-timers. (Part time employees submit their availability and shifts are staffed accordingly.)

Binks, who worked for the ambulance service from 1974-2006, and Castlegar mayor Lawrence Chernoff have been advocating for improvements. Response times could be faster if all stations were manned full-time, Binks said, but attendants have to be adequately compensated, rather than a standby pittance.

Chernoff, who retired in 2006 after 29 years as a paramedic, suggested the service isn’t as good as it used to be, and one reason is training.

“That’s been identified as a key issue. In the past BC Ambulance trained you. Now you pay for it yourself. If you invest $5,000 and work in a small-volume station, you’re never going to get that money back.”

Chernoff and Binks met with BC Ambulance management this month at the Union of BC Municipalities conference, although Chernoff said previous talks were “frustrating ... It’s moving too slow for us. We’ve met with probably everybody in BC Ambulance.”

BC Ambulance spokeswoman Kelsie Carwithen said response times aren’t determined solely by staffing — other factors include weather, terrain, roads, traffic, and geography. Reponses in rural and remote areas are generally longer due to the distances involved, she said.

Sixteen ambulances respond to calls in West Kootenay, including stations in Nelson, Castlegar, Trail, Kaslo, Fruitvale, New Denver, Riondel, Rossland, Salmo, and Winlaw. They aren’t restricted to emergencies in their immediate area, so a Nelson-based ambulance might handle calls from Castlegar and Salmo.

Carwithen said the ambulance service constantly monitors call volumes and is committed to improving all response times, especially for the most urgent calls where speedy arrivals can affect patient outcomes.

“Despite increased call volume, overall response times for urgent events in the West Kootenay have remained consistent since 2011/12,” she said. “Response times are extremely important, but the care and treatment paramedics provide when they arrive is equally important.”

Carwithen also said the nine-minute standard is only a target that applies to urgent calls in metropolitan and urban areas — but one they do try to achieve.

“Response time figures are not based on the time it takes to have a trained emergency medical responder reach a patient; they only reflect the response time of paramedics,” she said. “First responders can arrival on scene before paramedics and begin providing care.”

Carwithen said the ambulance service is looking at ways of doing business differently and has already made several improvements including implementing an automated vehicle location system that lets dispatchers see where ambulances are in relation to the incident, and adopting computer-aided systems to maximize efficiency and better relay information to crews.



BC Ambulance critic points to Europe

Don’t tell Hans Dysarsz BC has a first-class ambulance system.

The former air ambulance pilot and outspoken critic of the BC Ambulance Service says this province and much of Canada lags behind European nations in pre-hospital care.

“A true first-class system uses doctors in pre-hospital response. If you’re downtown Nelson and there’s a car crash with a doctor’s office around the corner [in Europe] those doctors would be paged at the same time as the ambulance. We don’t do that here.”

Further diminishing BC’s status, he says, is a lack of advanced life support paramedics. While Trail and Castlegar have such a crew, there isn’t one in Nelson.

“There is a misperception by politicians that pre-hospital care is too expensive and we can’t afford it,” Dysarsz says. “That is patently false. There is no medical reason for it and no financial reason for it. It’s cheaper to provide care sooner.”

He points to Switzerland and Germany as nations that long ago embraced different models which reduced mortality rates and saved money.

Dysarsz, who helped create Alberta’s STARS air ambulance service, advocates for what he calls “the five cent solution” — a nickel per day per year from each BC citizen to raise up to $84 million for a European-style system with more paramedics, advanced life-support paramedics, and helicopters in key locations. That money could come at least partly through finding efficiencies within the existing system, he said.

Dysarsz further suggests the ambulance service be broken into regions attached to individual health authorities and that municipalities who want to fund an additional layers of care be allowed to do so. He says paramedics would fare better under such a system in terms of pay and hours.

However, it will take a lot of people contacting their MLAs to make any of it happen, he added.

“We have an outdated system that’s deeply and highly dysfunctional. So many barriers are in place that have nothing to do with providing best medical care or best patient outcomes. That should be the absolute focus of all first-class ambulance systems.”

Blue Divider Line

Hans Dysarsz sent this to us by email so there is no link:

BC Ambulance Service 2010, 2011 and 2012 response times

Via an FOI request, I recently received the BC Ambulance Service 2011 and 2012 ‘average’ Code 3 response times. The 2010 times were already published and I have attached them as well.

The indicated response times are somewhat misleading (in the favour of BCAS) as they indicate ‘average’ response times (i.e. 50th percentile) and not 90th percentile response times like how they are reported in other jurisdictions around the world.

Showing (BCAS) code 3 response times as ‘average times’, makes system appear better than it actual is compared to other EMS systems.

‘North American standard’ maximum Code 3 ambulance response time is 8 minutes, 59 seconds, most European countries require a code 3 response time of 7 minutes and 59 seconds. All other ambulance jurisdictions, at least that I know of, report in ‘90th percentile’ times (not 50th percentile / average response times).

To be clear, other jurisdictions’ response time are MUCH shorter than BCAS’. Fire departments, which provide ambulance services, typically have even faster responses, usually within 4 to 6 minutes (!). For any “code 3” responses, i.e. patient has a life threatening condition or injury and is in need of critical care, saving seconds can make the difference between life and death, additional minutes can kill, additional 10s of minutes can spell certain death for many life threatening but otherwise ‘clinically treatable condition/injury’ patients.

Currently still, in BC, neither non-profits service providers nor fired departments are NOT legally allowed to provide/operate ‘full spectrum’ ambulance services, in fact neither non-profits nor fire departments are even allowed to provide any EMS service beyond first responder level, not even Basic life support, never mind advanced life support; why is that and how is our apparently unnecessary ‘supply managed EMS system’ in BC better for our loved ones. Someone please explain to me why we still have such a byzantine EMS system in BC? Cost can’t be a factor as fire departments are a municipal paid service so there would be NO additional cost to the province.

Out of BC’s 233 BCAS ambulance stations throughout the province only the following met North American / European standard ambulance response times:



2010:

- only 8 BC communities met North American standard ambulance response times

- only 1 met European standard ambulance response times

- Vancouver was the only ‘mainland community’ to meet North American standard ambulance response times the rest were on Vancouver Island



2011:

- Only 13 out of 233 BC ambulance stations met North American standard ambulance response times

- Only 2, namely Victoria and Hornby Island (???) stations, met European ambulance response time standards

- BCAS station ‘Tachie’ had the longest wait times at 43:33 (meaning 70 critically injured / ill patients waited an average time of 43 minutes and 33 seconds for their ambulance to show up.



2012:

- Only 10 out of 233 BC ambulance stations met North American standard ambulance response times

- Only 1, namely ‘Victoria’ BCAS station met European ambulance response time standards

- BCAS station ‘Manning Park’ had the longest wait times at 50:14 meaning 63 critically injured / ill patients waited an average time of 50 minutes and 14 seconds for their ambulance to show up.



I wish I had more time to do a complete statistical breakdown to show you at a glance how many BC patients and stations had average response times of over 10 minutes, 20 minutes, 30 minutes even over 40 and 50 minutes (!!) but since this is not my job, I will let you do that yourself.

No matter which way one looks at these numbers they are utterly unacceptable for any western country never mind a country like Canada. The BC Ambulance Service is anything but a first class / world class service, at best and only in our high density urban areas, we have a second class EMS system and our rural areas have a third class EMS system.

If that is not enough, I was recently told (by a working ER doctor here in BC) that in their estimation over 50% of all prehospital deaths in BC are from ‘clinically treatable conditions’ meaning the BCAS is not getting these patients to a hospital in time! That’s nearly 4,000 men women and children each year!

As a BC journalist, is that the kind of critical care EMS system you want for your loved ones?

Now that you know the facts, I sure hope you decide to do some investigation yourself and hopefully do a number of feature stories about this issue as to be sure, there is lots that can be done, just look to how the Europeans do it, how the fund and operate their EMS systems and you will be awestruck by how much lower their mortality and morbidity rates are than ours.

Sincerely, Hans Dysarsz


PS: Response Code Definitions:

CODE 1: Non-emergency response. No lights or siren, following the flow of traffic.

CODE 2: Non-emergency response, but important. Must follow traffic laws. Lights and siren may be used to avoid stopped or slow traffic and to maintain safety.

CODE 3: Life-threat response. Emergency traffic, or simultaneous use of lights and siren required in order to achieve a rapid response. In most circumstances this does not allow the responding unit to ignore jurisdictional traffic laws or operate without due regard to safety. It does however give the authority to request the right-of-way from other vehicles on the roadway.

BC Ambulance Average Response Times 2010

BCAS Code 3 Average Response Times for 2011 and 2012

Blue Divider Line

Hans Dysarsz sent this to us by email so there is no link:

FYI,

There has never been a more important issue in BC than fixing our almost 40 year-old deeply flawed ambulance system. I invite you to read on and judge for yourself, hopefully convincing you to have someone research what I claim. We can save more lives and many hundreds of millions of dollars in the process, all it will take is the political will to do it.

BC has been caught in a turf war since 1974, when the NDP create the mess we today call the BC Ambulance Service, since then, many thousands of men, woman and CHILDREN have died, unnecessarily, from easily treatable conditions, from conditions and injures that have rarely caused death (or even permanent injury) in other more modern EMS systems around the world, this, due solely to long outdated and highly dysfunctional EMS system we have in BC.

I urge you to come to know the facts and become involved, what BC desperately needs, is a non-aligned prehospital care watchdog society, one that can not only hold all EMS service providers stakeholders to account but also let the general public know that BC has nothing even remotely close to a first class ambulance system as all associated with EMS in BC continue to claim; to be clear BC’s EMS system is nowhere near as good as Alberta’s, Canada’s best EMS system today, and we certainly have nothing even remotely close to what they have have/had in most European countries for many decades.

Before you read on, please take 5 minutes to view the attached video of what they have in the UK, there are 39 similar programs in the UK alone, many other EU countries have the same EMS capabilities, including tiny Luxembourg, this type of EMS response was first introduced in Europe by Switzerland over 60 years ago, and we in BC, still do not have anything like it.

http://www.londonsairambulance.co.uk/about-us

=====================


“Death by bureaucratic manslaughter”: BC’s deeply flawed EMS system

The BCAS was created by the NDP 40 years ago as a result of the Foulkes Commission recommendations to create a single EMS provider for the entire province, the goal: to bring a uniformly highly level of care to all residents of BC, in reality, the exact opposite happened. Today, the BCAS is a deeply flawed and highly dysfunctional organization, there is nothing ‘patient-centric’ about BCAS; it is an entirely ‘service provider(s)-centric’ system.

- BCAS remains the sole legal ‘full spectrum EMS service provider’ in province.

- BCAS one of largest government/non-government operated EMS services in N. America.

- BCAS employs 199 Advanced Care Paramedics, 56 Critical Care Paramedics, rest is mix of circa 3,300 primary care attendants (basis life support), ambulance drivers and dispatchers.

- Majority of BCAS attendants are part-timers.

- Still ‘illegal’ for any organization, other than the BCAS, to operate an ambulance service in BC without the written permission of the EHSC/PHSA (notable exception, Kitimat Fire Department).

- Full spectrum EMS may NOT be provided by any of BC’s 50 professional fire departments, same goes for nonprofits orgs like the Red Cross.

- BC today has a very large, single supplier, government operated, strongly union influenced, ambulance service, one which has had a severe, decades-long, Advanced life Support paramedic shortage.

- Majority of BC residents have inadequate EMS, mainly due to extreme response times / low attendant medical training, this results in poorer patient outcomes, i.e. increased mortality and morbidity.



The facts:

- BC land area is 940,000 sq km, with circa 27,000 km of coast line, we have both some of the lowest and highest population densities in world (northern BC and Vancouver’s West End).

- BC’s extremely diverse and challenging topography clearly indicates far more capable and sooner medical intervention, i.e. use of doctors prehospital as well as more and better air mobility

- NDP philosophy of, ‘one EMS system fits all areas of BC, is, was and remains unrealistic

- NDP created an EMS system ‘that fits their political philosophy’ but does not fit the actual needs of the residents of BC; a “ ... uniformly high level of EMS care ... “ was never realised anywhere in the province.

- BCAS provided EMS is ‘marginally adequate’ in the higher density areas of the lower mainland and Victoria, but is completely inadequate in rural BC.

- EMS in BC is 25 to 30 years behind ‘state-of-art’ international EMS systems, i.e. BCAS does not provide equal level of care / service / capabilities today, that other EMS systems provided over 25 years ago.

- No question ongoing shortcomings at BCAS directly contribute to ‘many thousands of unnecessary deaths’ and has ‘generated many times more permanent injuries / long term care patients over the decades’.

- Enhanced EMS in BC will save taxpayers / society many hundreds of millions and save many more lives.

- State-of-the-art EMS system are 100% patient-centric resulting in ‘best possible patient outcomes’, that has not been the case in BC for the last 40 years.



Fixing our broken EMS system:

No Royal commission is needed, all that is needed is to send a small group of backbencher BC Liberal MLAs to first Alberta and then Europe to view true ‘state-of-the-art’ EMS systems. Based on their findings, we create a ‘Made in BC’ version of what they saw.



Necessary steps:

1. Instruct the Emergency Health Services Commission /Provincial Health Services Authority to transfer EMS service provision to the regional health authorities immediately.

2. Instruct regional health authorities to work with all willing / interested professional municipal fire departments, which meet provincially set minimum EMS service standards, to once again provide full spectrum EMS to their residents - as an ‘ADDITIONAL layer of EMS’ to the existing services provided by the BCAS. The associated cost of this ‘additional EMS layer’ would be solely covered by the ‘willing municipalities’ via both municipal taxes and local charitable fundraising. FYI, BC’s professional fire departments currently already spend many HUNDREDS of millions on their respective first responder programs already – but do not have the ability to enhance their services due to bizarre ‘scope of practice limitation place on them by the BC Emergency Medical Licensing board, a de-facto sister off-shoot of the BC Ambulance Service.

3. Province wide EMS dispatch MUST be transferred away from BCAS control and given to newly created, non-aligned government dispatch agency.

4. Make it government policy to allow and encourage charitable status community service organizations to fundraise in support of their local community operated / supplemental EMS operations. Government should actively encourage private and corporate donations to EMS.

5. Commence planned phase out of BCAS over 10 years with goal of creating a ‘blended’ regional, municipal and nonprofit EMS system. Standards and seamless system operation assure by provincial standards and single nonaligned EMS dispatch system.

6. Amended policy for BC EMA Licensing board, goal: to put many MORE EMA, PCP and ALS attendants into all areas of BC.

Supporting Facts:

- There is no other sector of modern health care where such a relatively small increase in investment could make such a profound difference in reducing mortality and morbidity

- Population densities and numbers, in some parts of BC, are equal to or even higher, than in some European countries where both rapid response ‘doctor ground cars’ and rapid response doctor helicopter systems are used.

- BCAS has 199 Advanced Care Paramedics (ACP) for 4.4 million residents, by comparison, Alberta has 2,139 ACP for 3.6 million residents and 1/3 less land area.

- Every ambulance in Calgary is an ‘Advanced Life Support’ ambulance, that is not even close to being the case in Vancouver

- BCAS operates 478 ground ambulances, from 184 stations, only 9 ambulances are 4wheel-drive, and it snows east and north of Vancouver for many months of the year and ambulance ‘mobility problems’ regularly factor into negative patient outcomes in BC

- BCAS does NOT routinely employ doctors prehospital, on either ‘rapid response doctor cars’ or rapid response EMS helicopters. This has been a common practice in Europe for over 40 years.

- Every ambulance in Cuba has a Emergency medicine trained doctor aboard (1,100 in total).

- BCAS does not have a ‘virtual doctor’ EMS program

- Each year 40,000 people are hospitalized in BC for heart conditions, 9,000 for strokes, BCAS does not have special cardiac or Stroke teams even in our higher population density areas

Heart Attack:

o The most important factor in treating heart attacks is time, the shorter the time interval between condition onset and first definitive treatment, the better the patient outcome

o BCAS ambulances DO NOT carry, nor are BCAS attendants allowed to administer advanced ‘clot busting’ Thrombolytic drugs. Early Thrombolytic administration can dramatically enhance patient outcome for up to 80% of stroke victims, even more for heart attack victims.

o Well over half of all ‘out-of-hospital-deaths’ in BC involve heart attacks, strokes and trauma, that’s well over 4,000 people per year.

o BC has circa 8,400 heart attacks each year resulting in roughly 2,000 deaths, most deaths occur out-of-hospital, most of these heart attacks were ‘clinically treatable’.

o Cost of heart attacks to BC society is roughly $2.52 billion annually ($20.1 billion nationally).

o Up to 85% of all cardiac arrests occur at homes / public places.

o After more than 12 minutes of ventricular fibrillation, survival rate from cardiac arrest is less than 5% (Hazinski et al, 2004).

o For every 1 minute delay in defibrillation, the survival rate of cardiac arrest victim decreases by 7% to 10% (Larsen et al, 1993).

o Combination of CPR, and AED may increase likelihood of survival by 75% or more

o BCAS has extremely slow response times

o BC’s professional fire departments are ‘on scene’ many life saving minutes sooner 98% of the time, but are not legally allowed to provide care beyond first responder level (little more than first aid essentially)

Strokes

- The most important factor in treating strokes is time, the shorter the time interval between condition onset and first definitive treatment, the better the patient outcome

- Stroke is the third leading cause of death in BC

- Circa 1,680 British Columbians die from stroke annually

- Each year, more women than men die from stroke (Statistics Canada, 2012).

- About 38,000 British Columbians are living with the effects of stroke (at huge cost to society).

- Most strokes are clinically treatable, early treatment dramatically reduces chain of care costs and dramatically enhances patient post event quality of life

Stroke Effects

- For every minute delay in stroke treatment, patients loses 1.9 million brain cells, 13.8 billion synapses, and 12 km of axonal fibres (Saver, 2006).

- For each hour in which treatment does NOT occur, the brain loses as many neurons as it does in 3.6 years of aging (Saver, 2006).

Stroke Cost to BC Society

- Stroke costs BC economy $430 million a year in physician services, hospital costs, lost wages, and decreased productivity.

- BC stroke patients spend more than 76,600 days in acute care and 540,000 days in residential care facilities.



Trauma

- Trauma is the leading cause of death for ages 1 to 44 costing BC health care circa $5 b per year.

- Trauma is 3rd largest cost contributor to BC health care system.

- Improving trauma services is clearly an important part of improving health care for BC



o BCAS ambulances do NOT carry universal donor whole blood

o Circa 50% of trauma deaths are from blood loss (a highly treatable condition)

o For every death from trauma 10 permanent injuries are created, associated cost to society are extreme



General

- BC restricts all higher levels of EMS to a single service provider, the BCAS (except in Kitimat)

- BC professional firefighters are highly restricted in their ‘scope of practice’ (except in Kitimat)

- All other 49 BC professional Fire Depts are ‘on scene’ many lifesaving minutes before BCAS 98% of time.

- Ambulance service in Kitimat is delivered by the District Fire & Rescue Services Department.

o All members of the department fill two professional roles: firefighter and primary care paramedic.

o The Kitimat station has one of the fastest EMS response times in the province.

- Average BCAS response times province-wide are longer that accepted standards for 178 of our 187 stations, some are extreme, see attach BCAS province-wide response times for 2010, since 2010, the BCAS has closed 2 stations and decommissioned 5 ambulances

- BCAS does NOT use the superior and long proven ‘Rendezvous system’ of EMS response used in EU countries

- The Emergency Health Services Act, legally restricts nonprofit, charitable status service providers from providing both full spectrum EMS and ambulance service in BC, except with the written permission of the EHSC

- BCAS has never had a patron charitable fundraising organization to augment operating / service provision costs

- BC has never had a non-vested interest, non-government, non-aligned, prehospital care watchdog agency

- BC municipalities are legally NOT allowed to ‘augment fund’ EMS services within their own communities – they only get only what EHSC / PHSA unilaterally decides to give them

- BC Emergency Medical Assistants Licensing Board highly restricts ‘scope-of-practice’ for ALL first responders, including all fire and police department members as well as non-military SAR organizations

- Literally, for decades, some EU jurisdictions have utilized ‘local family practice doctors’ to be paged for immediate response to close proximity medical emergencies, not in BC

- BCAS is a standalone branch of the M/Health, in other jurisdictions EMS provision is a fully integrated part of the national health care system

- BCAS ONLY tracks ‘cost per patient transported’ and NOT ‘cost of patient thru the entire chain of care’, i.e. hospital / long-term care, to patient system discharge. BCAS does NOT calculate ‘total cost to society’ of injury / condition vs cost invested in patient, this, to properly evaluate BCAS performance / role played by BCAS in patient outcome. Other jurisdictions carry out ‘regular universal cost benefit analyses’ on their EMS systems, this, so they can definitively gauge whether or not their EMS systems are delivering patients to their hospital system in the best possible condition, thereby maximising chances of best possible patient outcome, and in turn, yielding lowest cost to society (not just ambulance service costs, not just health care system costs but total costs to their society). ‘Cheaping-out’ on the front of the health care system, (i.e. on the EMS system), can cost a society significantly more than it needs to in terms of increased patient recovery times, increased insurance payouts, increased employer costs etc.

- Based on the above, it is very possible that somewhere between 700 and 1,000 British Columbians die each year from ‘highly treatable conditions’, conditions which have rarely caused death in true ‘first class’ international EMS systems in decades

All BCAS mangers, as well as all CUPE 873 members, consistently publicly state that “... the BC has a world class, first class ambulance system ...” If that is the case, why do so many international EMS providers both structure their systems differently and offer such vastly advanced capabilities, if according to BC EMS service delivery stakeholders, it is simply not required to achieve the same results (and far less costly to do it the BCAS way)?

Why are (literally hundreds) of international programs wasting billions of dollars (over the last 60 years) to provide ‘enhanced EMS’ to their residents, when the less costly BCAS model provides the same patient outcomes?

Why does Germany, the most efficient and productive / robust economy in the world, provide EMS service levels that are vastly beyond what BCAS provides?

So who is doing going down the wrong path, most of Europe and many other nations around the world, or us here in BC?

Perhaps the BCAS should send them all a note informing them that their continued expanding and enhancing of their EMS system - for the last 60 years - has been a giant waste of money. That the way to go is to go is to create a giant government run, heavily unionized ambulance service as that will yield better patient outcomes, you know, like we have in BC.

Of course that is not the case, these many other international jurisdictions provide the service levels they do because they see the results they bring, consequently, they continue to expand their EMS service capabilities.

FYI, I am not sure about other countries but I know Germany carries out regular EMS system ‘universal cost benefit studies’ (every 10 years) nation-wide. From these ongoing reviews, they can accurately gauge the cost savings of their approach; they conclusively prove that sooner, better care, results in sooner patient stabilization, which in turn translates into shorter ‘chain-of-treatment’ and recovery times. They have found that this highly proactive action saves their society between 4 and 6 times more than their enhanced EMS system costs them up front, - and as a side benefit, it saves them thousands of additional lives each year and dramatically reduces, by 10 times that number, the number of permanent injuries, and that is where the real savings to a society lays, in reducing permanent injuries and that is simply ‘a good business approach’ to this vital government service provision, but not here in BC; I want to know why?

When you come to know the facts of modern EMS, the financial case becomes overwhelming in favour of enhanced EMS; to NOT provide enhanced EMS is self-defeating, in our case, not adopting this approach will lead to the eventual financial collapse of our socialized health care system; putting people into long-term care (unnecessarily) is simply too closely for our society to keep doing.

Prevention remains our first line of defence but when prevention fails, only the most rapid and most aggressive intervention possible is indicated, both medically and financially; it is in our best societal interest to truly do all we can in this regards, as it stands today, that is not the case, not even close.

The recent BC Auditor General investigation into BC’s air ambulance system proved that it is as deeply flawed as I claimed, that is why the AG initiated their investigation in the first place, now it is time for the AG to carry out a full investigation of BCAS ground operations, as the shortcoming there far outweigh the problems within the air ambulance system.

I hope that all BC residents will finally come to understand that we in BC have nothing even remotely close to a first class ambulance service – like all EMS service provider stakeholders here keep telling us we do.


click for a larger copy

Blue Divider Line

Hans Dysarsz sent this to us by email so there is no link:

If you think BC has a first class ambulance system; guess again, not even close

These are the facts:

· 31,000 people die in BC each year, of that, 7,800 die outside of hospital (BC Coroners Service).

· Outside-of-hospital-patients are the exclusive (legal) responsibility of the BC Ambulance Service.

· It is ‘illegal’ for any organization, other than the BCAS, to provide ambulance services, including ALL fire departments and nonprofits, including organizations like the Red Cross, the world’s largest nonprofit EMS provider.

· Many additional deaths occur after patients are (finally) brought to hospitals.

· International statistics indicate 55% of trauma-related deaths are from ‘clinically treatable conditions’, meaning they did not have died.

· High percentages of (fatal) heart attacks, strokes, anaphylaxis, accidental substance overdose, poisonings, drownings, etc., are also ‘clinically treatable’.

· BC’s ‘unnecessary deaths’ could easily reach over a thousand persons each year!

· Calgary has more Advance Life Support paramedics (350) than all of BC.

· BC has 199 ALS paramedics (3,400 ‘basic life support’ attendants of which 2,100 are part-timers).

· Alberta, which has a million fewer residents, 300,000 sq km less land area, far less challenging topography, has 2,130 Advanced Life Support paramedics.

· ‘First class’ EMS services routinely employ doctors, they routinely provide lifesaving emergency surgical procedures at the scene. They routinely carry and provide ‘universal donor blood’ to treat potentially fatal bleeding injuries, they carry ‘clot busting drugs’ to treat potentially fatal heart attacks and strokes, they routinely carry other lifesaving drugs as well.

· EMS systems that routinely employ doctors are considered to be ‘true first class’ EMS systems.

· BCAS does NOT routinely use/employ doctors as prehospital practitioners, even in BC’s high density urban areas, thereby making our urban EMS system a ‘second class EMS system’.

· In BC rural areas, the BCAS primarily uses part-timers, all of which are only ‘basic life support’ qualified, making our rural EMS system a ‘third class EMS system’.

· A recent ‘BC trauma fatality reviewed’ showed; all patients that died from trauma, the following percentages died BEFORE they made it to a hospital: Lower mainland 12%, Parts of Van Isl 45%, Interior 59%, Northern BC 75% and Northwest BC 82%.

· These are third world-like death rates.

· ALL MLAs are fully aware of these stats, how do I know that; because I have written every single one informing them (over the last 2 and half years).

· I even had a meeting with the Mike de Jong when he was Minister of Health, to personally make sure the government and the minister of health personally knew of these horrific statistics – Christy Clark CHOSE NOT TO ACT while she could, that was 2 years ago. In that time I also made every opposition and independent MLAs aware of the dire state of affairs at the BCAS – NOT ONE of them cared enough to bring up this deadly issue in the Legislature! I brought it up with the BC Auditor General and they conducted a yearlong investigation of BCAS air ambulance system and found all kinds of deficiencies. If the BCSA can’t efficiently operate 10 air ambulance aircraft, does anyone really believe they can efficiently operate over 480 ground ambulances? FYI, only 4 out of our 180 BCAS ambulance stations actually met international response time standards in 2010, several had a average response time of over 44 minutes!

· The official opinion of the NDP is that ‘BC has a first class ambulance service’ and if they form government, they have NO plans to make any changes how EMS is delivered in BC.

· The Conservatives didn’t even acknowledge receipt of any of many emails or phone calls.

Why don’t our elected official care about our loved ones, our children? Why do their ‘pet projects’ received hundreds of millions in funding but lifesaving services like enhanced EMS don’t?

To be clear; there is NO REASON for this; there are no medical reasons to continue to ‘legally restrict’ all willing fire departments to provide (their) communities with an additional EMS services, especially given that Fire Recue is always ‘on-scene’ far sooner than BCAS 98% of the time. There are no operational or medical reasons, to continue to legally prohibit nonprofit EMS service providers from providing an additional layer of EMS to all rural areas of BC.

Finally, if anyone says ‘BC can’t afford enhanced EMS’; they are dead wrong, enhanced EMS ‘has proven to save socialized societies 3 to 5 times more than the additional investment up front’; in other words, in addition to the many hundreds of unnecessary deaths in BC each year, we are all paying far more than necessary to keep our long outdated EMS system.

I want to know why NONE of our politicians, from all parties, feel British Columbians are not worthy of a level of EMS care enjoyed by Albertans for decades? Why don’t British Columbians deserve a level of EMS care some European jurisdictions have had for 60 years? I’ll tell you why; the only reason I found is ‘stakeholder turf protection’, plain and simple! Hundreds of our loved ones, men, women and children, are dying each year in BC because of turf protection issues!

Hans Dysarsz

Blue Divider Line

Hans Dysarsz sent this to us by email so there is no link:

With respect to the recently published BC Auditor general report on the dismal state of BC’s air ambulance service along with the numerous news stories about the utterly unacceptable BCAS ground response times (and attendant training levels).

The following will help you decide what the facts of the matter really are and how you can get involved in finally bringing true ‘first class’ prehospital care to all parts of BC.

Please watch the 5 minute video and see for yourself what other jurisdictions have had for many decades. http://www.londonsairambulance.co.uk/about-us

After watching the video, you should have come to the realization that not even Metro Vancouver has a ‘first class’ ambulance system. Why; because the BC Ambulance Service do not use doctors pre-hospital, the BCAS do not use rapid response EMS helicopters, the BCAS do not carry universal donor blood, the BCAS do not do surgery at the scene, the BCAS do not carry ‘clot busting drugs’, the BCAS only has a small handful of Advanced Life Support (true) paramedics for all of BC (199 in total, the City of Calgary alone has 350 and Alberta has 2,139!). You get the picture.

So as you saw, by comparison, even Metro Vancouver has a ‘second class’ EMS system (at best, as only two ambulances in Vancouver are actually ALS ambulances, the rest are Basic Life Support). When it comes to rural areas, BC has a (bottom-end) ‘third class’ EMS system, indicated by the complete lack of Advance life support attendants (with the notable exception of 3 towns many Kamloops, Kelowna and Prince George and their ALS paramedics are not allowed to leave city limits) the widespread use of part-time basic life support attendants the complete lack of use of all wheel drive ambulances.

The video showed only one of circa 400 such enhanced EMS systems in Western Europe, some of which have been in operation for 60 (sixty) years (there are over 600 nearly as capable programs in the US). Please come to understand that there is no reason why BC residents can’t have similar systems in both our urban and rural areas. With the exception of only a handful, all 400 EU rapid response EMS helicopter programs there are nonprofit, charitable status operations – NO profit margins are paid, all monies raised/paid by government health care plans there, go to providing best possible patient care. (not the case in the US systems).

Some will argue that the distances in Europe are shorter and their population densities are higher, making their programs ‘more cost effective’ than they would be here; this is grossly misleading and simply not true. From a medical perspective, the longer distances (the longer the ground ambulance response times), the lower the attendant training level, the more a rapid response, doctor staffed, EMS helicopter system is (medically) indicated, period, full stop! That is not opinion that is fact and is supported by common sense.

Let’s forget the moral justifications for such vastly more capable prehospital care for a moment and only focus on its financial cost/benefits; the ‘efficiency obsessed’ Germans have the world’s largest rapid response EMS system, both air and ground. They have over 100 helicopters and literally thousands of doctors in their system, all of which routinely work prehospital, they have been providing this level of enhanced EMS care since conducting a pilot project in 1968. As a result, they stated their nationwide enhanced EMS system in 1970, since then, they have conducted nationwide universal cost benefit studies every ten years and concluded that their return on investment (as a society) of their enhanced EMS system is between 3 and 5 times cost! (depending on the area of the country) In other words, they save far more money for their society with their system, than it costs; consequently, they keep expanding their enhanced EMS system every year. Understand that have flown over 1.9 million missions since 1970.

Clearly BC doesn’t need hundreds of EMS helicopters or thousands of doctors on ground cars, but given BC’s extreme topography and distances, we would save more lives here if had 10 such programs. Even if the BC system didn’t break even, it would save certainly hundreds, if not thousands of lives here each year. Don’t believe me; understand this: 7,800 people died in BC last year ‘outside of hospitals’; that’s BC Ambulance Service jurisdiction. If even 10% of the deceased were ‘clinically salvageable’ patients (which is a very realistic number given that international trauma statistics indicate that over 50% of all trauma deaths are from ‘clinically treatable conditions’), it would mean almost 800 British Columbians would not die each year here! Furthermore, international statistics also show that for every persons that dies from trauma, 10 times more sustain permanent injury or require long term care, and that is where the really big, long terms cost are to socialized health care systems like ours. FYI, the cost of trauma in BC is estimated to be $5 billion dollars each year (source: BC Trauma Services), making this a huge problem as it represents 1/3 of our entire provincial health care budget.

To sum up; while the BCAS may in fact have one of the ‘lowest costs per patient transport’ in Canada, is their ‘skimping at the front end’ of our health care system, actually costing us all far more than it needs to at the other end of the health care system, since no one has ever carried out a universal cost benefit study of the BC Ambulance System in its almost 40 year history, we could be wasting billions and not know it, not to mention loosing circa 800 or so loved ones unnecessarily – each year- in the process.

As all in BC know, we have an election in a few weeks, please find a way to hold your candidates to account in this issue, one that affects every single British Columbian, regardless of political stripe, the lives of our loved ones, our children, depend on it.

Hans Dysarsz

Blue Divider Line

Medical system in northern B.C. 'systematically helps people die,' critics say
By Cara McKenna, The Canadian Press - April 7, 2013

VANCOUVER - Jackie Inyallie didn't have to die, in fact the 24-year-old woman's injuries were considered "non-life threatening."

But her foster mother says what should have been a 90-minute ambulance ride four years ago, instead took five hours. Inyallie bled to death before doctors could save her.

The young woman's family says the story isn't unusual in British Columbia's north, where harsh weather, lack of a trauma centre, no cellular service, only one air ambulance, lesser-trained paramedics and a general centralization of services in the Lower Mainland can turn what would be a survivable trauma in southern B.C. into a tragedy.

Auditor General John Doyle found in a recent report not much has changed since Inyallie's death.

His March 21 report, the first audit ever done on the BC Ambulance Service, found the service wasn't adequately reviewing dispatch decisions or properly reporting or addressing safety issues, and that lesser skilled paramedics are sometimes sent out together because of understaffing issues.

One study from 2002 used BC Coroners Service data to find there was an alarming 75 per cent pre-hospital trauma-related death rate in northern B.C., a rate about six times higher than that in the Lower Mainland, where it's 12 per cent.

Statistics from Vancouver Coastal Health show the northern and interior health regions experience the highest incidences of trauma overall.

But in the north there is only one fixed-wing jet, even though ground ambulances often have to drive long distances, face bad weather conditions, and sometimes can't get to patients at all.

The closest trauma-receiving hospital is in Vancouver, and helicopters can't fly the distance without needing refuelling, so there are none in the north.

Doreen Spence lives in Prince George, and when her foster daughter Inyallie was in a car accident near Bear Lake that caused her to suffer a broken arm and punctured lung, two paramedics-in-training from Mackenzie District Hospital were sent to attend to her, but got delayed by slushy road conditions.

Reports given to Spence indicate it took almost five hours to transport her foster daughter to the hospital, and by that time, doctors weren't able to save her before she bled to death.

"There was absolutely no need for Jackie to pass away with what she had," said Spence. "We have stretches of highway from Prince George to McBride where there's no phone service. To get an ambulance there takes forever, where a helicopter, if we had one, or two, or whatever (it would be much faster)."

Spence and her husband Brian are now involved in an organization called Northern B.C. HEROS, which they hope will soon be able to provide helicopter ambulance service to the region.

HEROS aims to bring non-profit helicopter ambulances to northern B.C. and the organization is currently working out a business plan.

"I know there are a lot of people dying up here that don't need to be," she said.

"It's not a good system out here and with people that have non-life threatening injuries, because they're on the road for too long, their lives are threatened," she said.

"That first hour is a big thing."

The lack of a trauma centre in the north forces patients with severe injuries in need of vascular or neurosurgery to be transported to either Vancouver or Edmonton.

Multiple studies, such as one from the B.C. Centre for Disease Control, have shown a significant decrease in death rates for those admitted to a trauma-receiving hospital.

But trauma-receiving hospitals in B.C. are all centralized: Victoria General, Vancouver General, Royal Columbian and BC Children's.

Les Fisher, chief operating officer of BC Ambulance Service, said the service is doing the best it can as a part of the health system to transport patients to those centres.

He said there is one fixed-wing jet in Prince George used to transport patients to Vancouver for trauma care, but there are no longer any helicopters because pilots can't make it from northern B.C. to Vancouver.

"You can't get any kind of distance with a helicopter without having to refuel," said Fisher.

"Even if you could stop for refuelling to get from, say, Prince George to Vancouver, you wouldn't want to do that trip in a helicopter. Helicopters fly at lower altitudes, it's much rougher. It would be a rough trip for the patient."

Fisher said putting helicopters throughout the north just to fly patients to community hospitals is an expensive proposition, and one that would ultimately be fruitless.

"It would get them to a community hospital where they still don't have the services that the patient needs," he said. "So all it does is add extra expense to the system without having any outcome benefit to the patient."

Hans Dysarsz helped start air ambulance non-profit STARS in Alberta almost 30 years ago and has worked for several helicopter companies.

He said he wrote auditor general John Doyle weekly prior to the recent audit of BC Ambulance Service with his concerns about the B.C. system.

"They're never had to track before. They've never had to be accountable before," said Dysarsz.

"We have third-world response times here."

Dysarsz said he is generally horrified by B.C.'s current medical system and said he thinks the province should be looking to Alberta and Europe — where he spent years reviewing ambulance systems — as examples.

"At the very best in downtown Vancouver we have a second-class system. When it comes to rural B.C., we have an absolute third-class system. And that's indicated by the extreme response times."

In 2010, CUPE BC president Barry O'Neill called ambulance wait times in the province a "disgrace."

On average, according to CUPE statistics, it takes an ambulance about 22 minutes to get to a patient in Hudson's Hope in Peace River, and 10 minutes for an ambulance to get to a patient in Prince George.

Those times are the not the longest times and don't include the return time to a medical facility.

Bronwyn Barter, president of the Ambulance Paramedics of BC, said the union has been advocating for integrated services in non-metropolitan areas of the province for years now and feels they are doing well.

She said services are directed at where the most call volume and need tends to be, which is in the Lower Mainland, and that B.C. does "more for less."

"A lot of people do look at our system and think it's a world renowned system and are out looking and seeing how to move to that," she said.

"We serve a lot bigger area compared to STARS and everybody else."

Barter acknowledges that finding enough trained paramedics for rural and urban B.C. is a problem, and one that she said the union is currently trying to fix.

"We agree there's probably need for more critical care paramedics centred around the province, but we have the attitude of, 'let's expand on what we have and it's a well proven air ambulance system.' We actually do more for less in B.C. and we have higher-trained paramedics in the works."

She stands by the system in place in B.C.

"There's always room for improvement (but) with our air ambulance service we really do have a gem."

© Copyright (c)

http://www.londonsairambulance.co.uk/about-us

Blue Divider Line

Hans Dysarsz sent this to us by email so there is no link:

 

This is an FYI, in light of the recent Auditor General’s report on the state of air ambulance in BC.

Please take a moment to watch the attached short videos; they will give you considerable perspective on the problem in BC and what other jurisdictions have done about similar problems decades ago; you will come to understand why the BCAS is in desperate need of a major overhaul, starting with our air ambulance system.

http://ckpg.com/local-family-wants-to-improve-air-ambulances-video

As you saw in the video, the death of a young northern BC woman was completely unnecessary. The really scary part is that this sort of thing happens every day in BC. This young woman died due to extreme transport time delays by the part of BC Ambulance Service.

In BC almost 8,000 people die each year outside of hospitals, many hundreds die from completely treatable conditions, just like the young women in the TV news story; that is fact and not opinion.

By comparison to other true ‘first class EMS systems’, BC has a second class EMS system in our urban areas and a lower end ‘third class’ ambulance system in rural areas.

I say BC has a third class rural EMS system because ‘true state-of-the-art/world class/first class’ EMS systems extensively use emergency doctors on both special doctor cars, as well as rapid response EMS helicopters (which are consistently airborne with 90 seconds of an incoming 911 equivalent call in which seasoned EMS dispatchers determine the response level. In BC, dispatch is an entry level position for EMS personnel).

The use of emergency doctors provides true first class EMS systems with vastly better medical capabilities, when this is coupled with vastly faster time to the scene, then followed by vastly faster patient transport back to the ‘best suited hospital for the patient’s condition’ (via rapid response EMS helicopter), the result is vastly lower mortality rates and even much greater reduction in morbidity rates – and that translates into much greater savings to socialized societies - where everyone picks up the cost of every medical intervention. The total savings which come with such enhanced EMS systems are between 3 and 5 times higher than initial cost. Those are the traits of a true first class, state of the art EMS systems, and we in BC have nothing even remotely close to that here.

By comparison, the BCAS does NOT use doctors any region of BC, nor do they use universal donor whole blood or clot busting drugs, then there is the complete lack of use of rapid response EMS doctor cars and EMS helicopters. As a result, I feel very comfortable in stating the BC has a ‘second class’ EMS system in our urban areas and a third class EMS in our rural areas. The third class rating stems from the fact that the BCAS ‘exclusively’ uses basic life support attendants in rural BC, most of which are part-timers. Couple those two factors to the extreme response and return transport times and you have a deadly combination.

Using a very conservative estimate, I believe the chosen BCAS service provision model directly contributes to (at least) 10% of all outside of hospital / prehospital deaths in BC. This, due to the indicated combination of factor listed above.

What that means to BC families is that somewhere between 2 and 3 British Columbians die each day from completely treatable conditions. My question is, if we know how to fix the systemic root cause of these many unnecessary deaths, why are we not taking immediate steps to make the necessary changes? If a new cancer drug were developed (somewhere in the world) one which clearly reduced cancer related deaths by up to 12%, how long would you think it would take for this drug to find its way to BC; weeks, months, certainly with a year or two, well other international EMS jurisdictions have developed an approach that clearly demonstrates a dramatic reduction in both mortality and morbidity – starting 60 years ago in Switzerland, 45 years ago in Germany, and over 24 years ago in the UK – and yet we in BC still chose to hold on to a overly costly system which is clearly failing so many of our loved ones, year after year; I want to know why?! All I claim can easily and quickly be confirmed by anyone with a computer and an internet connection.

In light of the recent damning BC Auditor General’s report on the state of BC air ambulance system, we must all ask, how many people have died due to incompetence at the BCAS over the last 40 years of air ambulance service in BC. Also, how many more people will die due the lack of vision and refusal to adopt proven better service provision models?

This government, or the next government, must now act and soonest, to do all that is necessary to (finally) fix the systemic problems within our prehospital care system, if not to save all those that are dying unnecessarily then to start saving the hundreds of millions of precious health care system dollars currently being wasted by the our broken system each year.

Like the news stories attached outline; the death of this young woman, and many deaths just like it, are directly attributable to a series of long standing systemic deficiencies/deep flaws within the BC Ambulance service – flaws that can easily be fixed if the political will is there to do it, and that process can start with a simple stroke of the pen by the Health Minister or Christy Clark herself.

http://www.londonsairambulance.co.uk/about-us

London’s air ambulance is representative of circa 400 such programs throughout Western Europe. Please understand that there is no reason why we can’t have what they have, in fact, given our extreme distances and challenging topography, such vastly more capable EMS system are absolutely medically indicated. FYI, there are 35 similar programs in the UK alone.

To make myself perfectly clear on this fact; BC has nothing even remotely close to a true first class EMS system – and there is no reason for it, literally only one thing prevents us from bringing this level of care to all parts of BC, and that is lack of will at the political level (supported apparently by extreme incompetence at the senior management levels of the BC Ambulance Service).

Again, enhanced EMS systems save socialized societies, like ours, between 3 and 5 times what they cost up front, in other words, it is (very) bad business for us to carry on with the system we have; there is an (overwhelming) supporting financial case to be made to (finally) bring high performance EMS to BC – not doing so is costing BC taxpayers hundreds of millions, per year, more than it needs.

Sincerely, Hans Dysarsz

Blue Divider Line

Air ambulances not doing enough to improve service, says B.C. auditor general
GlobalTVBC - Thursday, March 21, 2013

British Columbia's air ambulance provider seems to have its head in the clouds when it comes to tracking its own performance and looking for ways to improve, findings the auditor general warns could be putting patients at risk.

John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.

"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.

Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.

It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.

It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.

"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."

The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.

After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."

It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.

Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.

"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.

He said it aims to develop concrete service standards and improve data collection.

During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.

— By Cara McKenna in Vancouver

Blue Divider Line

This is an email from Hans Dysarsz:
 

FYI,

It is important to note that the AG investigation had very narrow terms of reference, as a result, the biggest issues within the BCAS air ambulance service were NOT revealed.

It is important to understand that BC’s chosen air ambulance operational structure is decades out of step with the state of the art air ambulance systems worldwide. It is even more critical to understand that the many systemic flaws within the BC air ambulance system can (and have) directly contributed to (like very many) unnecessary deaths in BC over the decades.

To be clear, what the BCAG investigation uncovered on their investigation is but ‘the tip of iceberg’ in terms of many issues of BC’s air ambulance system.

Sincerely, Hans Dysarsz

The complete report can be read at:

http://www.bcauditor.com/pubs/2013/report13/air ambulance

Air Ambulances Not Doing Enough to Improve Service says BC Auditor General

Air ambulance service lacks goals, monitoring: B.C. auditor general

Major problems in air ambulance service: report



B.C.’s Auditor General has found problems in planning and service records in the province’s air ambulance service
Cara McKenna, The Canadian Press
Published Thursday, Mar. 21, 2013 6:32PM PDT
Last Updated Thursday, Mar. 21, 2013 7:52PM PDT

VICTORIA -- British Columbia's air ambulance provider seems to have its head in the clouds when it comes to tracking its own performance and looking for ways to improve, findings the auditor general warns could be putting patients at risk.

John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.

"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.
Photos

Air ambulance

An air ambulance lands down in this CTV News file photo.

Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.

It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.

It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.

"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."

The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.

After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."

It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.

Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.

"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.

He said it aims to develop concrete service standards and improve data collection.

During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.




Air ambulances not doing enough to improve service, says B.C. auditor general
globaltvbc.com Thursday, March 21, 2013

British Columbia's air ambulance provider seems to have its head in the clouds when it comes to tracking its own performance and looking for ways to improve, findings the auditor general warns could be putting patients at risk.

John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.

"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.

Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.

It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.

It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.

"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."

The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.

After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."

It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.

Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.

"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.

He said it aims to develop concrete service standards and improve data collection.

During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.

— By Cara McKenna in Vancouver

© The Canadian Press, 2013

Blue Divider Line

Did you know if you were injured and were taking someone to court over it, that you are required to inform the BC Government so that the BC Government may lay a claim against the wrongdoers who caused your injury to recover Healthcare costs, except if the injury was caused by the operation of a motor vehicle, tobacco related, or employment related?

Health Care Costs Recovery Act

Requirement to notify government of claim
4 (1) Within 21 days after commencing a legal proceeding referred to in section 3 (1) [obligation to claim], written notice of the legal proceeding must be given to the government.

Application of this Act
24 (3) This Act does not apply in relation to health care services that are provided or are to be provided to a beneficiary in relation to

(a) personal injury or death arising out of a wrongdoer's use or operation of a motor vehicle if the wrongdoer has, when the injury is caused, coverage under the plan, as those terms are defined in the Insurance (Vehicle) Act,

(b) personal injury or death arising out of a tobacco related wrong as defined in the Tobacco Damages and Health Care Costs Recovery Act, or

(c) personal injury or death arising out of and in the course of the beneficiary's employment if compensation is paid or payable by the Workers' Compensation Board out of the accident fund continued under the Workers Compensation Act.

Here is a link to the form you would fill out to notify the government of your claim.

Blue Divider Line

This is an email we received from Hans Dysarsz who is trying his best to make our healthcare system better:

So you understand why you need to read the following:

31,000 people die each year in BC, of that almost 7,800 die before getting to hospital – prehospital deaths fall into the BC’s ambulance service domain.
Of the 7,800 (men women and CHILDREN) that (continue to) die each year before getting to hospital, a very high percentage have die from “.. Clinically treatable conditions...” meaning had they been attended to sooner and/or by more capable medical personnel, they would have lived. Imagine if there were a bridge or highway somewhere in BC with such an atrocious death record, don’t you think the government would spend whatever it takes to fix that problem piece of roadway? Of course they would, like they don the Sea to Sky highway to Whistler ($360 million) or the new roof on BC Place Stadium for $560 million (because they didn’t like the way it looked any more).
FYI, BC’s professional firefighters have been trying to have the EMS problem fixed for decades now and the politicians, both sides, are not responding, in fact, they continue to create legislation that further entrenches the existing, grossly out of date, grossly inadequate EMS system we have; my question is why? How is what we have, in any way, better than what they have in other jurisdictions? And one does not have to look far like to the many first class ambulance systems in Europe, all one has to do is look right next door in Alberta. FYI, Alberta has 2,139 Advanced Care Paramedics, BC has 150 (!). Alberta has Advanced Care Paramedics throughout rural parts of their province, BC’s handful of ACP working in 7 of our larger communities. Why is that? Funny thing, the City of Calgary has more Advance Care paramedics than the entire province of British Columbia, they have 350 of them, making every single ambulance in Calgary an Advance Life Support ambulance, even Vancouver does not have that!
So you know the frightening statistics here in BC: Prehospital death rates for persons that died from trauma (alone: much higher if other time sensitive conditions like heart attack, stroke, etc., were included) are: 12% for Metro Vancouver, 45% for parts of Vancouver Island, 59% for the Interior, 75% for BC’s North, and a staggering 82% for BC’s Northwest. These are third world death rates; I want to know why nothing is being done to fix the HUGE problem! This is exactly why I am writing your paper, apparently all these numbers and stats are little known by the average British Columbian, and only by way of educating the people will the politicians finally have enough pressure put on them to FIX THE PROBLEM. I sincerely hope you will check the facts and print as many stories on this issue as it will take to get the message out; OUR EMS SYSTEM IS BROKEN AND IS DIRECTLY CONTRIBUTING TO THE UNNECESSARY DEATHS OF HUNDREDS OF BRITISH COLUMBIANS EACH YEAR!
The basis for this ongoing death sentence for so many British Columbian each year is the NDP created Emergency Health Services Act of 1974 (used to be called the Health Emergency Act)
When I read the attached Emergency Health Service Act (attached below) one thing struck; it primarily focused on EMS system structure and entrenching EMS service provider rights (BC Ambulance Service) but stated little in the way of entrenching/making sure that critical needs patients are guaranteed to get life saving care throughout BC.
The (current) BC Emergency Health Services Act is directly responsible for the propagation of an EMS system in BC which directly contributes to the unnecessary deaths of many hundreds of British Columbians each year. FYI, almost 7,800 men, women and children die outside of hospitals each year in British Columbia, a very high percentage from ‘clinically treatable’ but time sensitive conditions; treatment time delays and inadequate attendant training contribute greatly to many of the unnecessary deaths.
The BC EHS Act helps to ensure these ‘unnecessary deaths’ by way of (highly) restricting the provision of ‘full spectrum EMS care’ to only one service provider, namely the BC Ambulance Service. Because of the EHS Act, over 6,000 first responders in BC are literally prevented, by law, from practicing beyond ‘first responder level of care’ (first aid), that includes over 3,800 professional firefighters in some 51 communities around BC.
Some perspective here, BC currently (only) has 1,300 full-time BCAS ambulance attendants, with only about 150 or so working paramedics (Advance Life Support qualified), the remaining 2,300 or so are Basic life support part-timers.
It is important to understand that by far and away the majority of BCAS personnel, are as mentioned, only ‘basic life support’ ambulance attendants – they are NOT true paramedics (by international standards), there is a huge difference in medical training between a Basic Life Support ambulance attendant and fully trained (true) paramedic (advanced care paramedic). So when you see a BCAS ambulance drive by and you see ‘Emergency Paramedic’ written on the side, the attendant crew inside is only a Basic Life Support crew and NOT an actual Advance Life Support Paramedic crew as this writing on the side of the ambulance would (by deliberate design) suggest. FYI, for a ‘basic life support’ ambulance attendant to call themselves a ‘paramedic’ would be illegal in many jurisdictions around the world but not here in BC, anyone with a 2 month BLS training course can call themselves a ‘Paramedic’ here.
For the EHS Act to deliberately set in law the exclusion of over 3,800 professional firefighters from providing basic life support EMS (and beyond) is not only beyond comprehension but directly contributes to the unnecessary suffering and deaths of many hundreds of persons in BC – year each.
From a practical point of view: The bureaucracy (that has been created to artificially protect BC Ambulance Service turf) actually legally prevents a firefighter first responder from administering a lifesaving EpiPen to a person in anaphylactic shock (!!) yet a bystander can legally administer the very lifesaving EpiPen to the dying person; how screwed up is a law that entrenches such restrictions? This insanity MUST be stopped; the EHS act must be amended soonest if we are to stop losing perfectly salvageable, critical needs, prehospital care patients, and the only way that is going to happen is by way of public pressure.
In recent conversations with high ranking firefighter reps, it was made (crystal clear) to me that there are is a ‘special interest group’ that has been working diligently (for the last several DECADES) to maintain the status quo, even though they know full well (as all informed EMS stakeholders do) that our current chosen EMS system in BC directly contributes to the unnecessary deaths of many British Columbians each year. The message was clear: Firefighters have tried for many years, supported by solid statistics and official reports to convince the government to make the necessary changes to the EHS Act but all to no avail, it is felt today that only public pressure, stemming from public problem education, will push the (self-serving) interests in this issue to finally ‘do the right thing’ and allow the necessary changed to be made.
FYI, fire departments respond to (most) 911 calls already and typically arrive ‘on scene’ within 4-6 minutes yet they are restricted to only proving first aid, how is that good for someone that is in dire need of a higher level of care (soonest) or they will die? I have also attached the actual reported ‘average’ BC Ambulance Service response times for 2010 – in a word, they are disgraceful and utterly unacceptable, when you see the response times you will see why so many British Columbians are dying needlessly each year, including many children. It begs the question: why are we deliberately keeping Fire/Rescue services from providing full spectrum EMS – that would be good for all British Columbian, except of course, it wouldn’t be so good for the BC Paramedics Union, who absolutely, under no circumstances, want anyone other group working on ‘their turf’ be that firefighters, doctors, nonprofit groups (Canadian Red Cross) and of course for profit ambulance companies. In short, we have a highly ‘supply managed’ EMS system in British Columbia, and if we don’t like, too bad! It doesn’t matter how many of have to us die unnecessarily, the EMS turf in BC is locked up.
Hans Dysarsz

Health Professions Council Health Emergency Act Legislative Review
Preliminary Report (today called the EHS Act)



June 1998


FOREWORD

This report is the result of the Health Professions Council's legislative review of emergency medical assistance pursuant to the Terms of Reference from the Minister of Health and Minister Responsible for Seniors. Under the Health Professions Act, the Health Professions Council is a six person advisory body appointed by the Government of British Columbia to make recommendations to the Minister of Health and Minister Responsible for Seniors about the regulation of Health Professions.

In this report the Health Professions Council examined two issues:

1. whether designation of the health profession of emergency medical assistance under the Health Professions Act would be in the public interest or whether there are unique features of the health profession, or other relevant factors, that justify a continuing need for a separate statute; and

2. what amendments, if any, are required to the current statute, rules, regulations and bylaws for the profession of emergency medical assistance to provide adequately for the regulation of the profession in the public interest and to ensure that the current statute contains the core principles of professional regulation reflected in the Health Professions Act and discussed in Schedule B to the Terms of Reference.


CONTENTS

EXECUTIVE SUMMARY

I. INTRODUCTION

1. THE NATURE OF THE REVIEW
2. THE PROCESS FOR THE REVIEW

II. DISCUSSION OF ISSUES

1. IS THERE A NEED FOR A SEPARATE ACT?
1. The General Policy Favouring Designation
2. The Regulatory Structure for Emergency Medical Assistance
1. Historical Development
2. The Present Structure
3. Summary
3. The Profession Specific Arguments Regarding Designation
4. The Council's Conclusion Regarding Designation
2. DOES THE HEALTH EMERGENCY ACT CONTAIN THE CORE PRINCIPLES OF PROFESSIONAL REGULATION?
1. Quality Assurance Mechanism
2. Complaint and Disciplinary Process
3. Summary Regarding Health Emergency Act Core Principles of Professional Regulation

III. RECOMMENDATION

APPENDIX: THE TERMS OF REFERENCE AND GUIDELINES
EXECUTIVE SUMMARY

The Health Professions Council has conducted a comparative analysis of the Health Emergency Act (the HEA) with the Health Professions Act.

After reviewing the analysis and considering the core principles of professional regulation embodied in the Health Professions Act and discussed in the Terms of Reference, the Health Professions Council has determined that designation of the profession of emergency medical assistance under the Health Professions Act would not be in the public interest. In the Health Professions Council's view, the unique nature of the profession is not suitable to the self-regulatory structure embodied in the Health Professions Act and therefore designation is not in the public interest.



1. INTRODUCTION

This is the preliminary report of the legislative review of the Health Emergency Act (the HEA) conducted by the Health Professions Council (the Council).

The review was conducted pursuant to the Terms of Reference issued by the Minister of Health and Minister Responsible for Seniors in accordance with section 24, now section 25, of the Health Professions Act (the HPA).

The Terms of Reference direct the Council to review the governing statutes for each of ten Health Professions, of which emergency medical assistance (EMA) is one.



A. THE NATURE OF THE REVIEW

The purpose of the review as set out in the Terms of Reference is twofold:

1. To determine whether designation of the health profession under the HPA would be in the public interest or there are unique features of the health profession, or other relevant factors, that justify a continuing need for a separate statute.
2. To determine what amendments, if any, are required to the current statute, rules, regulations and bylaws for each profession to provide adequately for the regulation of the profession in the public interest and to ensure that the current statute contains the core principles of professional regulation reflected in the HPA and discussed in Schedule B to the Terms of Reference.

The Terms of Reference and the Criteria and Guidelines which expand upon them are included as an Appendix to this report.

The Council's primary task in conducting the legislative review is to determine whether it is in the public interest that a health profession be designated under the HPA. The analysis of whether the professional statute contains the core principles of professional regulation is an important element in the consideration of whether designation is in the public interest. The extent to which a professional statute currently embodies these core principles is clearly one of the factors the Council must consider in making this determination.

However, the core principle analysis is not the only factor that must be considered. The Terms of Reference reflect a general policy that designation under the HPA is the favoured option. They refer to the desirability of minimizing the number of statutes that govern the Health Professions and the importance of a high degree of consistency among statutes. The Terms of Reference also direct the Council to consider specifically whether there are unique features of a health profession or other relevant factors that justify a separate statute. In the case of EMA, the Terms of Reference also direct the Council to have particular regard to the role of the Emergency health Services Commission and the terms of the collective agreement in its review.

In summary, in determining whether a profession should be designated under the HPA the Council must consider, first, whether there are unique features of the profession or other relevant factors that justify the retention of a separate statute and, second, the extent to which the current professional statute embodies the core principles of professional regulation.


B. THE PROCESS FOR THE REVIEW

The general process for the review provides for an initial meeting with the profession, preparation by the Chair of the Council of a comparative analysis of the profession's current statute with the HPA, consultation with the profession regarding the analysis, drafting of a preliminary report, discussion of the preliminary report within the Council, consultation meetings and a final report.

The Council Chair met with representatives of the Emergency Medical Assistants Licensing Board (the Board), the B.C. Ambulance Service (the BCAS), and representatives of C.U.P.E. Local 873 (the Union) on May 1, 1995 to discuss the review process. In a joint submission dated July, 1995, all three bodies indicated their support for the present legislative structure.

The Chair then completed the comparative analysis of the HEA and the HPA, and provided the Board and the Union with a detailed summary of the analysis of the HEA. The Board and the Union were asked to provide responses to a number of questions and to describe the unique features of EMA, or any other relevant factors, that justified the retention of a separate statute. In response, the Board made a written submission on July 10, 1996.

The Chair then completed this preliminary report which will be circulated to all Health Professions and other interested parties upon request.



II. DISCUSSION OF ISSUES

As noted above, the Council's primary focus in conducting this review is to determine whether designation of the profession of EMA under the HPA would be in the public interest. The Council has determined that it would not be in the public interest for the profession of EMA to be designated under the HPA and proposes to discuss its conclusion by considering first, whether there is a need for a separate statute, and second, whether the HEA contains the core principles of professional regulation reflected in the HPA and discussed in Schedule B to the Terms of Reference.


A. IS THERE A NEED FOR A SEPARATE ACT?

The Council proposes to address this issue by discussing the general policy favouring designation, the regulatory structure for EMA and the profession specific arguments regarding designation.

1. The General Policy Favouring Designation

As stated above, the Terms of Reference reflect a general policy that designation is the favoured option, and that a profession must justify a continuing need for a separate statute. The Council would like to expand on this important issue.

Under the existing regulatory system, each profession is governed by its own professional statute. The terminology used as well as the regulatory structures and processes created vary widely from profession to profession, especially with respect to the complaint and disciplinary process. This variation and resulting complexity is confusing to the public and registrants. In the Council's view, a uniform regulatory system under the HPA would eliminate much of the complexity and confusion, and foster the development of a common jurisprudence for the Health Professions.

Several recent reports of Royal Commissions and government policy statements have emphasized that an integrated approach to the delivery of health care is in the public interest. Coordination and cooperation amongst health care providers is of fundamental importance to such an approach, and in the Council's view, a uniform regulatory structure enhances the government's ability to apply health care policy consistently.

The general policy of legislative uniformity is also consistent with initiatives in several other provinces, notably Ontario which has implemented umbrella legislation for the Health Professions and Alberta which is in the process of enacting umbrella legislation.

The Council agrees with these statements about the desirability of uniformity in legislation and accepts that, as a general rule, designation under the HPA is the preferred option. This general policy favouring designation is embodied in the Terms of Reference which refer to the desirability of a "high degree of consistency between statutes" and of "minimiz[ing] the number of statutes that apply to the governance of Health Professions".

Nonetheless, the Terms of Reference and attached Criteria and Guidelines make it clear that the Council is to consider each profession individually to determine whether there are unique features of the profession or other relevant factors that justify a need for a separate statute.


2. The Regulatory Structure for Emergency Medical Assistance

a) Historical Development

Prior to 1974, emergency medical services were essentially unregulated. They were provided by both public and private bodies, and the service varied widely.

In 1974, the issue of ambulance service was reviewed by the Foulkes Commission and referred to in its report, "health Security for British Columbians, Special Report: Consumer Participation, Regulation of the Professions, and Decentralization". Several recommendations were made regarding ambulance service and emergency hospital facilities. The Report stated that ambulance services should be provided by persons employed for that purpose and that services should be provided in a consistent and uniform fashion. One of the Report's recommendations was as follows:

That a provincially financed ambulance service be developed on a province-wide basis by the director of the emergency health services unit and ambulance crews be members of the health Services Unit.

In 1974, the government established the Emergency health Services Commission (the Commission) under the HEA. The Commission was given exclusive jurisdiction to provide emergency services throughout the province, and to deal with all matters related to ambulance services, including recruiting and training emergency medical assistants (EMAs).

In its submission, the Board indicates that the reason for the centralization of ambulance services was to avoid the "fractionation" of services. The Board notes that a provincial system provides consistent training and patient care for optimum delivery of pre-hospital care, and that many regulatory functions have been assumed by the employer. The Council notes that other government reports such as the Cain Review and the Boyes Report have supported the notion of a centralized, provincial system.

Over time, it became apparent that there were problems associated with the Commission acting both as employer and licensing body. Specifically, it was felt that it was not appropriate for one body to have the mandate to both hire and license EMAs. As a result, in 1991, the Board was established and given the mandate to examine, register and license EMAs, and investigate complaints made against them.


b) The Present Structure

As a result of these developments, there are essentially two bodies responsible for the delivery of emergency services in British Columbia, the Commission and the Board.

The Commission is not an independent body, but a body made up of senior government employees appointed by the Lieutenant Governor in Council. Pursuant to the HEA the Commission is for all purposes an agent of government, and it is required to submit an annual report to the Minister about its operation.

The Commission's role is set out in section 5(1) [5(1)] of the HEA:

Power and authority of commission

5 (1) The commission has the power and authority to do one or more of the following:

1. provide emergency health services in British Columbia;
2. establish, equip and operate emergency health centres and stations in areas of British Columbia that the commission considers advisable;
3. assist hospitals, other health institutions and agencies, municipalities and other organizations and persons, to provide emergency health services and to train personnel to provide services, and to enter into agreements or arrangements for that purpose;
4. establish or improve communication systems for emergency health services in British Columbia;
5. make available the services of medically trained persons on a continuous, continual or temporary basis to those residents of British Columbia who are not, in the opinion of the commission, adequately served with existing health services;
6. recruit and train emergency medical assistants;
7. provide ambulance services in British Columbia to be known as the British Columbia Ambulance Service;
8. perform any other function related to emergency health services as the Lieutenant Governor in Council may order.

Thus, the Commission has a very broad mandate, dealing with virtually all matters related to emergency services, including, under section 5(1)(f) [5(1)(f)] of the HEA, the responsibility for recruiting and training all EMAs. Thus, all EMAs are government employees. It is also important to note that all EMAs are represented by one bargaining unit, the Canadian Union of Public Employees.

The Commission is essentially the board of directors for the BCAS which is part of the Ministry of Health. The BCAS is the operational arm of the Commission, and provides it with support. It has full-time staff, including an executive director. The Commission has also established a medical advisory committee consisting of selected medical personnel and educators. The advisory committee's role is to discuss medical protocols and process issues, and to make recommendations to the Commission.

The Board, like the Commission, is made up of Lieutenant Governor in Council appointees. The Board has three members, one of whom must be an emergency medical assistant and another of whom must be a medical practitioner. The third, in practice, has been a lawyer experienced in labour law. The Board reports to and is funded by the Minister.

The Board's role is set out in section 6(5) [5.1(4)] of the HEA:

Emergency Medical Assistants Licensing Board

6(5) Subject to this Act and the regulations, the board has the power and authority to do the following:

1. examine, register and license emergency medical assistants;
2. set terms and conditions for a licence under this section;
3. investigate complaints;
4. delegate to one or more persons the power and authority to act under one or more of the provisions of paragraphs (a), (b) and (c).

Thus, the Board's main functions are licensing and discipline.

Support for the Board's activities is provided by the Emergency Medical Assistants Licensing Branch of the Ministry of Health. The Branch has several full time staff, including a Registrar who manages the Board's activities.

Thus, it is clear that the regulatory functions in the profession are shared by the Commission and the Board, with support from various personnel within the Ministry of Health.


c) Summary

The foregoing review of the regulatory structure for EMAs indicates that the profession is not, in fact, a self-regulating profession.

Self-regulating professions are typically governed by officers and directors elected by members of the profession who are given the power, among other things, to set entry and practice standards, and administer a disciplinary regime. In a self-regulatory system, government effectively delegates its administrative and regulatory authority to the profession so that it may govern itself. It is for this reason that when self-regulating status is granted, the legislation implementing the system typically contains several safeguards, such as public membership and reporting requirements, in order to ensure that the regulatory powers are exercised in the public interest. The HPA contains such safeguards.

In contrast, the profession of EMA is regulated both directly and indirectly by government, through the Commission and the Board. The regulatory regime is essentially a government administered licensing and certification system. Of the professions subject to the Council's legislative review the profession of EMA is unique in this regard. This is an important point, because in the Council's view the current regulatory structure is a factor to consider in determining whether a profession should be designated under the HPA which clearly embodies a structure for self-regulating professions.


3. The Profession Specific Arguments Regarding Designation

The Board is of the view that a separate statute is necessary for EMA because of the unique nature of the profession, and in particular its unique regulatory structure.

The following comments regarding the regulatory structure are from a joint submission made by the BCAS, the Board and the Union:

Unlike other professions, there is only one employer for all emergency medical assistants (E.M.A.s) working in the Province of British Columbia. A further difference is that the employer is a government body rather than a private or institutional organization.

As the employer, the Emergency health Services Commission (E.H.S.C.), Ministry of Health, is responsible for all pre-hospital emergency care services. As will be discussed in greater detail, it is this environment and its related infrastructure that impacts upon E.M.A. scope of practice.

In its submission, the Board states that because there is only one employer for EMAs, many regulatory functions have been assumed by the employer:

As the single employer, the Commission has developed protocols and procedures, on the basis of recommendations put forth by the Medical Advisory Committee, which will apply to all E.M.A.s in the Province. In addition to ensuring consistency, it affords the general public a high level of comfort in what care is being provided. All training is provided by the Paramedic Academy; protocols are only changed, added or deleted if recommended by the Medical Advisory Committee; and local, regional or provincial needs can be quickly addressed since the information flows from one source.

The existence of a single employer, bargaining unit and current legislation also facilitates free movement of patients throughout the Province. Given the immense geographical area that needs to be covered and location of tertiary hospitals in urban areas, this concept is of critical importance. The passage of time has demonstrated the current infrastructure to function very well.

The Board states that the one employer, centralized approach to regulation is necessary in order to ensure consistent training and patient care. Further, it states that government must provide the service in order to ensure province wide delivery, because private providers would not operate in less populated areas.

The Board also points out that registration requirements and post employment training differ significantly from that of other Health Professions. It states that for EMAs, all raining specific to the job is completed after employment and entirely by the employer through the Justice Institute of B.C. All training is job specific and standardized because it is provided by one facility, the Paramedic Academy, Justice Institute of BC. As regards registration criteria, the Board emphasizes the unique features of EMA. Other health professional bodies require specific qualifications from an applicant. For EMA, however, an applicant is hired and licensed by the Commission only to fill a vacancy, and only after satisfying the hiring requirements and qualifications set out in Part 3 of the HEA Regulations.

The Board notes that these unique characteristics are reflected in the HEA. Further, the Board is of the view that the current regulatory structure which involves both the Board and the Commission as employer, is the most effective way to ensure optimum delivery of ambulance services in the public interest.

Finally, the Board notes that although Ontario adopted umbrella legislation for Health Professions, ambulance services there continue to function under separate legislation.



4. The Council's Conclusion Regarding Designation

In the Council's view, the unique features of the profession of EMA, including the nature of the services provided and the public interest as reflected in reports of previous studies regarding this profession, justify the retention of a separate statute.

Unlike the other professions subject to the legislative review, the profession is not self-regulating and thus is not well suited to the structure under the HPA which is clearly intended for self-regulating professions. There is no need for a college, and many of the accountability mechanisms set out in the HPA are intended for bodies that are independent from, and not part of, government.

The structure that has developed, which is essentially a shared system of regulatory functions between the Commission and the Board, would be difficult to adapt to the HPA model. Under the HPA, a single college is charged with the duty of protecting the public interest, and ensuring that various statutory objects are carried out. In contrast, in the profession of EMA, responsibility for these matters is shared between the Board and the Commission. Further, the Council is persuaded that this structure works well for this profession, and in this regard notes the conclusions of various reports regarding EMA.

Unlike other Health Professions, the regulatory structure under the HEA provides not only for the regulation of practitioners but also for the mandate of delivery of all ambulance services in the province. An example of this wider mandate is the First Responder Program which was created by the Commission upon the recommendation of the Cain Report. A province wide program was established for police and fire departments to serve as first responders in emergency situations. Because of the strategic location of many departments, police and/or fire fighters are often capable of being the first at a scene of accident or medical emergency. Through the Paramedic Academy at the Justice Institute of B.C., the First Responder Program trains the police and fire fighters in basic first aid treatment and strengthens their role in the "emergency care linkage". In the Council's view, this broader mandate favours the preservation of the present system under the HEA whereby the entire field of ambulance service is effectively regulated by government.

The Council also notes that all practising EMAs are represented by a union, C.U.P.E., Local 873 (the Ambulance Paramedics of British Columbia), and that a process has developed whereby practitioner input is sought on decisions through the bargaining process. An example of this is the creation and development of Standards of Care Committees (SOCC). The SOCCs serve as peer review bodies and review patient care matters that need to be resolved and ensure, through the participation of a physician, that matters involving medical protocol and patient care are appropriately addressed. This kind of working environment differs significantly from the other Health Professions where typically there are many employers or widespread self-employment.

For these reasons, the Council is of the view that the public interest favours the retention of a separate HEA.



B. DOES THE HEALTH EMERGENCY ACT CONTAIN THE CORE PRINCIPLES OF PROFESSIONAL REGULATION?

Schedule A to the Terms of Reference which embodies the Criteria and Guidelines, directs the Council to determine what amendments, if any, are required to the current statute, rules, regulations and bylaws for each profession to provide adequately for the regulation of the profession in the public interest and to ensure that the current statute contains the core principles of professional regulation reflected in the HPA and discussed in Schedule B to the Terms of Reference. In short, the Council must examine, in the event that designation of the health profession under the HPA is not in the public interest, what changes to the health profession statute in issue are necessary to conform to the core principles reflected in the HPA and discussed in Schedule B to the Terms of Reference.

Schedule B to the Terms of Reference organizes the core principles of professional regulation under five headings:

1. mandate of the regulatory body;
2. registration requirements for entry into the profession;
3. quality assurance mechanisms;
4. complaint and disciplinary process; and
5. accountability mechanisms.

In the Council's view, because of the unique nature of the EMA the core principles regarding mandate, registration and accountability mechanisms are not particularly relevant to the profession of EMA. Regarding registration, the Council notes that there is only one employer for EMAs, and all training and licensing is post-employment, thus justifying a unique registration process. Regarding mandate and accountability mechanisms, the core principles related to these issues are not well suited to comparison with a profession such as EMA which is not self-regulating.

The Council does however have some concerns regarding the other two categories of core principles, quality assurance mechanisms and complaint and disciplinary process. In the Council's view, the core principles related to these matters raise important public interest issues for health care practitioners regardless of the regulatory structure.



1. Quality Assurance Mechanisms

Under this heading, Schedule B of the Terms of Reference states that there should be effective mechanisms for monitoring practitioner competency including the ability to set continuing education requirements, and that a committee of the board should be responsible for reviewing standards of practice and codes of ethics.

The Council notes that sections 16(2)(d) and (g) [15.1(2)(d) and (g)] of the HPA provide that a board's objects include responsibility for standards of practice and ethics. Further, section 16(2)(f) [15.1(2)(f)] and Bylaw 18 [17] of the HPA establish a patient relations program to prevent professional misconduct of a sexual nature.

Neither of these provisions is contained in the HEA. The Board offers no objection to either issue. The Council is of the view that these matters should be included as specific statutory mandates for the regulatory body for EMA. In the circumstances of the profession of EMA, whereby regulatory responsibilities are shared between the Commission and the Board, the Council believes that both bodies should be consulted about which is best able to fulfil the duties required by these programs.



2. Complaint and Disciplinary Process

A review of the HPA and the principles outlined in Schedule B to the Terms of Reference indicates that a designated health profession's complaint and disciplinary process must, at a minimum, incorporate certain key elements:

1. the investigative and adjudicative bodies must be made up of different people and the bodies administered independently;
2. dissatisfied complainants and registrants must be afforded rights of appeal;
3. the process must be consistent with the rules of natural justice, and provide for proper notice of a proceeding and a right to be heard; and
4. the process must not be complex: complainants and registrants must understand how the process works.

With these principles in mind, the Council asked the Board several questions about its complaint and disciplinary process, and after reviewing the responses, notes the following concerns:

1. The Council has a concern about the general framework of the complaint and disciplinary process found in the HEA. It appears that the Board receives the complaint at the initial stage, or the Board may on its own initiative commence a complaint, pursuant to section 7 [5.2(1)] of the HEA. At the same time, after a complaint has been referred by the Board to the Investigation Committee, which may feel that a hearing is recommended, the complaint is again referred to the Board which is then responsible for the conduct of a hearing. These steps are embodied in the HEA Regulations, specifically sections 3(b), 4 and 5.

The Board states that its procedure is advantageous in that it is designed to accomplish all required objectives of an effective complaint process. It believes that the creation of additional committees would simply add costs without adding benefits. Further, the Board claims that the investigative and adjudicative functions are separate under the HEA. It states that the initial complaint review by the Board is based only on the complaint itself and does not include any detailed evidence supporting or refuting the complaint.

In the Council's view, the investigative and adjudicative functions under the HPA are not sufficiently separate. Under the HPA, the investigative and adjudicative bodies must be made up of different persons and the bodies must be administered independently. The fact that the Board as the initial recipient of a complaint limits its findings within the four corners of the complaint does not validate the process presently set out in the HEA. The fact remains that the same persons on the Board - which consists of three individuals - are the ones that receive or initiate a complaint and adjudicate upon it after it has undergone scrutiny by the Investigation Committee.

In summary, the Council feels that the present mechanism of the complaint and disciplinary process in the HEA is flawed as regards the overlapping investigative and adjudicative functions within the Board. The Council notes that the Board offers no objection to clarifying the roles played by the Investigation Committee and the Board, provided that there are no unnecessary costs without new benefits. The Council appreciates these concerns but believes that the necessary separation can be achieved without significant disruption. Specifically, the Registrar of the Board could be given the initial screening function, thus preserving the impartiality of the Board.

2. The Council asked the Board about sections 34(1) and (2) [33(1) and (2)] of the HPA which provides that the inquiry committee must report to the board in all cases where it decides not to refer the matter to the discipline committee and which gives the complainant a right to appeal such decision to the Board. The Board replies that as part of standard practice, it is advised of the status of each complaint once the Investigation Committee has completed its findings on a complaint. Although the Board does not object in principle to these HPA sections, it maintains that the complainant's right to appeal such a decision should be to the Investigation Committee because the Board would be biased should a hearing on the matter subsequently be commenced.

The Council believes that complainants should be granted some form of internal appeal regarding dismissed complaints, and accepts the Board's concession - that granting the right to appeal to the investigation committee would be appropriate.

3. The Council inquired whether the Board makes its hearings open to the public. The Board points out Rule 9 which empowers the Board to conduct a private hearing if the complainant or respondent so requests or if the Board feels that it is more appropriate to hold a private hearing. In the Council's view, the scope of this provision is too broad. The Council believes that the core principles require that hearings of an adjudicative nature must generally be open to the public, with specific exceptions providing for precise grounds for holding the hearings in private. Such a provision is embodied in sections 12(5) [11(3)] of the HPA Bylaws.

4. Finally, the Council notes that the Board offers no objections to the adoption of the following HPA provisions:

1. section 33(4) [32(4)] of the HPA which deals with the inquiry committee's power to take any action it considers appropriate to resolve a complaint, including mediation;
2. section 36 [35] of the HPA which provides that the inquiry committee may resolve complaints by way of registrants' undertakings or consents;
3. section 37 [36] of the HPA which describes the contents of a citation;
4. section 38 [37] of the HPA which sets out the procedure for a discipline committee hearing; and
5. section 40 [39] of the HPA which provides for an appeal by a person aggrieved or adversely affected by a decision of the discipline committee.



3. Summary Regarding Health Emergency Act Core Principles of Professional Regulation

After a careful review of the HEA and Rules, the Council is of the view that the legislation regarding the profession of emergency medical assistance is for the most part consistent with the core principles of professional regulation. However on some important issues, notably those related to quality assurance mechanisms and the complaint and disciplinary process, the Council found several provisions to be inadequate, incomplete or missing.

Therefore, the Council recommends that changes to the HEA be made in accordance with the Council's suggestions regarding quality assurance mechanisms and the complaint and disciplinary process discussed at p. 12 to 15 of this report. In the Council's view, these changes are necessary in order to ensure that the HEA is consistent with the core principles of professional regulation embodied in the HPA and set out in Schedule B to the Terms of Reference.
D. RECOMMENDATION

The Health Professions Council recommends to the Minister of Health and Minister Responsible for Seniors that the Health Emergency Act be retained. The Council also recommends that the Health Emergency Act be amended to include the suggested changes discussed in this report.





The following is the current BC Emergency Health Services Act

Home > Documents and Proceedings > 4th Session, 39th Parliament > Bills > Bill 48 — 2012: Emergency and Health Services Amendment Act, 2012
4th Session, 39th Parliament (2011-2012)
FIRST READING

The following electronic version is for informational purposes only.
The printed version remains the official version.

HONOURABLE MICHAEL DE JONG
MINISTER OF HEALTH
BILL 48 — 2012
EMERGENCY AND HEALTH SERVICES
AMENDMENT ACT, 2012

HER MAJESTY, by and with the advice and consent of the Legislative Assembly of the Province of British Columbia, enacts as follows:



1 The title of the Emergency and Health Services Act, R.S.B.C. 1996, c. 182, is repealed and the following substituted:
EMERGENCY HEALTH SERVICES ACT .



2 Sections 1 to 5.1 are repealed and the following substituted:
Definitions

1 In this Act:

"ambulance" means a conveyance that is designed and constructed, or equipped, to provide ambulance services;

"ambulance services" means the use of an ambulance to

(a) provide emergency health services, or

(b) transport an individual

(i) under the care of, or

(ii) who requires, or may require, a service provided by

a medical practitioner, a nurse practitioner, an emergency medical assistant or another health care provider;

"ancillary health services" means health care that supports, supplements or complements, or that is related or ancillary to, one or more of the following:

(a) ambulance services;

(b) emergency health services;

(c) urgent health services;

(d) services provided by, from, in or through a facility;

"board of directors" means the corporation's board of directors appointed under section 2;

"bylaw" means a bylaw, made under section 2, of the corporation;

"corporation" means the corporation described in section 2;

"emergency health services" means first aid or other health care provided in circumstances in which it is necessary to provide the first aid or other health care without delay in order to

(a) preserve an individual's life,

(b) prevent or alleviate serious physical or mental harm, or

(c) alleviate severe pain,

but does not include

(d) services provided by, from, in or through a facility, or

(e) a service excluded by order of the minister for the purposes of this definition;

"emergency medical assistant" means a person licensed by the licensing board under this Act as an emergency medical assistant;

"facility" means

(a) a hospital as defined in section 1 or 5 of the Hospital Act,

(b) a Provincial mental health facility as defined in the Mental Health Act,

(c) an assisted living residence or community care facility as defined in the Community Care and Assisted Living Act, or

(d) a facility, or class of facilities, designated by order of the minister for the purposes of this definition,

and, for the purposes of agreements or arrangements under section 5.4 for the provision of ancillary health services, includes an equivalent or similar facility in another province or a foreign jurisdiction;

"governing body", except in section 5.6, means a body, in another province or a foreign jurisdiction, that regulates a health profession in that other jurisdiction;

"health care" has the same meaning as in the Health Care (Consent) and Care Facility (Admission) Act;

"health profession" has the same meaning as in the Health Professions Act;

"licensing board" means the Emergency Medical Assistants Licensing Board continued under section 6 (1);

"profession" means practice as an emergency medical assistant;

"Provincial Health Services Authority" means the Provincial Health Services Authority, a society incorporated under the Society Act;

"regional health board" means a regional health board designated under the Health Authorities Act;

"restricted activity" has the same meaning as in the Health Professions Act;

"urgent health services" means health care provided in circumstances in which a medical practitioner or nurse practitioner determines that an individual

(a) needs the health care urgently, and

(b) does not need emergency health services,

but does not include services provided by, from, in or through a facility.
British Columbia Emergency Health Services

2 (1) The Emergency and Health Services Commission is continued as a corporation, under the name British Columbia Emergency Health Services, consisting of a board of directors made up of one or more members appointed by order of the minister.

(2) The chair of the board of directors is a member of the board of directors

(a) designated as chair by order of the minister, or

(b) elected under the bylaws by the board of directors, if a chair is not designated under paragraph (a).

(3) The minister may, by order, determine

(a) remuneration for members of the board of directors in accordance with the general directives of Treasury Board, including different rates of remuneration for different members, and

(b) other terms and conditions of appointment of a member.

(4) The corporation must pay members of the board of directors

(a) the remuneration, if any, determined under subsection (3) (a), and

(b) reimbursement, in accordance with the general directives of Treasury Board, for reasonable travelling and out-of-pocket expenses necessarily incurred while exercising powers or performing duties on behalf of the corporation.

(5) For the purposes of exercising its powers and performing its duties under this Act, the corporation has the powers and capacity of a natural person of full capacity.

(6) The Business Corporations Act does not apply to the corporation unless the minister, by order, directs that one or more provisions of that Act apply to the corporation.

(7) Subject to this Act and the regulations, the board of directors may make bylaws that it considers necessary or advisable, including bylaws to do the following:

(a) determine its own procedure;

(b) provide for the control and conduct of its meetings;

(c) provide for the election of officers of the board of directors, including the chair and the member to be the acting chair in the absence of the chair, and provide for the powers and duties of the officers of the board of directors;

(d) establish committees and specify the powers and duties of those committees;

(e) delegate administrative or management duties to persons appointed or retained under section 5;

(f) provide for the preparation and custody of minutes of meetings of the board of directors, and of committees established under the bylaws.

(8) The following may be done only on authority of a bylaw:

(a) the acquisition or disposal, by the corporation, of real or personal property;

(b) the exercise of the corporation's borrowing powers, including any prohibitions or restrictions on those powers.

(9) A bylaw made under subsection (7) or (8) has no effect until it is approved by order of the minister.

(10) Subject to subsections (11) to (14), a meeting of the board of directors must be open to the public.

(11) A part of a meeting of the board of directors may be closed to the public if the subject matter being considered relates to a matter or circumstance specified by order of the minister for the purposes of this subsection.

(12) A part of a meeting of the board of directors must be closed to the public if the subject matter being considered relates to information that must be withheld from disclosure under another enactment.

(13) If the only subject matter being considered at a meeting of the board of directors relates to

(a) one or more matters or circumstances specified by order of the minister, as set out in subsection (11), or

(b) information that must be withheld from disclosure under another enactment, as set out in subsection (12),

subsection (11) or (12), as applicable, applies to the entire meeting.

(14) Before a meeting or part of a meeting of the board of directors is closed to the public, the board of directors must state, by resolution passed in a public meeting,

(a) the fact that the meeting or part of the meeting is to be closed, and

(b) the basis under subsection (11) or (12) on which the meeting or part of the meeting is to be closed.
Financial administration

3 (1) The corporation must establish and maintain an accounting system satisfactory to the minister and must, whenever required, render in the form specified by the minister detailed accounts of revenues and expenditures of the corporation for the period or to the day the minister designates.

(2) All books or records of account, documents and other financial records of the corporation must be open at all times for inspection by the minister or a person designated for that purpose by the minister.

(3) The minister charged with the administration of the Financial Administration Act may direct the Comptroller General to examine and report to Treasury Board on any or all of the financial and accounting operations of the corporation.

(4) The accounts of the corporation must, at least once in every year, be audited and reported on by an auditor who is authorized to be the auditor of a company under sections 205 and 206 of the Business Corporations Act, and the costs of the audit must be paid by the corporation.

(5) No later than 120 days after the end of its fiscal year, the corporation must prepare and submit to the minister, in a form satisfactory to the minister,

(a) a report of the corporation on its operations for the preceding fiscal year, and

(b) a financial statement showing the assets and liabilities of the corporation at the end of the preceding fiscal year and the income and expenditures of the corporation for that year, and a statement of changes in financial position of the corporation for the year then ended.

(6) The financial statement referred to in subsection (5) (b) must be prepared in accordance with generally accepted accounting principles and regulations, if any, made under section 15 (2) (q).

(7) The Financial Information Act applies to the corporation.

(8) The fiscal year of the corporation is the period of 12 months beginning on April 1 in each year and ending on March 31 in the next succeeding year.
Public administrator

4 (1) The Lieutenant Governor in Council may appoint a public administrator to discharge the powers and duties of the corporation under this Act if the Lieutenant Governor in Council considers it to be necessary in the public interest.

(2) On the appointment of a public administrator, the members of the board of directors cease to hold office unless otherwise ordered by the Lieutenant Governor in Council.

(3) The Lieutenant Governor in Council may specify

(a) the powers, duties and responsibilities of a public administrator appointed under this section,

(b) the terms and conditions for management of the property and affairs of the corporation during the transition period preceding the ending of the appointment of a public administrator, or

(c) how the corporation will operate after the ending of the appointment of a public administrator.
Staff

5 (1) The board of directors

(a) must appoint a person as the president of the corporation to exercise the powers and perform the duties that the board of directors specifies, and

(b) may determine the remuneration and other terms and conditions of employment of the president.

(2) The board of directors or, if authorized by the board of directors, the president of the corporation may

(a) appoint officers and employees of the corporation and retain specialists and consultants to exercise the powers and perform the duties of the corporation, and

(b) determine the remuneration and other terms and conditions of employment or retainer of the persons referred to in paragraph (a).

(3) The Public Service Act and the Public Service Labour Relations Act do not apply to the corporation or its officers and employees appointed under subsection (1) (a) or (2) (a).
Purposes of corporation

5.1 (1) The corporation has the following purposes:

(a) to provide, in British Columbia, ambulance services and emergency health services;

(b) to provide, in areas of British Columbia that the corporation considers advisable, any urgent health services or ancillary health services the corporation considers advisable;

(c) to establish, equip and operate, in areas of British Columbia that the corporation considers advisable, centres and stations for the purposes of providing

(i) ambulance services and emergency health services, and

(ii) the urgent health services or ancillary health services referred to in paragraph (b);

(d) to collaborate, to the extent practicable, with regional health boards, the Provincial Health Services Authority and societies that report to the Provincial Health Services Authority, facilities and other health institutions and agencies, municipalities and other organizations and persons in the planning and coordination of

(i) the provision, in British Columbia, of provincially, regionally and locally integrated ambulance services, emergency health services, urgent health services and ancillary health services, and

(ii) the recruitment and training of emergency medical assistants and other persons to provide the services referred to in subparagraph (i);

(e) to establish or improve communications systems, in British Columbia, for ambulance services and emergency health services;

(f) to make available, in areas of British Columbia that the corporation considers advisable, the services of emergency medical assistants or other persons on a continuous, continual or temporary basis for the purposes described in paragraph (b), (c) (ii), (g) or (h);

(g) to provide, in British Columbia as the corporation considers advisable, a service designated under subsection (2) that provides emergency or other health information or services, or referrals, for the purposes of

(i) assessing an individual's health status and responding to a particular problem or circumstance, including the assessment of whether emergency health services or urgent health services are required,

(ii) supporting individuals in caring for themselves,

(iii) assisting persons, including health care providers, in accessing care, information and services available through the health system, or

(iv) a purpose specified by order of the minister;

(h) to participate in research projects, conducted in whole or in part in British Columbia, related to the provision of ambulance services or emergency health services and to approve such projects if they involve the provision of any of those services to individuals;

(i) to recruit and train emergency medical assistants and other persons

(i) for the purposes set out in this section, or

(ii) under an agreement or arrangement entered into under section 5.4;

(j) to enter into

(i) agreements for the purposes set out in this subsection, or

(ii) agreements or arrangements under section 5.4;

(k) to administer and allocate grants made or funds provided, for the purposes of this section or section 5.4, by the government, the Provincial Health Services Authority or a person;

(l) any other purpose specified by order of the minister;

(m) to exercise any power or perform any duty of the corporation under this Act.

(2) The minister may, by order, designate a service for the purpose of subsection (1) (g) by

(a) setting out the name by which the service is commonly known, and

(b) describing the nature of the service.

(3) A person, other than the minister or the corporation, must not, in British Columbia, do or offer to do anything described in subsection (1) (a), (c) (i), (e), (k), (l) or (m) or approve a research project referred to in subsection (1) (h), except

(a) a person who is employed by, acting under the direction of or acting on behalf of the corporation,

(b) in accordance with

(i) an agreement or arrangement referred to in subsection (1) (j) (i) or (ii), or

(ii) the written consent of the corporation and any terms, limits or conditions the corporation may specify, or

(c) as authorized by order of the minister and in accordance with any terms, limits or conditions the minister may specify.

(4) Subsection (3) does not apply to a person who is

(a) rendering emergency medical services or aid, as described in section 1 of the Good Samaritan Act, unless the person

(i) is employed expressly for that purpose, or

(ii) does so with a view to gain, or

(b) acting in connection with the provision of occupational first aid in accordance with the requirements under the Workers Compensation Act.

(5) The corporation may enter into information-sharing agreements, as defined in section 69 (1) of the Freedom of Information and Protection of Privacy Act, for the purpose of enabling the corporation to exercise any power or perform any duty of the corporation under this Act.

(6) If the corporation enters into an information-sharing agreement under subsection (5), the corporation may, in accordance with the agreement, collect and use personal information from, and disclose personal information to, the body, institution, organization, person or entity with whom the agreement was made.

(7) For the purposes of subsection (6), "personal information" has the same meaning as in the Freedom of Information and Protection of Privacy Act.
General or special direction

5.2 The corporation must comply with any general or special direction made by order of the minister with respect to the exercise of the powers and the performance of the duties of the corporation.
Reporting requirements

5.3 (1) In this section, "personal information" and "stewardship purpose" have the same meaning as in the Ministry of Health Act.

(2) Without limiting section 5.2, if the minister is satisfied that it is reasonably needed to fulfill a stewardship purpose the minister may by order require the corporation to

(a) report on any matter relevant to the stewardship purpose, and

(b) disclose personal information within a report made under paragraph (a).

(3) The corporation must comply with an order made under subsection (2) in the manner and form, and within the time, set out in the order.

(4) The minister must make an order made under this section publicly available by posting the order on a website maintained by or on behalf of the ministry of the minister.
Interjurisdictional service agreements

5.4 (1) The minister or, with the prior written approval of the minister, the corporation may enter into an agreement or arrangement with

(a) a government of another province or a foreign jurisdiction, or any of its agencies,

(b) the government of Canada or any of its agencies, or

(c) an organization, body or person that offers or provides medical, humanitarian or charitable assistance or relief to supplement, substitute or support public services in or after an emergency or crisis situation

for the provision, inside or outside British Columbia, of

(d) ambulance services, emergency health services, urgent health services, ancillary health services or services described in section 5.1 (1) (g), or

(e) a service specified in an order under section 5.1 (1) (l) if the order specifies that the corporation may provide the service outside British Columbia.

(2) The minister may grant an approval under subsection (1) with or without terms, limits or conditions.

(3) The minister and the corporation each have and may exercise, in accordance with an agreement or arrangement made under subsection (1), the power and authority to provide, outside British Columbia, a service referred to in subsection (1) (d) or (e).
Provision of services by visiting health professionals

5.5 (1) In this section:

"requesting agency" means any of the following who request the services of a visiting health professional:

(a) the minister;

(b) the corporation;

(c) the Provincial Health Services Authority, or a society that reports to the Provincial Health Services Authority;

(d) a regional health board;

(e) an organization, body or person designated by order of the minister as a requesting agency for the purposes of this section;

"visiting health professional" means a person who is authorized by a governing body to provide the services of a health profession in another province or a foreign jurisdiction.

(2) A visiting health professional may, while in British Columbia,

(a) provide the services described in subsection (3) (d) for a period of up to 72 consecutive hours, and

(b) use, when providing services under paragraph (a), any of the following that he or she is authorized, in the jurisdiction of his or her governing body, to use in relation to the practice of his or her health profession:

(i) a title or term;

(ii) an abbreviation of a title or term;

(iii) an equivalent of a title, term or abbreviation in another language.

(3) In order for subsection (2) to apply, the following requirements and conditions must be met:

(a) the services are requested by a requesting agency in accordance with an agreement or arrangement under section 5.4;

(b) the requesting agency is satisfied that the visiting health professional is in good standing with his or her governing body;

(c) the visiting health professional provides the services only under the direction of the requesting agency or its representatives, and only while the request for services is in effect;

(d) the visiting health professional provides only those services

(i) that he or she is authorized to provide in the jurisdiction of his or her governing body, and

(ii) for which he or she has received, to the satisfaction of the requesting agency, sufficient additional training, if he or she is not authorized to provide those services in the jurisdiction of his or her governing body.
Interjurisdictional cooperation

5.6 (1) In this section, "governing body" means a body, in another province or a foreign jurisdiction, that regulates a health profession that corresponds with the profession in that other jurisdiction.

(2) The minister may promote cooperation with one or more governing bodies by doing one or more of the following:

(a) subject to paragraph (b), entering into agreements with one or more governing bodies respecting

(i) the interjurisdictional practice of the profession and a health profession, regulated in another province or a foreign jurisdiction, that corresponds with the profession,

(ii) the recognition of another governing body's procedures for and results from the assessment and verification of the credentials, competencies or other qualifications of persons educated or trained in another province or a foreign jurisdiction,

(iii) the implementation of a trade agreement, as it relates to labour mobility, designated by order of the minister for the purposes of this section, or

(iv) any other matter related to the labour mobility of emergency medical assistants;

(b) entering into information-sharing agreements, as defined in section 69 (1) of the Freedom of Information and Protection of Privacy Act, to allow the release to a governing body of personal information, as defined in that Act, respecting a current or former emergency medical assistant and in the custody or control of the minister, including information about practice restrictions, complaints, competency or discipline.

3 Section 6 is amended

(a) in subsections (2) to (5) by adding "licensing" before "board" wherever it appears, and

(b) by adding the following subsections:

(7) The licensing board may, with the prior approval of the minister, make rules governing its own procedure.

(8) No later than 120 days after the end of the government's fiscal year, the licensing board must prepare and submit to the minister, in a form satisfactory to the minister, a report of the licensing board on its operations for the preceding fiscal year, including any information that the minister may, in writing, direct the licensing board to provide.



4 Sections 7 to 9 are amended by adding "licensing" before "board" wherever it appears.


5 The following section is added:
Injunction to restrain contravention

9.1 The corporation may apply to the Supreme Court for an interim or permanent injunction to restrain a person from contravening section 5.1 or 12 or the regulations.

6 Section 10 is repealed and the following substituted:
Liability protection

10 (1) In this section, "protected individual" means any of the following individuals:

(a) a member of the board of directors;

(b) a member of the licensing board;

(c) the president, or another officer or employee, appointed under section 5.

(2) No legal proceeding for damages lies or may be commenced or maintained against a protected individual because of anything done or omitted

(a) in the performance or intended performance of any duty under this Act, or

(b) in the exercise or intended exercise of any power under this Act.

(3) Subsection (2) does not apply to a person referred to in that subsection in relation to anything done or omitted by that person in bad faith.

(4) Subsection (2) does not absolve the corporation from vicarious liability for an act or omission by a person referred to in subsection (1) (a) or (c) for which the corporation would be vicariously liable if this section were not in force.

(5) Subsection (2) does not absolve the government from vicarious liability for an act or omission by a person referred to in subsection (1) (b) for which the government would be vicariously liable if this section were not in force.


7 Section 12 is amended by striking out 'title "emergency medical assistant" or otherwise' and substituting 'title "emergency medical assistant", or a title prescribed in a regulation under section 15 (2) (c), or otherwise'.


8 Section 13 is repealed.


9 Section 14 is repealed and the following substituted:
Regulations of the Lieutenant Governor in Council

14 The Lieutenant Governor in Council may prescribe the manner of selection of an emergency medical assistant for the purposes of section 6 (2).


10 The following sections are added:
Regulations of the minister

15 (1) The minister may make regulations referred to in section 41 of the Interpretation Act.

(2) Without limiting subsection (1), the minister may make regulations as follows:

(a) respecting the qualifications, examination, training, registration and licensing of emergency medical assistants;

(b) respecting the continuing competence of emergency medical assistants, and providing for the assessment, by persons designated by the minister or the licensing board, of the professional performance of emergency medical assistants;

(c) prescribing titles that may be used by, or that are to be used exclusively by, emergency medical assistants, and providing for limits or conditions on the use of prescribed titles, or other titles or terms, by emergency medical assistants;

(d) prescribing services that may be provided by emergency medical assistants, and providing for limits or conditions on the provision of those services;

(e) prescribing restricted activities that may be performed by emergency medical assistants in the course of providing services referred to in paragraph (d), and providing for limits or conditions on the performance of those restricted activities;

(f) prescribing services that may be provided under the supervision of an emergency medical assistant by a person who is not an emergency medical assistant, and providing for limits or conditions on the provision of those services;

(g) prescribing restricted activities that may be performed, in the course of providing services referred to in paragraph (f), by persons who are not emergency medical assistants, and providing for limits or conditions on the provision of those restricted activities;

(h) authorizing an emergency medical assistant to determine which of the

(i) services referred to in paragraph (f), and

(ii) restricted activities referred to in paragraph (g)

a person who is not an emergency medical assistant may provide under the supervision of the emergency medical assistant, and providing for limits or conditions on the exercise of that authority;

(i) respecting standards, guidelines or protocols for, and audits of, the provision of services by emergency medical assistants;

(j) prescribing fees payable in respect of the qualifications, examinations, training, registration, licensing, continuing competence or assessment of emergency medical assistants;

(k) prescribing fees payable for any service rendered under this Act, and providing for different fees for a service rendered to

(i) a person who is not a beneficiary as defined in the Hospital Insurance Act,

(ii) an employee who requires an emergency health service if the employer is, under an enactment, obliged to supply emergency health services, or

(iii) different persons or classes of persons;

(l) authorizing the waiving of fees for

(i) different persons or classes of persons, and

(ii) involuntary committals under the Mental Health Act;

(m) respecting the equipping of centres and stations referred to in section 5.1 (1) (c);

(n) establishing standards of construction and maintenance required for an ambulance;

(o) establishing the standard of equipment and supplies to be carried in an ambulance while it is being used, or held out as being available for use, as an ambulance;

(p) respecting the services that may be provided in accordance with section 5.1 by the corporation, or a person who is employed by, acting under the direction of or acting on behalf of the corporation, despite a prohibition established under the authority of another enactment;

(q) respecting the practices or procedures that must be followed by the corporation in the conduct of its affairs;

(r) respecting the manner, form and amount of insurance that must be maintained by the corporation;

(s) respecting the transfer of records to or from the corporation under section 16.

(3) A regulation under

(a) subsection (1) or (2) (a) to (j) or (m) to (o) may make different provisions for different classes of

(i) emergency medical assistants,

(ii) centres or stations referred to in section 5.1 (1) (c), or

(iii) ambulances, and

(b) subsection (1) or (2) (a) to (i) or (m) to (o) may delegate a power to, or confer a discretion on, a person designated in the regulation, including the power or discretion to exempt a person or class of persons from any condition or requirement imposed under the regulations, and may set out considerations that the person must or may take into account when a matter is delegated or a discretion is conferred.

(4) A regulation under subsection (2) (j) to (l) may

(a) authorize the corporation to collect and retain, or waive, a specified fee, and

(b) impose limits or conditions on the corporation's exercise of that authority.

(5) A regulation may be made under subsection (2) (j) to (l) or (4) only with the prior approval of Treasury Board.
Transfer of records

16 (1) Despite the Document Disposal Act and subject to the regulations,

(a) the minister, in writing, may transfer records to the corporation or another person, and

(b) the corporation, in writing, may transfer records to the minister.

(2) On the effective date of a transfer under subsection (1), the records cease to be the records of the transferor and become the records of the transferee.

(3) Records in a transfer under subsection (1) may be identified by name, class or description.
Transfer of rights, property, assets, obligations and liabilities

17 (1) The Lieutenant Governor in Council, by regulation, may authorize the transfer of any right, property, asset, obligation or liability of the government to the corporation, subject to the terms and conditions set out in the regulation.

(2) On the date that a transfer authorized under subsection (1) takes effect,

(a) the right, property, asset, obligation or liability transferred ceases to be the right, property, asset, obligation or liability of the government and becomes the right, property, asset, obligation or liability of the corporation, and

(b) the government is released from the right, property, asset, obligation or liability so transferred.

(3) A regulation made under subsection (1) may identify any right, property, asset, obligation or liability by name, class or description.

(4) The Minister of Finance may make payments out of the consolidated revenue fund for the purpose of subsection (1).

(5) Any payments made by the Minister of Finance under subsection (4) must be attributed to, and must not exceed the amount available in, the voted appropriation of the minister responsible for the right, property, asset, obligation or liability transferred.

(6) A transfer under subsection (1) is effective despite any lack of fulfillment of a provision in an agreement or instrument requiring consent, leave or approval respecting the transfer or assignment of the right, property, asset, obligation or liability, and the lack of fulfillment does not constitute a breach or default of the agreement or instrument.
Assignment of agreements

18 (1) The government, in writing, may assign to the corporation any agreement entered into by the government that relates to the powers or duties of the corporation.

(2) On the effective date of an assignment under subsection (1), all rights and obligations of the government under the agreement cease to be the rights and obligations of the government and become the rights and obligations of the corporation.

(3) A reference to the government in an agreement assigned under subsection (1) is deemed to be a reference to the corporation.

(4) An assignment under subsection (1) is effective despite any lack of fulfillment of a provision in an agreement requiring consent, leave or approval respecting assignment of the agreement, and the lack of fulfillment does not constitute a breach or default of the agreement.
Transitional Provision


Transition — regulations

11 (1) The Lieutenant Governor in Council may make regulations necessary or advisable to more effectively bring into operation the provisions of sections 16 to 18 of the Emergency Health Services Act and to remedy any transitional difficulties encountered.

(2) A regulation under subsection (1) may suspend, for a period the Lieutenant Governor in Council specifies, the operation of a provision of an enactment.

(3) Unless earlier repealed, a regulation made under this section is repealed one year after the regulation is enacted.
Consequential Amendments

Business Practices and Consumer Protection Act


12 Section 142.1 (2) (s) of the Business Practices and Consumer Protection Act, S.B.C. 2004, c. 2, is amended by striking out "Emergency and Health Services Act;" and substituting "Emergency Health Services Act;".

Emergency Communications Corporations Act

13 Section 1 of the Emergency Communications Corporations Act, S.B.C. 1997, c. 47, is amended in the definition of "emergency services agency" by repealing paragraph (d) and substituting the following:

(d) British Columbia Emergency Health Services under the Emergency Health Services Act, and .

Evidence Act

14 Section 51 of the Evidence Act, R.S.B.C. 1996, c. 124, is amended

(a) in subsection (1) in the definition of "board of management" by striking out "Hospital Act;" and substituting "Hospital Act or the board of directors as defined in the Emergency Health Services Act;",

(b) in subsection (1) in the definition of "committee"

(i) in paragraph (b) by striking out "committee established" and substituting "committee that is established" and by striking out "hospital, and that for the purpose of improving medical or hospital care or practice in the hospital" and substituting "hospital and that, for the purposes of improving medical or hospital practice or care in that hospital, or during transportation to or from that hospital,",

(ii) in paragraph (b) (i) by striking out "the hospital practice of or hospital care provided by health care professionals in the hospital," and substituting "the medical or hospital practice of, or care provided by, health care professionals in that hospital or during transportation to or from that hospital,", and

(iii) by adding the following paragraph:

(b.1) a committee that is established or approved by the boards of management of two or more hospitals, that includes health care professionals employed by or practising in any of those hospitals and that, for the purposes of improving medical or hospital practice or care in those hospitals, or during transportation to or from those hospitals,

(i) carries out or is charged with the function of studying, investigating or evaluating the medical or hospital practice of, or care provided by, health care professionals in those hospitals or during transportation to or from those hospitals, in relation to a matter of common interest among those hospitals, or

(ii) studies, investigates or carries on medical research or a program in relation to a matter of common interest among those hospitals; ,

(c) in subsection (1) in the definition of "health care professional" by adding the following paragraph:

(d.1) an emergency medical assistant as defined in the Emergency Health Services Act, ,

(d) in subsection (1) in the definition of "hospital" by striking out "and" at the end of paragraph (a) and by adding the following paragraph:

(a.1) the corporation as defined in the Emergency Health Services Act, including any centres or stations established, equipped and operated by the corporation, and ,

(e) in subsection (1) in paragraph (b) of the definition of "legal proceedings" by striking out "profession represented" and substituting "profession licensed, certified, registered or represented",

(f) by repealing the definition of "organization of health care professionals" and substituting the following:

"organization of health care professionals" means any of the following that are designated by regulation of the Lieutenant Governor in Council:

(a) an organization of health care professionals;

(b) a body or person that licenses, certifies or registers a class of health care professionals; ,

(g) by repealing subsection (5) (a) and substituting the following:

(a) to a board of management or, in the case of a committee described in paragraph (b.1) of the definition of "committee", to the boards of management that established or approved the committee, ,

(h) in subsection (6) by striking out "subsection (5) (c)." and substituting "subsection (5) (c) or (6.1).",

(i) by adding the following subsection:

(6.1) If information or a record submitted by a committee to a board of management of a hospital includes information that the board of management considers relevant to medical or hospital practice or care in another hospital, or during transportation to or from another hospital,

(a) the board of management may disclose the information or record to the board of management of the other hospital, and

(b) the board of management of the other hospital must not disclose or publish the information or the record disclosed to it under paragraph (a), except in accordance with subsection (5) (c). , and

(j) in subsection (7) by striking out "Subsections (5) and (6)" and substituting "Subsections (5) to (6.1)".

Freedom of Information and Protection of Privacy Act



15 Schedule 1 of the Freedom of Information and Protection of Privacy Act, R.S.B.C. 1996, c. 165, is amended in the definition of "health care body" by striking out "or" at the end of paragraph (f), by adding ", or" at the end of paragraph (g) and by adding the following paragraph:

(i) British Columbia Emergency Health Services, as described in section 2 (1) of the Emergency Health Services Act; .



16 Schedule 2 is amended by striking out the following:

Public Body:


Emergency and Health Services Commission

Head:


Chair .

Gunshot and Stab Wound Disclosure Act



17 Section 1 of the Gunshot and Stab Wound Disclosure Act, S.B.C. 2010, c. 7, is amended in the definition of "emergency medical assistant" by striking out "Emergency and Health Services Act;" and substituting "Emergency Health Services Act;".

Health Authorities Act


18 Section 5 (1) of the Health Authorities Act, R.S.B.C. 1996, c. 180, is amended by adding the following paragraph:

(h) to collaborate, to the extent practicable, with British Columbia Emergency Health Services, the Provincial Health Services Authority and societies that report to the Provincial Health Services Authority, facilities and other health institutions and agencies, municipalities and other organizations and persons in the planning and coordination of

(i) the provision, in British Columbia, of provincially, regionally and locally integrated ambulance services, emergency health services, urgent health services and ancillary health services, as those terms are defined in the Emergency Health Services Act, and

(ii) the recruitment and training of emergency medical assistants, within the meaning of the Emergency Health Services Act, and other persons to provide the services referred to in subparagraph (i).

Health Care (Consent) and Care Facility (Admission) Act


19 Section 1 of the Health Care (Consent) and Care Facility (Admission) Act, R.S.B.C. 1996, c. 181, is amended in the definition of "health care provider" by striking out "a person who," and substituting "a person, or a person in a prescribed class of persons, who,".


20 Section 34 (2) (c) is amended by striking out "prescribing Acts for" and substituting "prescribing Acts or classes of persons for".

Health Care Costs Recovery Act


21 Section 1 of the Health Care Costs Recovery Act, S.B.C. 2008, c. 27, is amended in paragraph (d) of the definition of "health care services" by striking out "Emergency and Health Services Act," and substituting "Emergency Health Services Act,".

Health Planning Statutes Amendment Act, 2002


22 Sections 2 to 7 and 26 of the Health Planning Statutes Amendment Act, 2002, S.B.C. 2002, c. 15, are repealed.

Health Professions Act

23 Section 14 (a) of the Health Professions Act, R.S.B.C. 1996, c. 183, is amended by striking out "another Act," and substituting "another enactment,".

Miscellaneous Statutes Amendment Act (No. 2), 2010

24 Section 169 of the Miscellaneous Statutes Amendment Act (No. 2), 2010, S.B.C. 2010, c. 6, is repealed.

Motor Vehicle Act


25 Section 214.3 (b) of the Motor Vehicle Act, R.S.B.C. 1996, c. 318, is amended by striking out "Emergency and Health Services Act;" and substituting "Emergency Health Services Act;".

Supplements Repeal Act


26 Section 15 of the Supplements Repeal Act, S.B.C. 2006, c. 33, is amended by striking out "Health Emergency Act," and substituting "Emergency Health Services Act,".

27 Section 15, as it enacts section 6 (6) of the Emergency Health Services Act, R.S.B.C. 1996, c. 182, is amended by adding "licensing" before "board".

28 Section 16, as it enacts section 8.1 of the Emergency Health Services Act, R.S.B.C. 1996, c. 182, is amended by adding "licensing" before "board".

Workers Compensation Act

29 Section 37 (1) of the Workers Compensation Act, R.S.B.C. 1996, c. 492, is amended

(a) by striking out "British Columbia Assessment Authority, British Columbia Ferry Corporation," and substituting "British Columbia Assessment Authority, British Columbia Emergency Health Services, British Columbia Ferry Corporation,", and

(b) by striking out "Emergency and Health Services Commission,".
Commencement

30 This Act comes into force by regulation of the Lieutenant Governor in Council.
Explanatory Notes

SECTION 1: [Emergency Health Services Act, title] is self-explanatory.

SECTION 2: [Emergency Health Services Act, sections 1 to 5.6] provides for continuation of the Emergency and Health Services Commission as a corporation and, with respect to that corporation, provides for matters relating to

* its purposes and board of directors,
* the appointment of a public administrator in specified circumstances,
* its financial administration and staff,
* general or special directions of the minister,
* minister's orders respecting stewardship purposes, and
* interjurisdictional service agreements, the provision of services of visiting health professionals and interjurisdictional cooperation.

SECTION 3: [Emergency Health Services Act, section 6]

* is consequential to the definition of "licensing board", as added by this Bill to section 1 of the Act;
* provides for rules of procedure of the licensing board;
* requires the licensing board to provide to the minister an annual report on its operations.

SECTION 4: [Emergency Health Services Act, sections 7 to 9] is consequential to the definition of "licensing board", as added by this Bill to section 1 of the Act.

SECTION 5: [Emergency Health Services Act, section 9.1] authorizes the corporation to apply to the Supreme Court for an injunction relating to a contravention of specified provisions of the Act or the regulations.

SECTION 6: [Emergency Health Services Act, section 10]

* makes the immunity provision consistent with other statutory immunity provisions;
* clarifies when the corporation or government is not absolved from vicarious liability.

SECTION 7: [Emergency Health Services Act, section 12] prohibits a person from using a title prescribed in the regulations if the person does not hold a licence under the Act.

SECTION 8: [Emergency Health Services Act, section 13] repeals the annual reporting requirements rendered unnecessary by the enactment by this Bill of sections 3 (5) and 6 (8) of the Act.

SECTION 9: [Emergency Health Services Act, section 14] retains the authority of the Lieutenant Governor in Council to prescribe the manner in which an emergency medical assistant is selected to be a member of the licensing board.

SECTION 10: [Emergency Health Services Act, sections 15 to 18] provides for regulations of the minister and provisions relating to transfer of records, rights, property, assets, obligations and liabilities, and assignment of agreements.

SECTION 11: [Transition — regulations] provides for temporary regulations of the Lieutenant Governor in Council related to the transfer of records, rights, property, assets, obligations and liabilities, the assignment of agreements and any transitional difficulties.

SECTION 12: [Business Practices and Consumer Protection Act, section 142.1] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act.

SECTION 13: [Emergency Communications Corporations Act, section 1] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act, and to the change of name of the corporation in section 2 (1) of that Act, as repealed and replaced by this Bill.

SECTION 14: [Evidence Act, section 51] makes the language consistent, expands certain definitions and expands the rules of disclosure of information and records.

SECTION 15: [Freedom of Information and Protection of Privacy Act, Schedule 1] expands the definition of "health care body" to include the corporation.

SECTION 16: [Freedom of Information and Protection of Privacy Act, Schedule 2] repeals the reference to the Emergency and Health Services Commission

* as, consequential to section 2 (1) of the Emergency Health Services Act, as repealed and replaced by this Bill, the name of the corporation is changed, and
* as, consequential to the expansion of the definition of "health care body" in Schedule 1 of the Freedom of Information and Protection of Privacy Act, as amended by this Bill, a reference in Schedule 2 of that Act to the corporation is no longer necessary.

SECTION 17: [Gunshot and Stab Wound Disclosure Act, section 1] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act.

SECTION 18: [Health Authorities Act, section 5] adds a purpose to regional health boards for consistency with section 5.1 (1) (d) of the Emergency Health Services Act, as repealed and replaced by this Bill.

SECTION 19: [Health Care (Consent) and Care Facility (Admission) Act, section 1] expands the definition of "health care provider" to include a person in a prescribed class of persons who is licensed, certified or registered to provide health care under a prescribed Act.

SECTION 20: [Health Care (Consent) and Care Facility (Admission) Act, section 34] is consequential to the amendment by this Bill of the definition of "health care provider" in section 1 of the Act.

SECTION 21: [Health Care Costs Recovery Act, section 1] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act.

SECTION 22: [Health Planning Statutes Amendment Act, 2002, sections 2 to 7 and 26] repeals provisions that are no longer necessary.

SECTION 23: [Health Professions Act, section 14] adds that a person is not prohibited from practising a profession, discipline or other occupation if the profession, discipline or other occupation is practised in accordance with the regulations.

SECTION 24: [Miscellaneous Statutes Amendment Act (No. 2), 2010, section 169] repeals a provision that is no longer necessary.

SECTION 25: [Motor Vehicle Act, section 214.3] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act.

SECTION 26: [Supplements Repeal Act, section 15] is consequential to the repeal and replacement by this Bill of the title of the Emergency Health Services Act.

SECTION 27: [Supplements Repeal Act, section 15] is consequential to the definition of "licensing board", as added by this Bill to section 1 of the Emergency Health Services Act.

SECTION 28: [Supplements Repeal Act, section 16] is consequential to the definition of "licensing board", as added by this Bill to section 1 of the Emergency Health Services Act.

SECTION 29: [Workers Compensation Act, section 37] updates the name of the corporation, consequential to the amendment by this Bill of section 2 (1) of the Emergency Health Services Act.

Copyright (c) Queen’s Printer, Victoria, British Columbia, Canada


Below are the 2010 BC Ambulance service response times (BCAS chooses to show their response times as ‘average’ times meaning that they are even longer than indicated for half the responses). To be clear, most of these are third world response times:

100 Mile House 12:50
Abbotsford 10:56
Agassiz 24:50
Alert Bay 14:02
Alexis Creek 31:50
Anahim Lake 29:43
Anmore 15:44
Armstrong 11:35
Ashcroft 13:00
Balfour 26:14
Barriere 12:51
Bella Bella 38:34
Big White 26:19
Black Creek 21:51
Blind Bay 27:06
Boston Bar 19:03
Bowen Island 18:46
Bowser 16:05
Britannia Beach 19:48
Burnaby 11:07
Burns Lake 12:00
Cache Creek 19:36
Campbell River 10:05
Castlegar 11:44
Central Saanich 10:24
Chase 13:09
Chemainus 09:57
Chetwynd 15:47
Chilliwack 11:26
Christina Lake 22:04
Clearwater 20:32
Clinton 23:50
Cobble Hill 13:20
Coldstream 13:56
Colwood 08:48
Comox 12:26
Coombs 14:16
Coquihalla 32:46
Coquitlam 11:03
Courtenay 10:16
Cowichan Bay 13:12
Cranbrook 10:06
Creston 10:10
Crofton 16:37
Cultus Lake 18:33
Cumberland 08:34
Dawson Creek 10:41
Delta 11:42
Duncan 09:36
Elkford 22:08
Enderby 11:22
Errington 15:14
Esquimalt 08:37
Fairmont Springs 25:20
Falkland 31:20
Fanny Bay 20:47
Fernie 12:01
Field 30:08
Forest Grove 28:34
Fort Fraser 28:58
Fort Nelson 19:18
Fort St. James 15:58
Fort St. John 11:26
Fraser Lake 19:20
Fruitvale 20:46
Gabriola Island 20:39
Galiano Island 23:57
Gibsons 10:33
Gitanmaax 12:23
Gitsegukla 30:12
Gold River 18:30
Golden 17:59
Grand Forks 11:56
Halfmoon Bay 18:35
Harrison Hot Spring16:15
Hazelton 14:14
Highlands 16:19
Hope 11:56
Houston 14:38
Hudson's Hope 21:49
Invermere 16:08
Kaleden 16:08
Kamloops 10:04
Kelowna 09:43
Kent 13:47
Keremeos 11:10
Kimberley 11:20
Kitimat 09:20
Kuper Island 35:31
Ladysmith 12:39
Lake Country 11:43
Lake Cowichan 10:22
Langford 08:42
Langley 12:12
Lantzville 12:10
Lillooet 15:35
Logan Lake 19:37
Lower Nicola 17:07
Lumby 17:05
Lytton 18:50
Mackenzie 20:02
Madeira Park 17:46
Maple Ridge 10:32
Masset 25:08
Mayne Island 18:57
Merritt 14:44
Metchosin 15:40
Mill Bay 12:33
Mission 10:49
Moberly Lake 25:37
Mount Currie 19:47
Mt. Washington 28:51
Nakusp 22:21
Nanaimo 09:21
Nanoose Bay 16:33
Nelson 10:12
New Westminster 10:24
North Saanich 11:46
North Vancouver 10:25
Oak Bay 08:41
Okanagan Falls 18:00
Oliver 10:31
Osoyoos 10:35
Parksville 09:42
Peachland 10:40
Pemberton 11:10
Pender Island 20:04
Penticton 09:24
Pitt Meadows 12:47
Port Alberni 09:48
Port Alice 20:33
Port Coquitlam 11:24
Port Hardy 10:59
Port McNeill 11:40
Port Moody 10:58
Port Renfrew 22:36
Pouce Coupe 14:05
Powell River 11:32
Prince George 09:49
Prince Rupert 09:50
Princeton 15:12
Qualicum Beach 11:33
Quathiaski Cove 22:43
Quesnel 12:00
Revelstoke 17:12
Richmond 11:04
Roberts Creek 14:30
Rock Creek 22:41
Rossland 23:08
Saanich 08:27
Salmo 20:40
Salmon Arm 11:39
Saltspring Island 12:21
Sayward 19:53
Scotch Creek 26:18
Sechelt 10:14
Shawnigan Lake 13:21
Sicamous 11:25
Sidney 08:01
Skidegate 30:14
Smithers 10:19
Sooke 11:05
Sparwood 17:21
Spences Bridge 33:47
Squamish 11:38
Summerland 09:29
Sun Peaks 44:10
Surrey 10:50
Tappen 21:41
Terrace 10:18
Tofino 20:40
Trail 11:09
Tumbler Ridge 23:14
Ucluelet 20:21
Valemount 23:54
Vancouver 08:54
Vanderhoof 15:15
Vernon 10:21
Victoria 07:20
View Royal 09:30
Warfield 13:05
West Vancouver 10:39
Westbank 10:10
Whistler 12:58
White Rock 10:22
Williams Lake 12:25
Wilson Creek 14:16
Winfield 11:10
Zeballos 34:10

Cameron Report 2007

Blue Divider Line

Below is an email okanaganlakebc.ca received from Hans Dysarsz Jan 6, 2013:

Even other unions are fed up with what we have in BC!!!

So why is this major issue being ignored by ALL our politicians? Why is by the mainstream media in BC ignoring this issue?

CUPE NEWS

January 14, 2010
Ambulance response times 'a disgrace'

BURNABY—Ambulance wait times in British Columbia point to the critical condition of ambulance services in B.C. according to CUPE 873. The ambulance paramedics say a lack of attention has seen the service deteriorate over the past decade. The list below of ambulance 911 call wait times is sad proof of this. The figures come from the employer – the BC Ambulance Service.

CUPE BC president Barry O’Neill says the figures are a disgrace when in a medical emergency every second counts. “This is not a game and the BC Liberal government should not be playing with peoples’ lives.” For more details see the President's Message on the Home page.

Please note that the times listed in minutes and seconds are only for the “most serious” 911 calls and only apply to the trip to the patient’s address. They do not include the return time to actually get a patient to a medical facility. Also note that these are the average times – not the longest times. The Canadian benchmark response time for an ambulance is 8 minutes, 59 seconds.

Printable version (PDF)

100 Mile House 12:50

Abbotsford 10:56

Agassiz 24:50

Alert Bay 14:02

Alexis Creek 31:50

Anahim Lake 29:43

Anmore 15:44

Armstrong 11:35

Ashcroft 13:00

Balfour 26:14

Barriere 12:51

Bella Bella 38:34

Big White 26:19

Black Creek 21:51

Blind Bay 27:06

Boston Bar 19:03

Bowen Island 18:46

Bowser 16:05

Britannia Beach 19:48

Burnaby 11:07

Burns Lake 12:00

Cache Creek 19:36

Campbell River 10:05

Castlegar 11:44

Central Saanich 10:24

Chase 13:09

Chemainus 09:57

Chetwynd 15:47

Chilliwack 11:26

Christina Lake 22:04

Clearwater 20:32

Clinton 23:50

Cobble Hill 13:20

Coldstream 13:56

Colwood 08:48

Comox 12:26

Coombs 14:16

Coquihalla 32:46

Coquitlam 11:03

Courtenay 10:16

Cowichan Bay 13:12

Cranbrook 10:06

Creston 10:10

Crofton 16:37

Cultus Lake 18:33

Cumberland 08:34

Dawson Creek 10:41

Delta 11:42

Duncan 09:36

Elkford 22:08

Enderby 11:22

Errington 15:14

Esquimalt 08:37

Fairmont Springs 25:20

Falkland 31:20

Fanny Bay 20:47

Fernie 12:01

Field 30:08

Forest Grove 28:34

Fort Fraser 28:58

Fort Nelson 19:18

Fort St. James 15:58

Fort St. John 11:26

Fraser Lake 19:20

Fruitvale 20:46

Gabriola Island 20:39

Galiano Island 23:57

Gibsons 10:33

Gitanmaax 12:23

Gitsegukla 30:12

Gold River 18:30

Golden 17:59

Grand Forks 11:56

Halfmoon Bay 18:35

Harrison Hot Spring16:15

Hazelton 14:14

Highlands 16:19

Hope 11:56

Houston 14:38

Hudson's Hope 21:49

Invermere 16:08

Kaleden 16:08

Kamloops 10:04

Kelowna 09:43

Kent 13:47

Keremeos 11:10

Kimberley 11:20

Kitimat 09:20

Kuper Island 35:31

Ladysmith 12:39

Lake Country 11:43

Lake Cowichan 10:22

Langford 08:42

Langley 12:12

Lantzville 12:10

Lillooet 15:35

Logan Lake 19:37

Lower Nicola 17:07

Lumby 17:05

Lytton 18:50

Mackenzie 20:02

Madeira Park 17:46

Maple Ridge 10:32

Masset 25:08

Mayne Island 18:57

Merritt 14:44

Metchosin 15:40

Mill Bay 12:33

Mission 10:49

Moberly Lake 25:37

Mount Currie 19:47

Mt. Washington 28:51

Nakusp 22:21

Nanaimo 09:21

Nanoose Bay 16:33

Nelson 10:12

New Westminster 10:24

North Saanich 11:46

North Vancouver 10:25

Oak Bay 08:41

Okanagan Falls 18:00

Oliver 10:31

Osoyoos 10:35

Parksville 09:42

Peachland 10:40

Pemberton 11:10

Pender Island 20:04

Penticton 09:24

Pitt Meadows 12:47

Port Alberni 09:48

Port Alice 20:33

Port Coquitlam 11:24

Port Hardy 10:59

Port McNeill 11:40

Port Moody 10:58

Port Renfrew 22:36

Pouce Coupe 14:05

Powell River 11:32

Prince George 09:49

Prince Rupert 09:50

Princeton 15:12

Qualicum Beach 11:33

Quathiaski Cove 22:43

Quesnel 12:00

Revelstoke 17:12

Richmond 11:04

Roberts Creek 14:30

Rock Creek 22:41

Rossland 23:08

Saanich 08:27

Salmo 20:40

Salmon Arm 11:39

Saltspring Island 12:21

Sayward 19:53

Scotch Creek 26:18

Sechelt 10:14

Shawnigan Lake 13:21

Sicamous 11:25

Sidney 08:01

Skidegate 30:14

Smithers 10:19

Sooke 11:05

Sparwood 17:21

Spences Bridge 33:47

Squamish 11:38

Summerland 09:29

Sun Peaks 44:10

Surrey 10:50

Tappen 21:41

Terrace 10:18

Tofino 20:40

Trail 11:09

Tumbler Ridge 23:14

Ucluelet 20:21

Valemount 23:54

Vancouver 08:54

Vanderhoof 15:15

Vernon 10:21

Victoria 07:20

View Royal 09:30

Warfield 13:05

West Vancouver 10:39

Westbank 10:10

Whistler 12:58

White Rock 10:22

Williams Lake 12:25

Wilson Creek 14:16

Winfield 11:10

Zeballos 34:10
cope491

The message is crystal clear: BC needs far more ambulances and paramedics in our communities! People are dying because of this government’s TOTAL LACK of interest in this life saving service.

Hans Dysarsz

=======================================

This below is also from Hans Dysarsz:

If you are still under the belief that if a loved one falls critically ill or victim to a time sensitive injury, that within 8 minutes (of your 911 call), a ‘state-of-the-art’ prehospital care system will come to their rescue, guess again.

Fact is BCAS’ publishes their response times as ”average” response times and not actual response times. Their published response times are 8.5 minutes. Any elementary school student will tell you that ‘an average value’ means that half of the numbers used will be higher and half lower. What that means in the BCAS response times case is that half the population got ambulances in under 8.5 minutes and the other half got them in over 8.5 minutes; international standards are actual response times of NO greater than 7.9 minutes.

So what level of practitioner level would most British Columbians get when the ambulance does show up? In a very high number of responses, they would get a response by a ‘part-timer’ ambulance crew, with only “.. basic life support .. “ qualifications (BLS attendants even in metro Vancouver!)

FYI, of BC’s 3,600 ambulance attendants, 3,300 are (only) ‘basic life support qualified’ (BLS) and of that, fully 2,100 are part-timers. In fact, only (very) few British Columbians, and only those that live in very small number of municipalities, i.e. in metro Vancouver and a few large cities around the province, even have a chance of an ‘Advanced Life Support’ ambulance showing up for your emergency (and only after an initial response by a BLS crew, which has to call in the ALS, making for a further time delay for critical injury). So why is that; because BC only has 150 (or so) Advanced Life Support paramedics working the entire province; compare that to Alberta’s 2,139 ALS paramedics. Just this year Alberta ‘graduated’ almost as many new ALS paramedic as BC has on ambulances province wide!

While there is little question that Alberta has a better prehospital care system than BC, Alberta still does not have the same capabilities that true “state-of-the-art” pre-hospital care systems have around the world.

There are a number or reasons why BC (and Canada as a whole) does not have ‘true first class/world class EMS programs’, first; because it is simply NOT a priority for our politicians (regardless of party); they simply don’t care enough about us, their constituents (the people that pay their wages, for whom they work), to provide us with a system that actually provides ‘best possible patient care/best possible patient outcomes’.

Don’t expect the status quo to change when Adrian Dix becomes premier this spring, nothing will change, why; because the NDP created the mess we call an ambulance service 40 years, and; because Dix will NOT do a thing that CUPE 873 (the ambulance attendants union) does not want and to be sure, CUPE 873 does not want any changes to the status quo. CUPE 873 is very vocal about NOT allowing: even one doctor, one firefighter or one ‘nonprofit ALS attendant’ working full-time in what they believe is “.. their turf ..”. Even though all stakeholders know for a fact (excluding the general public of course) that such a multi-supplier, full-spectrum prehospital care structure would save many more lives each year in BC. FYI, Ontario went back to allowing municipality to provide ‘full spectrum EMS’ 15 years ago (!), why; because they came to realise that doing so would provided better patient care to Ontarians! BTW, full spectrum EMS is routinely provided by a variety of providers in other jurisdictions; it is considered a ‘best practices’ approach for prehospital care worldwide, furthermore, it is fact that most major metropolitan areas (worldwide) have their own EMS systems, why; because their residents want (more) and direct control over this life saving service (just like they want direct control over their fire and police departments).

Please understand this fact; the EMS structure we have in BC is the exception rather than the rule WRT, to how prehospital care is delivered worldwide; regional and municipal prehospital care systems are known to provide better care to residents. If BC ‘went back’ to allowing municipalities to provide full spectrum EMS, it would result in many more full time attendants in our communities, this would result in much shorter ambulance response times. In fact, it would mean that most, if not all BCAS part-time attendants would become full-time attendants with (numerous) municipal fire departments around the province – but this would mean that they would then have to become firefighter and join the firefighter’s union – and that is something CUPE 873, the ambulance attendants union, absolutely does not want nor will allow.

Most people don’t know that prehospital care is NOT ensured or insured by the Canada Act; the provinces are directly responsible for all aspects of prehospital care standards, attendant numbers in communities and training levels, as a result, Canada has 13 different prehospital care systems/standards, and make no mistake about it, our low training standards (by international comparison) and high part-time attendant numbers can directly be linked to the unnecessary deaths of many hundreds of British Columbians each year, this, solely due to ‘how we chose’ to deliver this life saving service.

Also understand this: In areas of BC where ‘actual’ ground ambulance response times are consistently over 8 minutes (outbound), the use of Helicopter EMS (HEMS) starts to become medically indicated. In areas where response times are consistently over 15 minutes, doctor-led HEMS is definitely indicated and without question, would provide a (much) better/higher level of patient care. Even in BC’s ‘high density’ urban areas like metro Vancouver, Victoria, Nanaimo, Kelowna, Kamloops and Prince George, there is a place for ‘doctor-led EMS’ but there it would be provided by way of ‘doctor cars’ in addition to EMS helicopters.

For any politician, regardless of political affiliation, to make statements to the effect that, “.... BC has a first class ambulance system ...” is in my view not only deliberately misleading the public but outright irresponsible; at best, BC has a ‘third class’ prehospital care system in rural BC and a ‘second class’ prehospital care system in metro Vancouver/larger cities.

Politicians and even some doctors will tell you that we can’t afford a better prehospital care system, what you are hearing there are vested interest individuals fearing that spending more on prehospital care will take away from their personal area of practice. For a politician to make state statement is purely self serving; better/best prehospital care is simply not a priority for them. Alberta has had a non-profit, charitable status Helicopter EMS system for over 27 years; they have a fleet of 7 helicopters, doctor staffed as necessary, 75% of their program is donation funded. Manitoba, Saskatchewan and Ontario, also have nonprofit, charitable status HEMS systems. Under the current 40 year old law, the Emergency Health and Services Act, the provision of such a service is illegal in BC(!). Why is it illegal, why does BC NOT allow such an additional life saving layer for its residents? How is BC’s highly restricted/’highly supply managed’ prehospital care system (only one service supplier legally allowed, namely the BC Ambulance service), better for our most sick and injured? How is BC’s system better for OUR critically ill or injured children or other loved ones?

The following will give you some perspective on the capabilities of a true state-of-the-art prehospital system, one that is capable of and routinely provides their residents with such treatment capabilities like ‘on-site’ emergency surgical intervention (if necessary to save a life) but also provides patient in need with universal donor, whole blood, this, to help manage all too common (easily fatal) bleeding injuries; those are the traits of a “... first class ambulance system ....” and BC has nothing even remotely close to that kind of response capability.

If you think my claims are misleading (or even outright false), I invite you to go to London’s Air Ambulance (LAA) website (link below) and watch their 5 minute introduction video, it outlines what they do and how they pay for it; you will be astounded by the level of care they (routinely) provide their residents. Please understand that the level of care you see being provided by LAA could also (and easily) be provided to British Columbians, both rural and urban as there is nothing proprietary about what they do in London. In fact, from a medical justification point-of-view, the longer the initial ambulance response times, the lower the attendant skill level and the longer the ‘return-to-an-appropriate-treatment-facility’ time, the more necessary/medially indicated an LAA-type approach becomes, i.e. given our extreme distances and topography (not to mention our 27,000 km of coastline), British Columbia is in fact a ‘poster child’ for such a vastly more capable rural-based EMS helicopter capability.

BTW, while the LAA video details one HEMS program based in London, understand that there are 37 such HEMS programs throughout the UK today, in fact, there are 360 such programs operating throughout (western) Europe currently, all are nonprofit, (almost) all are doctor-led, and some, like REGA Swiss Air rescue have been in operation for 60 years (Germany’s nationwide HEMS system has grown from humble beginning some 45 years, to being the world’s largest HEMS system with over 100 helicopter EMS programs today, and with over 1.9 million missions flown in that time).

http://www.londonsairambulance.co.uk/about-us

The following news releases are from London’s Air Ambulance website:

A busy year so far - 2012 statistics

On the dawn of National Air Ambulance Week, we release incident breakdown figures from 1st January 2012 - 31 August 2012 to enhance public understanding of the vital life-saving work our charity provides on a daily basis.

So far this year, we have attended:

471 road traffic collisions: of which

    o 48 were pedal cyclists;

    o 204 were pedestrians hit by vehicles; and

    o 82 were motorcyclists

315 stabbings and shootings

286 falls from height

The incidents we attended so far this year involved 885 male patients and 207 female patients.

During this period we carried out 22 thoracotomies (open chest surgery), a procedure which we perform when a patient is in cardiac arrest due to penetrating injury to the chest, e. g. stabbing, shooting or accidental impalement. Sadly, the incidence of violent crime in London creates an ongoing requirement for this procedure and we remain a world leader in terms of experience and success with thoracotomy.

We demonstrate a long term survival rate of 18% in patients who would otherwise be clinically dead as a result of this type of injury.

Dr Gareth Davies, Chair and Medical Director of London’s Air Ambulance, says: “London’s Air Ambulance is the only service in London that can perform this type of procedure outside of hospital. Open chest surgery, is usually only performed by a cardiothoracic surgeon in an operating theatre. In 1993, London’s Air Ambulance was the first medical service in the world to perform this emergency procedure at the scene of injury and save a patient’s life and now other air ambulances throughout the world have followed in our footsteps.

“London’s Air Ambulance treats over 2,000 critically injured patients per year. Our teams work extremely hard to save the lives of those people who have been so tragically injured that minutes really will make a difference between life or death.”

“We seem to be one of London’s best kept secrets and we need everyone’s help to spread the word about our good work and the fact we are a charity. There are many ways to become involved. Call a member of our friendly team on 020 7943 1302 or visit our website for further details. http://www.londonsairambulance.co.uk/.”

 

London’s Air Ambulance attends its 25,000th mission

London’s Air Ambulance, the Charity which runs London’s only air ambulance has today attended its 25,000th mission. The service, which has been in operation for 23 years, also celebrates a year of being a 24hr operation next month, in April 2011, thanks to the continued support of its sponsors and the London community.

London’s Air Ambulance provides pre-hospital care to victims of serious injury throughout London – serving the 10 million people who live, work and commute within the M25. The service carries a Senior Trauma Doctor and a specially trained Paramedic, essentially bringing the hospital to the patient. In serious cases the patient may not always be able survive the distance to hospital so operations need to be performed on scene.

Last year London’s Air Ambulance attended 1979 incidents, including 185 children under the age of 16. London’s Air Ambulance is a pioneer of open heart surgery at the roadside for chest stabbings and in 1993 carried out this procedure which resulted in one of the world’s first survivors. The service is now experiencing a survival rate of 18% in patients who are clinically dead as a result of this type of injury.
 


London and Norwegian air ambulance collaborate

London’s Air Ambulance, the Charity which runs London’s only Helicopter Emergency Medical Service, is pleased to announce that it has signed a unique research and collaboration agreement with the Norwegian Air Ambulance.

This agreement formalises the existing strong links between two long established providers of physician-led pre-hospital care. Both organisations are committed leaders in the field of quality improvement in pre-hospital care and place research and development high on their agendas.

London’s Air Ambulance has an international reputation for clinical excellence and has trained the majority of pre-hospital clinical leaders in the UK and many from overseas. It has pioneered advances in care and procedures which have been adopted across the world. The Norwegian Air Ambulance has a rapidly expanding research programme and a unique designated centre for training and development as well as strong links with Norwegian Universities.

To date, the organisations have held three high level consensus meetings to improve their common approach to research and quality in pre-hospital care. The latest meeting set the international research priorities for pre-hospital critical care for the future, the results of which will be published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine in due course. The meetings have involved pre-hospital leaders from Europe and beyond and have been hosted and funded by the Norwegian Air Ambulance.

Hans Morten Lossius, Research and Development Director of the Norwegian Air Ambulance, said: We are very pleased that we have formalized a partnership with London’s Air Ambulance. Norwegian Air Ambulance has prioritized research in recent years. To ensure good research, we are however, dependent on good cooperation across national borders. A partnership with such a well-respected and professional environment that London’s Air Ambulance represents, gives us the opportunity to exchange experiences and engage in systematic collaboration that enables us to produce better research for the benefit of patients.”

Dr David Lockey, Research and Development Lead at London’s Air Ambulance, added: “We are delighted to have formalised our links with The Norwegian Air Ambulance. Both organisations share the drive and enthusiasm to build on past success and work together to improve the care of critically ill patients wherever they may be. Our colleagues in Norway have made great steps in moving research and training forwards and we expect this collaboration to be a springboard for the improvement of pre-hospital critical care.”

The following will provide more proof of the true state of BC’s prehospital system.
The following is a news story from ‘The Castlegar Source’ dated Jan 5, 2012.
BC Ambulance Services speak to lack of Castlegar coverage over the holidays

An investigation is being launched by BC Ambulance Services into why Castlegar was left without ambulance coverage Christmas Eve, Christmas Day and New Year’s Day, according to BCAS Central Kootenay Superintendent Chris Mason. He also said the investigation will also encompass the fact that Castlegar first responders (fire crews) weren’t notified of the coverage gap until 5:30 p.m. on Christmas Eve – just half an hour before Castlegar ambulance coverage came to a holiday halt.

“I can assure the public that this will be dealt with,” Mason said. “People need to feel confident that when they call 9-1-1, help will arrive.”

Mason said BCAS was aware of staffing issues in our area, and contingency plans were in place.

“We’re trying to figure out why contingency plans didn’t work,” he said, assuring residents that the situation is not the status quo, and is unacceptable by BCAS patient care standards. “That’s all being investigated right now, to find out what happened and why … and to ensure it never happens again.”

Castlegar fire chief Gerry Rempel said he paged a 10-man crew on Christmas Eve, a crew that served as first responders to five motor vehicle accidents on Christmas Day alone. Ambulances were dispatched from Rossland, Nelson and Trail. One such call ended in a 35-minute wait for an ambulance to arrive. Fire crews are not allowed to transport patients to hospital.

“We’re not certified to transport, and certainly there’s a difference in the training levels (between volunteer firefighters and paramedics),” he said. “An ambulance is also better-equipped than us, because of the higher level of training.”

Rempel had nothing but praise for the volunteer crew that ensured the city had emergency coverage over the weekend.

“They want to help, and the way they see it, there’s no better time to help people than on Christmas,” he said.

Mason was unable to comment on what reaction the City of Castlegar can expect when they send an invoice to BCAS for the expenses incurred by the Castlegar Fire Department over the holiday.

As it stands, Castlegar has one full-time unit chief and 20 part-time paramedics (but Mason said that number fluctuates).

Part-timers are paid different rates for different kinds of duty shifts: to be on call means carrying a pager, but being allowed to respond from home - that pays $2 an hour. To be at 'Foxtrot status" means being physically at the station, but not having to do any work unless called out, in which case the pay is $11.21 and does not count towards pension. If called out on Christmas Day, while on Foxtrot status, part-timers would receive what's called "super-stat" pay, which is double-time-and-a-half at the full paramedic pay rate.

Part-timers submit their availability for shifts, and a schedule is created from that, whereas full-timers are not allowed to choose which days they work.

When asked why BCAS doesn't merely elevate one or two of the 20 part-timers to full-time status, Mason said this:

"As with any complex problem, there's a number of reasons we're where we're at," he said. "If there was a magic bullet, we would have found it by now and used it."

He pointed out that they have a budget to work within, and staffing needs fluctuate according to times of year and call volume.

Happy New Year, Hans Dysarsz

PS: In the spirit of full disclosure: I am a supporter of the rank and file men and women of the BCAS. I am a union supporter. I am a ‘card carrying’ NDP supporter. However, I am NOT BC ambulance attendants union, CUPE 873, support, nor am I am a supporter of Adrian Dix. I will NOT be voting for the NDP in the coming May election as a result of their unwillingness to do the right thing and overhaul BC prehospital care system. I suggest that if you want (vastly) better prehospital care BC in the coming next 4 years, I suggest you make this issue an election issue for both parties. If you think this issue ‘doesn’t concern you’, think again, with a simple and unexpected ‘slip in the shower’ you too can find yourself at the mercy of our highly dysfunction prehospital care system, and remember, hospitals are full of people that swore ‘it would never happen to them’. To support my point; over 471,000 British Columbians had ‘ambulance transports’ just last year. This issue is every British Columbian’s issue, regardless of where you live, work, play or whatever your political leanings are. Just remember, the further you are when you have your ‘accident’ the worse the prehospital care system is, think about that before you vote in May.

Blue Divider Line

Here is another tidbit that Hans Dysarsz added in another email.

OUT of 478 ambulances BC Ambulances, only 9 are 4x4

Blue Divider Line

okanaganlakebc.ca knows of one instance where the BC ambulance got stuck at Valley of the Sun and they had to fly in a helicopter to pick up a stroke victim.

Blue Divider Line

Medivac Service Major Health Problem: local councillor
CBYG (CBC Prince George) - CBC Daybreak North - 20-Dec-2012

BC Air Ambulance

Air Ambulances like the one above transport patients. (Photo: BC Ambulance Service 2012)

Grounded and poor medivac service for emergencies. It's the plight of patients in Fort Nelson. Daybreak's Betsy Trumpener speaks with local politician Kim Eglinski of the Northern Rockies Regional Municipality about why she says the community has had enough.

Betsy Trumpener: We're heading now to Fort Nelson, where doctors, patients and politicians say medevac delays are putting northern lives at risk. They describe some terrifying situations

Trumpener: What do you want done?

Eglinski: Well, there's a lot of things I want done. One of the easiest solutions, and it's quite simple, is to go back to the way it was a few years ago. For years a local company, Villers Air, provided medevac flights out of the community. They did as many as about 120 a year. That works out to be about one trip every three days. This was working for us, and it was working quite well until BC Ambulance decided they needed two staff instead of one on every flight. BC Ambulance Service is reluctant to and do not as a result use the local charter aircraft company anymore for medevac patients due to a shortage of trained paramedics, likely due to the poor salaries that are not comparable with what a paramedic can be paid in the oil patch.

Betsy Trumpener: We're heading now to Fort Nelson, where doctors, patients and politicians say medevac delays are putting northern lives at risk. They describe some terrifying situations. A woman facing a life-threatening pregnancy who had to wait six hours before she could be flown out to hospital. Another patient, a teen, whose appendix was about to rupture, waited ten hours for a medevac flight. In some cases medical evacuations don't happen at all because of bad weather.

To find out more, we're joined now by Kim Eglinski. She is a councillor and acting mayor with the Northern Rockies regional municipality in Fort Nelson.

Good morning, Kim.

Kim Eglinski: Good morning.

Trumpener: We have heard about these two cases. Are these isolated cases? Are there other cases?

Eglinski: There are other cases, but I have specifically picked three specific cases that have happened or taken place within one year.

Trumpener: Tell us a bit more. I kind of did some broad strokes about these situations. What else can you tell us about these people who had to wait for medical care?

Eglinski: The most recent one was Sunday night. A 15-year-old boy arrived at Fort Nelson General Hospital. He was immediately diagnosed with appendicitis, and BC Bed was called to dispatch an air ambulance at approximately 9:30 on Sunday evening. After waiting most of the night for that ambulance to arrive, with no explanation on any delays, the patient's parents were finally advised late Monday morning that due to weather, the plane would not be coming. This patient was then prepared for ground transportation to Dawson Creek, which is about 450 kilometres away, which is about five and a half hours south of here.

The patient was transferred by ambulance approximately two hours south of Fort Nelson and then transferred to another waiting ambulance that was from Dawson Creek. Immediately upon his arrival in Dawson Creek, he was admitted into surgery. His appendix was as close to rupturing as it could get. Lucky. This boy came home yesterday. He's recovering well.

I've got some questions for the air ambulance people as to why this particular patient was not picked up on Sunday night and hope to get a response from BC Ambulance in this respect. This young boy's appendix could have ruptured at any time between Fort Nelson and Dawson Creek, and it could have ended a lot differently for this boy and his family.

Trumpener: Has anyone died?

Eglinski: Yes. A patient who was in their mid-50s suffered a cardiac arrest. This patient was successfully revived in Fort Nelson but required an immediately higher level of care. A BC Ambulance Service plane arrived in Fort Nelson five hours later, and then the plane was delayed due to a mechanical failure. This patient subsequently died without receiving the proper medical care that was needed.

Trumpener: How are you reacting to these stories? They're horrible to listen to.

Eglinski: They're horrible stories. They're not isolated.

The ministry is facing many challenges regarding a reliable emergency air ambulance system for residents that are requiring critical care. On numerous occasions persons in the region that have required critical care, such as heart and stroke patients, maternity patients, patients diagnosed with appendicitis, have been left waiting for as many as 12 hours for air ambulance service to arrive from either Vancouver, Prince George or Edmonton.

Transferring patients to centres where they can receive critical care is common practice here, but many times patients are left at the mercy of BC air ambulance medevac system. When a doctor makes a decision to fly a patient out, they contact BC Bedline, who then contacts BC Ambulance. After that, BC Ambulance then dispatches a flight, and after about a four-hour period, which does not include the dispatcher response time, then a plane is made available.

Trumpener: What are you hearing from these patients, from these families? I cannot imagine waiting for a dozen hours.

Eglinski: In most cases these are stressful situations already. It's adding even more stress. There's definitely concern.

You know, we had a pregnant woman approximately a year ago with a pre-existing medical condition. Her due date was March 23. Due to her pre-existing medical condition a C-section was scheduled for March 15. That C-section was scheduled because of her pre-existing medical condition. A vaginal birth was dangerous. Unfortunately, this woman went into premature labour on February 21 at a time when we did not have the capabilities of delivering a baby. Arrangements were made for a C-section in Dawson Creek. BC Bed was phoned to dispatch an air ambulance. It took three or four hours for BC Bed to confirm that they had a plane ready to leave Vancouver but that it would take three hours for the plane to get to Fort Nelson.

At this time, BC Bed does a routine inquiry on the patient's status, and they were told that the pregnant mum was dilated five centimetres, and they refused to take her because they don't take patients who are dilated over three centimetres. You know, not only is this putting the mum and the baby at risk, but it's also putting our doctors and our health care professionals in a very precarious position.

Trumpener: We have spoken to you over the past couple of years about the maternity problems. It sounds when we hear these stories extending to appendicitis, heart attack, dangerous pregnancy, that things are not getting better, that they may be getting worse.

Eglinski: They're certainly not getting any better.

Trumpener: What do you want done?

Eglinski: Well, there's a lot of things I want done. One of the easiest solutions, and it's quite simple, is to go back to the way it was a few years ago. For years a local company, Villers Air, provided medevac flights out of the community. They did as many as about 120 a year. That works out to be about one trip every three days. This was working for us, and it was working quite well until BC Ambulance decided they needed two staff instead of one on every flight. BC Ambulance Service is reluctant to and do not as a result use the local charter aircraft company anymore for medevac patients due to a shortage of trained paramedics, likely due to the poor salaries that are not comparable with what a paramedic can be paid in the oil patch.

I understand that a team of paramedics has to be available on the ground at all times. Doctors and nurses have also in the past been engaged with medevac flights, but of course, if you put them in the plane, then this leaves the hospital and the region short-staffed.

You know, we're simply asking for them to give us the resources to train staff, allow the community to resume using a private charter company. You know, quite honestly, I don't care. The current system is beyond broken. People's lives are at risk. These delays are preventable. It's extremely frustrating. It's totally unacceptable, and you know, we've had enough. I'm to the point now [where] in my opinion if BC Ambulance is unable to guarantee this community air ambulance transportation, then BC Ambulance needs to get the hell out of the way and let somebody else provide those services that can guarantee them. It's quite easy.

Trumpener: Kim Eglinski, we appreciate you telling us about a very critical situation in your community. Thanks for joining us.

Eglinski: Thank you for having me.

Trumpener: We are awaiting a response from BC Ambulance Service. We hope to have them on air tomorrow.

===============================================================

BCAS responds to medivac concerns

Some people are criticizing the BC Ambulance Service's response in Fort Nelson. Daybreak's Betsy Trumpener speaks with BCAS Director of Critical Care Transportation Dan Froom:

===============================================================

To whomever this may concern:

As you read in the above, these are the exact reasons why I am involved in this issue; this sort of thing happens across BC, on an almost daily basis. I know of several more such patient transport delays (in other parts of BC which occurred within just the last few weeks) – which there were no actual operational reasons for but rather, only cost issues and non-piloting personnel ‘weather concerns’(!!). Unfortunately, we in Lower mainland only rarely get to hear about upcountry SNAFUs like this and since all our politicians seem to think ‘their world’ revolves only around southwestern BC, few things get done anywhere else. If you can believe it, there is a guy with northern health going to all regional hospitals there telling them to close their hospital helipads!! (I think his name is Findlay Sinclair, not sure, my apologies if wrong). How is that better for the many families that live in remote BC? How is that good for all the workers that work in areas where ambulances can’t get to them?

When an average person get to the point where they feel they must take matters into their own hands and go through the trouble of getting themselves on (local) radio to say enough is enough, then you know the system, our system, is broken. I suggest ALL politicians, all community leaders (including all union leaders) pay attention in this matter, regardless of whatever rhetoric BC Ambulance Service management continues to spew that “... all is as it should be ... ” and “.... if we felt there was a need in the north, we would provide better service ....”. That has been the standard rhetoric from (all) senior managers at the BC ambulance service (and paramedics union) for far too long.

I hope CBC Daybreak sticks with this issue/story and I hope ALL BC politicians, come to understand (not just northern MLAs) how truly serious the situation is for all rural British Columbians; there is no question that they desperately need vastly better pre-hospital care, both on the ground and in the air; with an officially documented pre-hospital death rate of 75%, (only from trauma, much higher if other time sensitive conditions were added in) northerners are paying a huge and terrible price for the inaction of a very small handful of policy makers and (apparently incompetence) our senior BC Ambulance Service management. The BC paramedics union carries a fair amount of blame in this issue as well, as their members see this carnage on a daily basis, yet they don’t speak up; why are they not speaking up the media about this? Could it be that they also have a vested interest in maintaining the status quo? Could it be that they don’t want sound the alarm because an immediate (part) solution would be for local Fire/Rescue service could once again be tasked to provide additional full spectrum EMS service to the region; who knows for sure? Fact is, northern BC needs hundreds more advanced life support paramedics, the current 15 are simply not enough for the entire northern half of the province (BTW, all of those 15 only work within Prince George city limits and no further). Local fire/rescue services should once again be allowed to provide EMS service beyond just first responder level (which is only industrial first aid equivalent training), they should (finally) be legally allowed to provide (once again) any level of pre-hospital care (their community wishes them to provide - for their community) and not only be restricted to providing only “CPR and band-aids”.

Understand this; the story above happens all across BC and on an almost daily basis; I want to know why we are allowing this to go on! I want to know why the bizarre ambulance system we have in BC is better for my family? I want to know how it is less costly for me as a taxpayer, to let people die or end up with permanent injuries or in long term care due to unnecessarily long response times/transport times, inadequate first responder medical training/capabilities when we know that there are vastly better approaches being used both here in Canada and around the world. Why does a province of 4.4 million resident only have 150 full time, community-based, advanced life support paramedics serving (only) a handful of larger cities in BC (the other 150 or so are either attached to specialty transport teams and do now work on community-based ambulances or are only part-timers! This, out of our 3,600 total number of paramedics, most of which are only ‘basic life support’ part-timers. FYI, Alberta, has 2,100 ALS paramedics for a million fewer residents than BC and 300,000 sq km less territory).

Finally, someone please tell me, why does not even one of the BC pre-hospital/EMS stakeholders groups (patients excluded of course) want/will allow, doctors to work pre-hospital – like do (and have for many decades) in other jurisdictions? When you come to know the facts of this ‘life and death’ matter, you too will start asking the same questions as I do. The truly frightening fact of all this is coming to the realization that it is; ‘politics’, ‘protecting turf’, ‘vested personal interests’ and ‘perceived’ unaffordable costs, that have brought us to this point, that these are the actual and true drivers of BC pre-hospital care system. Understand this fact: the provision of best possible patient care/best possible patient outcome is not on any of the stakeholder’s agenda; and should all demand to know why that is being allowed to go on decade after decade in BC!

Happy holidays, Hans Dysarsz

Blue Divider Line

Hans Dysarsz has been keeping us up to date on our Ambulance, Paramedic, Air Ambulance service in B.C. by sending us emails so there is no link to this information from Hans Dysarsz.

Dec 17, 2012

I hope I am wrong but unfortunately I don’t think I am.

31,000 people die each year in BC, of that, 7,750 (plus) deaths are ‘considered unnatural’ and are investigated by the BC Coroner’s office. Of the 31,000 plus deaths each year, a high number are from ‘clinically treatable conditions’, i.e. these patients didn’t necessarily need to die. Take trauma related deaths, internationally accepted statistics indicate that over 50% died from ‘clinically treatable conditions’. Many deaths from ‘natural causes’, including heart attacks and strokes, are also from ‘clinically treatable conditions’. The connection between ‘clinically treatable/preventable deaths’, both from some ‘natural’ and ‘unnatural deaths’, appear to be inadequate initial treatment/long transport times back to an appropriate treatment facility. My conservative estimate is that ‘hundreds’, if not over a thousand British Columbians, are dying each year that didn’t need to.

Further research into the matter was even more shocking: BC has 3,600 paramedics, circa 300 advanced life support paramedics (ALS) of which 150 or so are part-timers and or are assigned to two special transport teams (which are restricted to special duties; not on ambulances in the community). BC has 4.4 million residents spread over 950,000 sq km of land area, we also have 27,000 km of coast line and only a few dozen of BC’s highly skilled ALS paramedics work outside the Lower mainland, all of which do not respond to out of city limits calls. The vast majority of BC paramedics, over 2,100, are part-timers, over 3,300 are only Basic Life Support (BLS); there is a 2.5 year training difference between a BLS and an ALS paramedic. FYI, Alberta, with a million fewer residents, and 300,000 sq km less land area, no coast line, much less challenging terrain, has almost 2,100 ALS paramedics, Fire department routinely provide EMS all over the province, just like in so many US states. The facts get even more bizarre: it is ‘illegal’ for anyone other than the BC Ambulance Service to provide pre-hospital care in BC beyond first aid, including fire/rescue and police departments. FYI, Fire/Rescue is always ‘on scene’ life saving minutes before the ambulance service. Some perspective: Internationally, pre-hospital care is delivered very differently than in BC, fire, police, private-for-profit and non-profit orgs, are all allowed to provide any and all levels of EMS care they want. Also, many international jurisdictions utilize doctors in their pre-hospital care systems but not even one doctor is ‘allowed’ to work in BC’s EMS system; countries like Cuba and Russia commonly use thousands of doctors pre-hospital, many EU countries also use doctors as a ‘regular part’ of their EMS systems. So why do they do that and we in BC don’t? Long ago, these other jurisdictions came to realize that sooner, more aggressive treatment, especially for time sensitive patients, resulted in lower mortality and morbidity and that translated into lower health care system costs for them.

One more bizarre twist to this story: I was told that BC can’t even hire out-of-province ALS paramedics because of an agreement with the paramedics union which prohibits such a practice; out-of-province paramedics can be hired but must start as part-timers and only practice as basic life support medics, at least until such time as they have sufficient seniority to get (re)trained as a ‘BC ALS paramedics’ and only by the BC Justice Institute; the only ALS training entity recognized by the BC Ambulance Service and that at a cost of $14,500 for tuition and 2.5 years without pay. How is this byzantine approach to delivering life saving pre-hospital care better for British Columbians, and more specific, for my family? How does our system benefit the taxpayer? The answer of course is it doesn’t, the only entity our current system benefits is the paramedics union, and no one else.

If we don’t change this byzantine and long outdated system, many more British Columbians will die from perfectly treatable conditions; are we as a society willing to live with that? I think not, if British Columbians came to know these facts, they would contact their MLAs and demand change. Think back for a moment, do you know someone that died due to transport time delays or inadequate paramedic training; I bet you do, since the present EMS structure has been in place in BC since 1974.

Hans Dysarsz

Blue Divider Line

.pdf icon December 10, 2012 Regional District of Central Okanagan Regular Board Meeting Minutes

6. CORRESPONDENCE

6.1 District of West Kelowna - re: Westside Medical Centre - Request for Letter of Support

District of West Kelowna's letter of November 8, 2012 requested the Regional Board provide a letter of support for development of a business case for the construction of a medical facility in West Kelowna. It was reported that West Kelowna Council at its November 13, 2012 meeting received a report from staff and their consultant, Joanne Konnert, regarding the feasibility of such a Centre for West Kelowna.
IHA has previously purchased land in West Kelowna and plans to hold onto the land. In the meantime, the community has an interest in seeing something happen, possibly an urgent care centre which would divert patients on the Westside from travelling to KGH. West Kelowna engaged Joanne Konnert, formerly of IHA, to put together a concept and speak to the various players from the health perspective, as well as Westbank First Nation (WFN), District of Peachland Council and resident associations. It was noted that a letter of support would not obligate the Board to any financial support. Letters of support
are being requested from WFN and District of Peachland as well.
Concern was expressed that WFN is progressing with a private care facility next year, why would West Kelowna not consider a venture with them? The concepts are different ie: private care facility, not public care. It was noted that a 'facility' on the Westside has been on IHA's capital program for a number of years but is not considered a priority.

ZIMMERMANN/BAKER
THAT the November 8, 2012 letter from the District of West Kelowna regarding support for development of a Westside Medical Centre business case be received;
AND FURTHER THAT the Regional Board approves forwarding a letter of support to the District of West Kelowna for the development of a business case for a Westside Medical Centre.

CARRIED

-------------------------------

.mp3 file icon - click here for help with audio December 10, 2012 audio of entire RDCO Board meeting - .mp3 (9.45 MB)

Click this Windows Media Audio icon for help with audio files December 10, 2012 audio of RDCO Board meeting only about Item 6.1 Support Letter - Westside Medical Centre - .wma (6.80 MB)

Blue Divider Line

This is an email Hans J Dysarsz sent us November 27, 2012, so there is no link:

Madame Premier,

It is my understanding that Harper Government has decided to dispose of 4 Canadair Challenger Jets from the RCAF VIP aircraft fleet. These jet have been exceptionally well maintained and are ideally suited for a medevac role for rural British Columbians. Since Canadian taxpayers have already paid for these aircraft, it is only fair that the federal government make them available to any provinces wishing to put them into a humanitarian role like medevac. May I suggest you contact Prime Minister Harper’s office soonest to request that at least 2 of these surplus aircraft be made available to British Columbians before they are auctioned off ‘for cents on the dollar’ as has been the case with previous military aircraft (the Canadian military Bell 212 helicopter disposal debacle comes to mind).

The Province of BC should acquire two of these jets (if possible) and have them re-outfitted as “.... dedicated air ambulance aircraft ....”, i.e. no VIP transport possible. Once the province of BC owns these aircraft, existing fixed wing medevac contracts should be terminated, (as is allowed without cause or recourse as per line item 11.4 of all BC medevac contracts) and retendered to seek contracting in only ‘air and ground crew services and no aircraft or ground facilities’. Preference should be given to non-profit, registered charity service provider operators.

To be clear, this suggested approach will dramatically improve patient care for rural BC patients needing urgent air transport to Vancouver. Furthermore, such a amended air ambulance program service provision would save BC taxpayers potentially into the many of millions of dollars in coming years; this would be a very good, reduced cost program for all British Columbians and not just British Columbians living in rural BC.

I urge all MLAs, from all parties, to contact Premier Clark’s office in support of this imitative – this is literally a ‘once in a lifetime opportunity’ to greatly improved health care for BC patients at much lower cost than taxpayers are paying now and in the future.

Sincerely, Hans J Dysarsz

==========================

CTVNews.ca Staff - Published Tuesday, Nov. 27, 2012

The federal government is getting rid of four of its six Challenger jets -- aircraft traditionally used to shuttle Canadian government officials and VIPs around the country, sometimes controversially.

The fleet reduction is part of ongoing Conservative efforts to cut spending and balance the books over the next few years. The Tories have already reduced the use of the jets by as much as 80 per cent since coming into office.

While the Challengers are used for VIP transportation, they're also used for administrative support, and, at times, for medical evacuations.

Photos

CC-144 Challenger

A CC-144 Challenger from 412 Transport Squadron, Ottawa, flies overhead as part of Centennial of Flight celebrations during Winterlude festivities at Dows Lake, Ottawa, Saturday, Feb. 21, 2009. (Sgt Frank Hudec / Department of National Defence)

A number of the six CC-144 Challenger twin-engine jets will come to the end of their lifespan in 2014, CTV’s Mercedes Stephenson says the government is not waiting until then to get rid of them.

"I asked if they were going to wait … I was told no, they absolutely will be gotten rid of by the Canadian Forces before they come to the end of their lifespan at 2014, so they're looking to do this for immediate cost savings," she told CTV News Channel.

The Challenger program has been the subject of controversy in recent years.

Former chief of the defence staff Gen. Walter Natynczyk was taken to task in 2011 for spending more than $1 million on personal flights aboard the jets, which shuttled him to such events as CFL games, fundraising dinners and even to join his family on a Caribbean vacation.

Natynczyk defended his actions at the time, saying he had been transparent about his flights, which were all approved through official channels.

Defence Minister Peter MacKay also came under fire that year for racking up $3 million in Challenger flights. The prime minister defended MacKay, saying the trips had all been for legitimate reasons -- including the repatriation ceremonies for fallen soldiers -- and said MacKay had used the VIP jets an average of 70 per cent less than previous defence ministers.

Documents showed only nine of MacKay’s 35 flights were for repatriation ceremonies, while the other flights were for press events and other political announcements.

The decision to get rid of four of the jets is largely about optics, saying they have come to be seen as an expensive "perk" for government officials at a time when many Canadians are struggling financially.

"I think you're seeing the military not only looking for cost-savings … but they're also looking at how does the average Canadian view it if you're essentially flying around in a private jet," Stephenson said.

http://www.ctvnews.ca/canada/feds-to-unload-4-of-6-beleaguered-challenger-jets-1.1055302#ixzz2DTanDkhc

Blue Divider Line

This came from Hans Dysarsz by email, so there is no link.

The following is NOT an indictment of the hard working men and women of the BC Ambulance Service, they are doing the best they can with what this government gives them to work with.

There is no other area of medicine where spending such a small amount more up front, will make such a profound difference both in terms of additional lives saved and people kept out of long term care (or from sustaining permanent injuries) than in our pre-hospital care system.

Fixing BC’s grossly out-of-date BC Ambulance Service should be the highest priority for this government; to be clear, the BC Ambulance Service is inadequate to the needs of British Columbians. Fixing the BCAS, will greatly help reduce our skyrocketing health care costs. So how do we fix our out of date ambulance service; by training more advanced life support paramedics and adding a dozen, rapid response, doctor-led, EMS helicopters to the system. This approach will provide patients with vastly more capable medical care much sooner, especially for all areas outside immediate Metro Vancouver and Greater Victoria. Such an approach will dramatic reduce our pre-hospital mortality and morbidity rates; to be clear, pre-hospital mortality rates remain extreme (third world like) in some areas of BC.

They are: 12% in Metro Vancouver, 49% for parts of Vancouver Island, 59% for the interior, 75% for the north and 82% for the northwest.

British Columbians should know that up to 50% for all trauma related deaths are from clinically treatable conditions, that means out of the 7,500 unnatural, pre-hospital deaths in BC each year, hundreds, potentially even into the thousands did not need to die had they been attended to sooner and by higher capability medical practitioners.

Furthermore, by (at least) a factor of 10 to 1, morbidity rates outnumber mortality rates, and morbidity is what costs societies the really big money. By (simply) choosing to change how we delivery pre-hospital care, it becomes possible to dramatically reduce our mortality rates (along with our morbidity rates) thereby saving British Columbian taxpayers many times more the money than such an enhanced EMS system would cost. Understand that trauma related injuries and deaths costs BC society an estimated $2.8 billion per year, and it simply does not have to!

The above facts were understood by many other countries / jurisdiction many decades ago, none more so than Germany, France, Austria and Switzerland. The reader needs to understand that for these very reasons, most western federal governments, except the Canada and the US, passed national pre-hospital care standards legislation, including such innovations as use of local family practice doctors to respond to certain medical conditions (such as accidents) located within a certain radius of their family practice. It is important to note that BC only has 148 actual ‘Emergency Medicine specialists’, the rest are General Practitioners / family doctors working in hospital Emergency Rooms, so why not use them in our urban and rural areas, whenever possible, to augment BC ambulance attendants, the vast majority of which are only basic life support qualified attendants? When lives are at risk, how is NOT using readily available family doctors better for BC families? How is NOT using them when available saving BC Taxpayers money?

Use of local practice family doctors, as an BC Ambulance Service augment, would begin to show traits of ‘a true world class / first class pre-hospital care system’, but that is not the case, and that is why we in BC, have nothing even remotely close to a world class system: the BC Ambulance Service is decades out of date with other first world nations and even other Canadian provinces.

Proof: Alberta, a province with almost a million fewer residents than BC, 1/3 less area than BC, vastly less challenging terrain than BC and two world-class trauma centers centrally located (Edmonton and Calgary) has 2,100 Advanced Life Support paramedics, BC has, out of our total circa 3,650 BC Ambulance Service employees, only has 137 (full-time) advanced life support paramedics; do you see something wrong with that? BC only has one ‘level one’ trauma center located in Vancouver, BC only trains 20 Advanced Life Support paramedics each year (with only 16 graduating on average) in Alberta they train hundreds of ALS paramedics each year; so why are British Columbians second class citizens when it comes to pre-hospital care in Canada? Do you see anything wrong with that?

In BC we have one (giant) government run, unionized, pre-hospital service provider, in other jurisdictions they have many municipal and even non-profit service providers. In Alberta, they have no hiring restrictions when I comes hiring in already trained ALS paramedics, here in BC, that is not legal (!!!) consequently other jurisdiction have far more capable EMS systems than we do. Why is this government allowing this byzantine system to carry on year after year? The BC Ambulance Act legally prohibits anyone other than the BC Ambulance Service from providing anything more capable than ‘First Responder’ services, even if entities like municipalities, charities/ non-profit service providers, want to provide Advanced Life Support (or even doctor-led) pre-hospital care for their community; how is this approach / our current system, better for my family? Clearly it’s not, and our families members are dying or ending up long-term care because of this stupid and archaic system we still have here in BC!

The BC Ambulance Service is a highly dysfunctional service and is in clear and dire need of overhaul, both to save more lives/keep more persons out of long-term care and to save our socialized health care system from financial collapse.

When carrying out your duties as an MLA, please try to remember these two facts:

- The greatest wealth we as individuals have is our health.

- 47% of people that voted in the last BC provincial election were aged 50 or over, an age demographic that consistently identifies “better health care” as being in their top three priorities. If I were a politician looking to get re/elected, I would pander to what the majority of voters want, clearly that is not what this government is doing and they will likely pay a price for that in the next election.

Blue Divider Line

West Kelowna plans for health facility
Castanet.net - by Jennifer Zielinski - Story: 74301 - Apr 24, 2012

West Kelowna could be getting a health facility.

The District and Interior Health are working together to investigate the possible creation of a Westside Health Facility at 3525 Elliot Road, including a third party partnership.

Interior Health sent the District of West Kelowna a letter that stated while a Westside Health Facility is important, it's not presently ranked among their top priorities. However, West Kelowna was encouraged to investigate potential partnerships for the provision of the service. Both parties agree there is considerable background work to be done before any move can be made on this important initiative.

Since the District has already had some preliminary discussions with third parties, Interior Health encouraged the District to take the lead on exploring options for a third party partnership, including identifying community stakeholders that may be interested in co-locating their services at the Elliott Road location. Once potential opportunities and possible challenges are identified, the two parties could then review the findings and discuss next steps to move the project forward.

Mayor Doug Findlater says, the District is happy to be given the green light to at least explore options.

"We know it’s not a top priority for Interior Health’s capital funding at this time, but a Westside Health Facility is most certainly a priority for our residents and West Kelowna Council. We’re happy to do a lot of the leg work if it means we can move closer to our goal. At the very least, we’ll be able to determine if it’s possible or not, and, at most, we may find a partnership that meets all our needs.”

Interior Health is supporting the District in this early stage of exploration, but updating the planning information that will be required in order to determine the mix of serves that the community will require.


Dr. Robert Halpenny says to support the District’s future goal, Interior Health has offered to review the population health needs of the residents of West Kelowna and surrounding areas.

"This information will help us understand exactly what health services residents currently have access to and services they may still require. This information will assist in making any future decisions.”

The property at 3525 Elliott Road, owned by Interior Health, was rezoned by West Kelowna Council in April of last year, to allow for a Health Facility. The entire property remains in the Agricultural Land Reserve (ALR), but half was approved for use for a health care facility subject to some conditions. Interior Health has requested an extension on the deadline for development from the ALR.

District staff are preparing a report to come before Council in the coming weeks to determine a strategy for moving forward in these investigations.

Blue Divider Line

WFN plans private hospital
Castanet.net - by The Canadian Press - Story: 73832 - Apr 12, 2012

The Westbank First Nation appears ready to build a state-of-the-art private hospital on its land overlooking Okanagan Lake.

Band Chief Robert Louie said in an interview with CHBC television that self-government gives his band the right to build the hospital without provincial interference.

"Well, we can't use the word private hospital, but it has the makings of a facility that people will pay for," he said.

Construction on the $120-million proposed facility could begin by later this year. The building would be three or four stories and have 100 beds.

Louie said it would offer full hospital services, except for emergency, psychiatric and obstetrical treatments. Patients would pay the entire cost of their stay. It would operate outside Canada's medicare system.

"We're not going to rely on the public system, we're not going to rely on taxpayers to foot the bill," Louie said, noting his community is trying to tap into the lucrative medical tourism business.

"Why not keep the money here? That's part of our focus."

Louie said band members voted 92 per cent in favour of the project, Louie says construction will begin this year or 2013 at the latest.

"There's no absolute guarantee, but things do look good, they look promising."

A statement from the BC Health Ministry declined to comment on the venture.

"It would be premature for the ministry to comment on the merits or legality of such a clinic, in the absence of any detail around the proposal itself and how it might fit with existing federal legislation, including the provisions of the self-government agreement between the Westbank First Nations and the federal government and the Canada Health Act."

Private hospitals are not unique in British Columbia.

Vancouver hosts the Cambie Surgery Centre, which bills itself as "the most modern and only free standing private hospital of its type in Canada."

Among the specialties it bills are arthroscopic surgery, gynecology, vascular surgery and neurosurgery.

Elsewhere in Vancouver, the private False Creek Healthcare Centre has grown to include services such as family practice, urgent care and pathology.

Charging patients for services funded through medicare is illegal under the Canada Health Act, and the federal government has withheld portions of health transfer payments from B.C. and other provinces when they've allowed the practice.

Blue Divider Line

Video of a BC Ambulance Service Helicopter in a NEAR CRASH

http://www.youtube.com/watch?v=zJSTyOPShOs&feature=related

The near crash of a BC Ambulance Service helicopter is what you will see at this link. I found it interesting that even though there was such dramatic video of this near disaster, it got nothing in the way of media coverage here in BC.

I invite you to see this for yourself. This near disaster occurred just a few months ago and only a couple of months after Helijet was awarded the current $104 million, 8 to 12 year service provision contract with BC Ambulance Service.

What makes this contract so interesting for me is the fact that the BCAS ambulance service ‘used the same contract awarding process’ for this contract as the federal government did with the insanely costly and unsuitable F 35 fighter contract; BC ambulance paramedics ‘were asked what helicopter model they would like to ride in’ and then the aircraft requirements were written around that for the RFP!

To be clear, the chosen S-76 helicopter is nowhere near ‘the best helicopter for the job’ but it was chosen never-the-less (amongst its many shortcomings, it can’t fly in all weather conditions and therefore is grounded for far too many days each year, as well as pilots can’t use true night visions systems as this model is not compatible with true military grade NVG systems! How stupid is that when there are a number of models that can all that and more!).

To add insult to injury with this contract, BC taxpayers are ‘renting’ all three of these totally inadequate helicopters for the 8 to 12 year contract period! So not only is the BC taxpayer paying Helijet a handsome profit margin for the provision of the service, we are also buying these helicopters (and hangars) for Helijet (a private for profit company, likely several times over at that) in this contract and then, we the taxpayers, will be left with nothing to show for it at the end of the contract period as someone else other than the BC taxpayer will end up owning these helicopters! At the end of the contract period, the owners will then be able to sell these three helicopters for many more millions for dollars of additional profit!

Please Ministers Falcon and de Jong, and Premier Clark, tell the BC taxpayer where the savings are in this approach for the BC taxpayers? Please tell us how this approach is better for our families or patients. Tell us again how we all have to live with ‘NET ZERO’ and your business buddies get incredible paydays like this contract. Tell us all again how ‘.... we have to do more with less ...’, this contract stinks to high heaven, just like the recently signed for EMS helicopter contract in Kamloops does, where BC taxpayers are renting a previously written off “salvaged helicopter” that was “....severely damaged ...” in a collision with a bridge in the US prior to being imported to BC and being ’fixed-up’ to transport some of sickest and most injured - for the next 3 to 5 years!! All this while the vast majority of rural BC has no EMS helicopter coverage at all! (and has so desperately needed for decades now as proven by the third world pre-hospital death rates from all time sensitive conditions).

All these shenanigans when all in the industry have known that all air ambulance services worldwide have long used (for decades) the “Gold standard non-profit service providers approach for this kind of service” (and where for the governments own all the assets), we here in BC still rent all these assets, including all aircraft and hangars! Where is the cost effectiveness in that Ms Clark? Who in their right mind rents their family car, their business’ delivery truck etc., if the cannot only easily afford to buy, them but knows full well that owning these assets will save them 10s of millions of dollars in the long run to do so!

The attached video is a “perfect training video on how not do it”. I warn you , it is scary footage and will disturb you knowing that there are 5 soles on aboard including the patient; events such as this rarely end well, even persons on the ground standing and watching could easily have been killed by flying debris.

BTW, the Ridge Meadows Hospital was only 2km down the road from where they picked up the patient (!!) where is the sense in that, especially given that it takes the BC Ambulance Service “a mean average time of 28 minutes to get a helicopter off the ground here in Vancouver” (this, from their own documents). FYI, other EMS helicopter operations around the world take only 2 to 3 minutes, fact! (like in Alberta, Sask, Manitoba, and all 200 European EMS helicopter programs!)

As for cost savings, an ambulance ride for the patient would have been vastly less costly, (and obviously far less traumatic).

As a sidebar, both pilots involved are still flying our air ambulance helicopters here in BC for the BCAS / Helijet, and for the record, this was not ‘just bad luck’, it was gross and complete pilot error! As a former commercial pilot myself, I make that statement without hesitation!

Is this what the BC Ambulance service calls “a highly level of service / or as they like to call it, a World class service”.

If I were premier, I would instruct my minister of health to fire all senior managers at the BC Ambulance service and then hire actually experienced EMS managers “with at least some post secondary education” preferably with a major in Business Administration (to run this circa $350 million dollar a year government service on behalf of the BC taxpayer). I suggest you have a look into the qualifications of the top people running this vital and rather large government service, you will be shocked, I promise you!

Kind regards, Hans Dysarsz

http://www.youtube.com/watch?v=zJSTyOPShOs&feature=related

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The most important information I can provide you with in this regard is a BBC produced news journal program (linked below email).
http://www.youtube.com/watch?v=G0EENc_zNR0&feature=related

As well I have attached information on direct operating cost on two of the three currently BCAS contracted EMS helicopter types, the Bell 429 (link to photos of the Bell 429 on google) would have been a vastly better and much lower cost choice for BC patients and taxpayers. The comparisons were prepared by Conklin & de Decker, an independent aviation consulting firm; a company like this is whom the BC government should have gone to when deciding on what kind of helicopter should have been used for our EMS applications here in BC (and definitely not asking local commercial operators what they want to rent us, as they have a clear vested interest).

This is their website and their mission statement is below:
http://www.conklindd.com/Page.aspx?nid=5

Numbers you can count on, advice you can trust
The mission of Conklin & de Decker is to furnish the general aviation industry with objective and impartial information in the form of professionally developed and supported products and services, which enables customers to make more informed decisions when dealing with the purchase and operation of aircraft.

Contracting a salvaged helicopter is for sure another of many ‘half measures’ and missteps of this government in this regard.

FYI, had the BCAS chosen to buy and then only contract out the operations of a new, state of the art Bell 429 EMS helicopter (with a purchase price of only $6 million for a brand new one!), tens of millions of tax dollars would have been saved. FYI, the Bell 429 is a twin engine helicopter capable of carrying 2 patients, 2 attendants and is 50 kph faster than the chosen 412 (as fast as the three S76C+ just contracted), and is far more less costly to operate per hour (about $700 less per hour!) than both the Bell 412 and the S76C+.

As well, the additional $750,000 to upgrade the RIH helipad so that the chosen Bell 412 helicopter for Kamloops would also not have been necessary (perhaps only a few thousand dollars might have been needed for a minor upgrade but that’s it).


The link below is the link to the recent BBC news journal production of London’s EMS Helicopter program I mentioned above.

Their program uses an ‘MD Explorer’ as their EMS helicopter of choice, the MD Explorer is ideally suited for an urban EMS helicopter application but not ideally suited for a BC application. That said, there are several others are and they are vastly better than the Bell 412 this government got for Kamloops and the three they got for Vancouver and Prince Rupert. I am referring to the Bell 429, and the Eurocopter EC145. I would have even preferred an older MBB BK117 B2 over the salvaged Bell 412 that went to Kamloops – this for many different reasons but primarily because they are all faster than the Bell 412 and none of the helicopters I would have chosen would have been salvaged.

Some perspective here: had the BC government still had government air for ministerial / Premier use, there is no doubt that such an aircraft would NOT have been salvaged (for the same reasons Jimmy Pattison, Bill Gates, Warren Buffett, even Donald Trump, would never climb aboard, let alone own, a salvaged aircraft for their personal use).

I challenge you to contact any executive air charter firm in the world and ask them if they have (or ever had), any salvaged aircraft in their executive charter fleet, but you already know the answer to that one. In the Kamloops case, the BCAS feels that the salvaged aircraft are ‘good enough’ for our sickest and most injured (when they are not acceptable for use by the rich or our own federal politicians).

WRT, the attached video, it will show London’s air ambulance – which after 23 years of operation - is still only 50% government funded, the rest of their operating funds come from donations.

Please note that the Emergency doctors they use are also ‘dual speciality’ Emergency doctor and anesthetist. One of the main benefits of having a dual speciality doctor ‘on scene’ is their ability to not only administer life saving drugs and procedures but also put the patient to sleep right on scene, thereby preventing much additional injury.

The link attached is part one of a 5 part series, at the end of the video you will see a number of small screen shots, just click on the top left screen shot to get to the next segment of the program.

There are many such ‘news journal EMS helicopter videos’ on Youtube unfortunately most are in German, the fact that this one is in English will serve to show you what most of Europe has been doing for over 40 years now!

The one thing that London’s air ambulance does (almost once a month now) is ‘side of the road’ open heart surgery! And with tremendous success rates! I am not aware of many other programs (worldwide) that have taken that step yet, you can be sure they are not far from it. Many already carry ‘universal donor’ whole blood, following the Australian lead.

Like I said before, the BC Ambulance Service / Les Fisher, keeps telling British Columbians that we have a ‘first class, world class ambulance service in BC, as you will see for yourself in the video, we have nothing even remotely close to that ( and we have the horrific pre-hospital death rates from trauma prove it).

HEMS LONDON – ‘Medic One’ part 1 of 5
http://www.youtube.com/watch?v=G0EENc_zNR0&feature=related

==========================

Bell_412_429_s76c_comparison 1.jpg

Bell_412_429_s76c_comparison 2.jpg



Kind regards, Hans Dysarsz

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As a BC MLA and or journalist, you need to see this information for yourself.

Please take a moment and go to the links attached below to see how other provinces in Canada are saving their taxpayers (and health care systems) 10s of millions of dollar each year, simply by choosing to work with non-profit service providers.

I have personally attempted to contact the Premier Clark (on many occasions) in this regard, just to let her know that she is getting really bad advice from her advisors on this matter, consequently, another recently awarded ‘for profit’ service provision contract in this field.

These additional contracts that keep being awarded are in direct contradiction to the promises she made during election campaign (when running for party leader); she clearly stated and put into writing, that she supported ‘non-profit, public partnerships’ for the delivery of necessary government services. See attached PDF. In the press release she acknowledges ‘the incredible added value for tax dollars spent’ but now that she is Premier, this press release appears to be have only been campaign rhetoric, in other words, she was being a typical politician, i.e. making promises she had no intensions of keeping.

FYI, both the Premier of Saskatchewan, Brad Wall, and the Premier of Manitoba, Greg Selinger recently (personally) directed their Ministry of Health bureaucrats to take the necessary steps to bring STARS to their respective provinces; so why not here in BC?

To-date, in Saskatchewan alone, over $50 million dollars have been pledged (some of that already in the bank) for their STARS program – and they haven’t even starting flying there yet!

Go to the links below to see for yourself.

So why is the BC Liberal government still so eager to continue throwing away 10s of millions of dollars each year on a patchwork of ‘for-profit service providers, when right next door in Alberta they have such a vastly better, less costly system? STARS has been doing a stellar job for Albertan for the last 26 years (?) and that wasn’t lost on the Premiers of both MB and SK, as they have asked STARS to come there and provide their patients and taxpayers with their stellar service!

Fact: STARS in Alberta has saved Alberta taxpayers over $250 million dollars in the last 26 years of operation! So why is the BC Liberal government not tripping over itself to bring that kind of true world class service and such tremendous savings to BC? I want to know, and as BC MLA and journalist, you too should be asking that very question of both the Minister and Premier!

Hans Dysarsz


http://www.helihub.com/2012/01/24/gala-raises-720k-for-stars-air-ambulance/

http://www.helihub.com/2011/06/29/stars-celebrates-husky-energy’s-1-million-donation-milestone/

http://www.helihub.com/2011/09/07/air-ambulance-raises-1-3m-from-one-event/

http://www.helihub.com/2012/01/17/stars-lottery-launches-with-prize-fund-of-5-2m/

http://starsinsaskatchewan.ca/funding/

Christy Clark wants non-profit and public partnerships

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If you are interested in air ambulance services in BC / Canada, the following will be of interest to you.

On March 5th, the BC Ministry of Health announced the awarding of a $2.35 million dollar per year, 5 year contract, to Kamloops based CC Helicopters for a helicopter air ambulance contract (see actual press release, please read the wording carefully).

The chosen helicopter was a Bell 412 as was expected by industry observers. There was nothing surprising about that in itself but for the fact that the chosen helicopter for this contract is a previously ‘written-off’ (in the US in 2007) air ambulance helicopter – it was involved in a collision with a bridge (!) while being transported by truck for other repairs. As one would expect in such a collision, it sustained extensive airframe damage.

The link below will take you to a site which shows a picture (of our newest addition to the BC air ambulance fleet) while sitting on the back of flatbed truck shortly after the major damage was incurred (in 2007. It “sat as parts” for 2 years before being bought by a Canadian aircraft salvage company and subsequently repaired).

Since I knew this helicopter had been written-off in the past, I thought I would contact the BCAS to inform them of this situation, no one there cared, so I decided to contact other stakeholder groups, including: the M/Health, BC Liberal MLAs (including the Premier’s office) even the BC Paramedics Union and again, no one cared. One would think that when someone with extensive aviation background like myself would take the time to make such a claim, that someone at the BCAS would simply call CC Helicopters to check if what I claimed were true prior to awarding this 5 year contract (especially since they had already been using this helicopter on a short term 2 month air ambulance contract the year before and causally since then). Well no one did.

In fact, I was shocked to find that nowhere in the, “…. rigours RFP ….. ” that was sent out to industry, that a ‘clean accident history’ was even mentioned let alone required for this contract. Apparently in BC it is fine to bid government air ambulance contracts using ‘salvaged’ / written-off aircraft. I can only wonder how many of our current air ambulance aircraft have “salvage status”, just when did we here in BC become a third world nation which allows this sort to thing. Do we also have salvage status road ambulances? Who knows, judging by this RFP, I wouldn’t be surprised if we do. Nothing but the best for the patients of Thompson North Okanagan / Interior Health Region, eh Kevin and Terry? You guys sure didn’t do your homework on this contract (for your constituents sickest loved ones)!!

Perhaps the contracting of this salvaged / written-off helicopter is just a sign of things to come for health care in BC; it seems to fit in perfectly with our C. Diff infested hospitals, our overcrowded ER rooms (which routinely extent into hospital hallways on a daily basis and often even into the attached Tim Horton’s coffee shops!) and even our many road ambulances that ‘get by’ with only ‘all season tires’ (not even proper snow tires!)

If this story wasn’t so sad, it would be funny; no one in the US wanted this severely damaged helicopter (it sat for two years and no one touched it, even for parts), but then it came to Canada and here it gets rebuilt and put back into service to transport our most sickest and critically injured. I hope that the paramedics and patients that rely on this helicopter – every day - are OK with the knowledge that their ride is a “salvaged” aircraft.

http://www.flickr.com/photos/rcsadvmedia/5662695941/

Salvage EMS Helicopter

This 1990 Bell 412SP, Serial Number 36009 and registered as N586AC was operated by Air Methods Corporation as an EMS air ambulance for Wake Forest University –North Carolina Baptist Medical Center for several years. The N586AC registration number was used to commemorate the start of the helicopter program in May of 1986 (5/86) with the letters AC standing for AirCare. In July 2007 the final mission this helicopter flew as AirCare ended with it being grounded on a scene call due to a mechanical failure. A maintenance team arrived later, removed the rotor blades, and loaded the helicopter on a flat bed truck so that it could be returned to Winston-Salem for repairs. Unfortunately, while traveling on the truck the helicopter sustained severe damage to the fuselage and rotor head when it collided with a low bridge underpass. It is seen here after the collision with the hospital markings and registration covered. The airframe was later sold as salvage and then completely rebuilt and refurbished by a Canadian aviation company. The helicopter returned to flight status in 2009 in an attractive blue and white civilian paint scheme. As of March of 2011 this helicopter was in British Columbia, Canada and is listed for sale.

You can check out all I claim on the net, all needed cross-references to serial numbers and present Transport tail numbers are there (the current Transport Canada tail number is C-FCCK) This helicopter has been for sale ever since it was salvaged and not takers !! I wonder why no one else wonted it even though worldwide helicopter sales were booming the last few years?. I found it interesting that in the ‘for-sale’ advertisement no mention was made of the fact that this helicopter had been written off / is a salvaged helicopter, I guess as they say, ‘… buyer beware …’ even with large ticket items like helicopters.

Making sure all the facts come to light, Hans Dysarsz

CC Helicopters (2011) Ltd. successful proponent in bidding process

1990 BELL 412 for sale description

Canadian Civil Aircraft Register

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August 12, 2010 Regional District of Central Okanagan Governance & Services Committee Agenda

Item 5.1 Quarterly Program Measures Report.pdf

Agenda No: 5.1
Mtg Date: August 12, 2010
TO: RDCO Directors and Department Heads
FROM: Donna Adams, Accounting Analyst; Marilyn Rilkoff, Manager of Finance and Administration
DATE: July 30,2010
SUBJECT: Quarterly Program Measures Report, Year to Date June 30, 2010

*This is only a snippet of the 8 pages*

The following are some of the highlights for the year from the Quarterly Report, but are certainly not all inclusive. We do recommend that the report and each program be reviewed, particularly with respect to "Department Initiative Status Reports", the "Summary of Year to Date Results", and Project Updates for the various programs. There are too many items too be covered in this summary, and everyone's level of interest in the various programs and departments varies.

Executive Summary:

Inspection & Bylaw Enforcement Services:

August 12, 2010 Regional District of Central Okanagan Governance & Services Committee Meeting Minutes

5. Finance and Administrative Services

5.1 Quarterly Program Measures Report - Year-to-date, June 30, 2010 Executive Summary

Staff presented the Quarterly Program Measures report, year-to-date June 30, 2010 Executive Summary which highlighted key areas in the Regional District services.

Questions:
• Dog Control- is that being enforced? Yes, except for the one section in the City of Kelowna.
• What is the T-Card system? An accounting form provided to the Ministry of Forests for tracking equipment and services used by the Regional District.
• Joe Rich Volunteer Fire Department - Medical First Response. Are we being compensated for accidents where the boundaries are in question?
We are negotiating a mutual aid agreement with Big White. No costs are being reimbursed at this time. RDCO subsidizes this service. Staff have unsuccessfully tried to recover costs from the trucking companies, ICBC and the province.
• What role does the Province play? They provide ambulance services.
• Is the RDCO covered by insurance for calls outside of our jurisdiction?
Believe that we are, but will confirm.
The Chair noted that this is a provincial problem.

#GS50/10 SHEPHERD/EDGSON
THAT the Quarterly Program Measures Report - year-to-date June 30, 2010 Executive Summary be received;

AND FURTHER THAT Staff bring back a report on the status of the Mutual Aid Agreements with the Kootney Boundary Regional District for Big White;

AND FURTHER THAT Staff confirm the insurance coverage for Medical First Response call outs outside of the RDCO jurisdiction.

CARRIED

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So many ambulance questions
Castanet.net - Story# 56193 - Aug 9, 2010

To the editor:

I would like to get the real story behind the B.C. Ambulance Service.

Lets start with:
How many ambulances are available to the Kelowna and Westside area per shift?
How many of those are manned by advanced life support crews?
What areas do the Kelowna and Westside crews cover?
Is it true that ambulance crews must stay with patients after arriving at Kelowna General Hospital (KGH) until a nurse gives them the okay to leave?
Is it true that getting a patient into a emergency bed could take up to six hours and therefore you have the ambulance crews tied up and unavailable to assist anyone else?
I saw nine ambulances in KGH parking lot at one time and they were still there two hours later, how many does that leave on the streets of Kelowna and Westside?
Out of our total allotment of paramedics, how many are full-time?
Is it true that on call paramedics are paid $2.00 to wear a pager and be available to respond to a call if needed?
If they do not get paged out in say a 12 hour shift, what would their wage be for that day?
I would assume that for $2.00 per hour -- they don't sit at the station during that shift so what is their response time once paged?
Would that not put lives at risk waiting for a paramedic to come from home?
Is it unusual for paramedics to work longer than a 12 hour shift -- and if so are they paid overtime?

I've also noticed there is a new ambulance service in town. What are they used for?
What training do their crews have?
Do they have all the equipment like BC ambulance does?
Can they provide advanced life support?

All these questions are important to me since I care for a very elderly parent and they should be important to every member of this community.

Val Schewe

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.pdf icon April 27, 2009 Regional District of Central Okanagan Regular Board Meeting Minutes

9.3 Director Items (items that require action only noted)

d) BC Ambulance

The question was raised regarding correspondence which has been circulating to local governments regarding working conditions and contractual issues for the BC Ambulance attendants.

It was noted that they will be addressing West Kelowna Council later this week.

By consensus staff were requested to circulate information to the Board on BC Ambulance operations.

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24/7 ambulance service recommended
Kelowna Capital News - Letters - Published: February 07, 2009

To the editor:

The Westside Public Support Organization (WPSO) delivered its first report on improving health care in Westside, WFN, and Peachland to the West Kelowna council on Jan. 27.

WPSO is very grateful for council’s firm support of our recommendation to upgrade the current rural ambulance service.

However, council chose not to support our first recommendation for a 24/7 level 2 health care facility, which was a disappointment, and largely due to Rick Thorpe’s scaremongering.

While we also appreciate the support given us by members of the press we are concerned about inaccuracies in the newspaper stories. In respect to Rick Thorpe’s statements, the WPSO has never, and are not now, suggesting that we need a $400 million to $500 million hospital. That is a ludicrous statement and simply demonstrates that Mr. Thorpe has not even read our report.

Newspaper reports are equally at fault, one reporting that council did not endorse the ambulance request when it did; another reporting us requesting an ambulance on call for 12 hours a day when the report clearly calls for 24/7 services.

The editor of the Capital News simply parrots Mr. Thorpe, without having any idea of the realities of care on the Westside.

It shouldn’t be necessary to say it, but councillors’ concerns about spending in these times are shared by all of us. But please let us all make accurate statements on such an important issue as health care.

Members of the public should all be made aware that our position was supported by the RCMP and every member of the Westbank First Nation council, as well as businesses and retirement associations. The WPSO is fully in agreement with IHA’s approach to phasing in services. It takes a very long time to design and build a health care facility of any size and there are many demands on IHA money and time. It is important to note that we are not seeking the duplication of all of KGH services as some councillors implied.

As our population grows and the percentage of seniors increases, the demands on the systems will only increase. The time to start the process is now, and the proposed joint meetings will at least get us started. Council is assisting the start by convening a round table discussion meeting with all interested parties. It is important that the final design should, at the very least, start to reflect defined needs, and most importantly, take some pressure off the existing Okanagan hospitals.

We want to assure the public that council’s refusal to support the motion made by Coun. Milsom does not mean a conclusion of our efforts on behalf of residents.

WPSO will continue to collect signatures via our website at wpso.ca and in person where practical, and the WPSO stands ready to assist the IHA in moving forward .

Copies of our report as presented to council can be viewed on our website at wpso.ca and anyone can e-mail us at info [at] wpso.ca or send a letter of support by snail mail.

R. F. Green,
Westbank

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December 17, 2007 we received word from one resident of Valley of the Sun that they helped to get the ambulance unstuck on Alpine near Wood road after one of the first snow falls of the year.  This was most likely the time it took 2 days for the snow plow to arrive after it snowed.  We are not positive but we think it was the time that the helicopter came and picked someone up at the entrance to Valley of the Sun.  This helicopter evacuation is posted on the North Westside Fire Dept. website on their front page.  By the looks of the snow piled up on Firwood road in the pictures that are posted there, it looks like this could have been the time the ambulance got stuck.

We suggest that everyone call and complain or it just may be your family member who needs the ambulance next time, and what if they can't get unstuck?  Plus sometimes a few minutes makes all the difference. 

Argo road maintenance should not be waiting for 2 days to plow out here or anywhere for that matter.  Why plow after the accidents and injury occur?  Wouldn't it be least expensive to just go buy the plow to start with?  If they are having a shortage of labour then maybe they need to increase wages.  Maybe it would entice some of the BC residents that fled to Alberta oil to come home???

Also if you have anything to add to ambulance problems in the area please contact us and let know so we can post it here.  Please use our feedback form to tell us your story.

To contact Argo road maintenance please phone: 1-877-546-3799

You can also contact your local representative.

Norm MacLeod at 250-260-3556 (Ceasar's Landing north to the OKIB boundary) *** Don't call Norm tonight December 18, 2007 because he just said his father is in the hospital and he does not wish to discuss anything tonight.

Roger Wood at 250-769-9355 (Ceasar's Landing south to Traders Cove)

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North Westside Official Community Plan (page 50 .pdf or 51)
5. Review opportunities and encourage the establishment of a mobile or satellite health clinic to serve the needs of the rural communities in the North Westside area.

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The Helland family have over 1000 signatures in support of a LOCAL Ambulance Service for the North Westside Road area.

45 minutes is too long to wait when your having a heart attack just ask the Helland family !

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In regards to my late father-in-law Dag Helland:

On October 10, 2005 Dag Helland was having chest pains and short of breath when he woke his wife Paula Helland. She got up and called 911, explained his symptoms to the dispatcher to please send an ambulance to her home in Killiney Beach, this is at 5:45 am.  Then my father in law had gone into the bathroom and got sick.

At this time the ambulance drivers get dispatched from Kamloops. They had to call the dispatcher back to inform him that the mapping system is wrong. Its directing them to South Vernon and the address is located out on the North West side. Now you would think that when they informed dispatch of this mistake, they would call our local First Medical Responders considering that it is cardiac arrest.

No, the dispatcher did not follow Ambulance of British Columbia policies and procedures, the first medical response team in this case, are not paged out.  By now Paula is thinking where are they, why are they not here yet. Dag at this time is writing all his medications that he is on for diabetes and his heart. It's approximately 17 min after 6:00 am Paula hears Dag grunt, but thinks he is having a rest. She is putting on her shoes to go direct the emergency vehicle, if only someone would show up she is thinking. At approximately 6:31 the ambulance arrives, they go in to find my father in law Dag slumped over with his eyes open, they then put him on the floor and start to work on him, they say to my mother in law Paula, how come the fire guys are not here? They actually have to page them themselves, to get dad out of the house.

At 6:41am our local fire department get the call to help move someone out to an ambulance, they are on route at 6:47am and on the scene at 6:56 am.  That took them 15 minutes, not the 45 minutes it took the ambulance to be on the scene. Dag passed because he had no brain function left due to lack of oxygen therefore we had to make the painful decision to remove him off life support. If the dispatcher only had the ambulance stationed out here or if he had thought to call our local First Response Team.

My father in law would still be here, I believe with all my heart, if our
first response team were dispatched, they are equipped to deal with cardiac arrest. This is a terrible mistake he was only 56 years old and is very missed by his wife Paula , Sons Mathew and Brent, his granddaughters Kristina and Tyra, his brother Ken, sister Kris, friends and family, and of course me Claudette his daughter in law.

Our family doesn't want this to happen to a friend, a mom, a dad, your child or mine. With the population growing out on the Westside. EVERY SECOND COUNTS!!!
 
                                    Claudette Helland

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"This was taken word for word from the North Westside Communities News"

by Fire Chief Wayne Carson

A sign up sheet is circulating in the community at the request of the Helland family to develop a pilot project that would see an ambulance station developed in our area.

Please be sure that you sign one of these forms.  They are available at the Community Hall, Fire Hall, local stores and restaurants.

With an ambulance station in our area the response time would be considerably less than 45 minutes.

Most people have heard of the recent death within our community and of a problem with the response.  First, let me express our sincere regrets to Paula, Matt, and the entire Helland family, we feel your loss.  Matt has been a firefighter since January 2002.  I would like to clarify some of the issues involved in this tragic event.

The North Westside Fire/Rescue and our dispatchers at the Kelowna Fire Department were not and are not consulted prior to a medical call.  If the ambulance dispatcher in Kamloops decides that a particular call needs a fire department/first medical response due to time delay or severity of the medical condition it is their call to make.

In this case there was a mapping error in the dispatch computer that compounded the problem, incorrectly indicating the area "Does Not Do First Medical Response".  This error has now been corrected.  By the time this error was discovered and corrected the call to our fire department had unfortunately fallen through the cracks and the call did not come to us until the ambulance was on scene 45 minutes after the original call was made.

Another issue brought forward by this call was the lack of addressing within the community.  I can't express how important this is.  We can't help you if we can't find you !!!

The ambulance response time is also a factor.  This is in the process of being addressed as well.

Call the Fire Hall 545-1195 if you have any further questions.

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"This was taken word for word from the North Westside Communities News"

The lack of visible addressing within the community is being dealt with.  If you want a speedy response from emergency services you must put an address sign at the end of you driveway where it meets the main road.  ESS has coupled with the Fire Department to supply and install reflective house number signs that are highly visible from the road.  They are available at a cost of $30.00 prepaid, to cover the cost of materials and installation.  The feedback has been very positive on these signs.  Installation will begin in the spring after the snow is gone and the ground is thawed.  Order yours now.  Call or stop by the Fire Hall 545-1195.

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It was the Helland family that started lobbying for better ambulance service, when Matt's father died out here on the Westside.  Matt and Claudette got a petition type form together, which residents in the area signed.  The credit needs to go to the Helland family for all the leg work they did and the loss of their family member to find out our ambulance service sucks!  Here is a page out of the NWCA News that speaks about the Helland family.

The Helland family started getting signatures to develop an ambulance station for the North Westside Road area
Click page to read larger print.
(Windows XP users will have to click in the bottom right corner of the page after clicking to keep it a large size for reading)

 

This article below was taken from the North Westside Communities News of December 2005 on page 3 and also speaks about this tragic event which hopefully will be rectified for next time.

Article about recent death in the community of the North Westside and our Ambulance Service

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From page 40
Obviously, these factors increase the time it takes prehospital caregivers to arrive at the patient’s site, and likewise the time it takes to travel to the definitive care facility. The impact, in the context of trauma care in the late 1980s, was described in the same article:
Trauma deaths were examined using hospital and coroner records. When evaluated by region, we discovered the expected discrepancy, with prehospital deaths much greater the farther the distances to definitive care. Twelve percent of all trauma deaths in the lower mainland were prehospital deaths. In a more sparsely populated area on Vancouver Island 45% of trauma deaths occurred before admission to hospital. In the interior of the province, the percentage rose to 59% and in northern British Columbia 75% of all trauma deaths occurred before reaching a hospital.

http:

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Competencies

The following are currently recognized competencies for EMA FRs in British Columbia, according to the EMA Regulation (Schedule 1):

• Scene assessment
• Assessment of levels of consciousness, skin colour and temperature, pulse, and respiration
• Rapid body survey to identify and attend to any life threatening injuries followed by a secondary assessment consisting of a physical examination, medical history, and vital signs,
• Cardiopulmonary resuscitation
• Basic wound and fracture management
• Maintenance of airways and ventilation
In addition, EMA FRs can achieve potential licence endorsements (Schedule 2):
• Use of airway management techniques including oropharyngeal airways, oral suction devices and oxygen-supplemented mask devices to assist ventilation
• Use of an automatic or semi-automatic external defibrillator
• Cervical collar application and spinal immobilization on a long spine board
• Administration of oxygen
• Administration of oral glucose

 

http: From page 43

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From page 45
One area seems particularly clear. Berringer et. al. acknowledge that there may be situations, including cardiac arrest, where the severity of the medical emergency justifies “a dual response”.xlix The subsequent OPALS study confirmed the wisdom of that observation: optimization of early defibrillation, including the use of AEDs by first responder fire fighters, significantly increased survival to hospital discharge. In this connection, it seems clear that AED should not be an endorsement, but rather a required part of the basic first responder
curriculum.

http:

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From page 47
The First Responder program is currently subsidized by the Ministry of Health.

http:

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BC Ambulance Service

Ambulance Paramedics of BC

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If you have comments good or bad, solutions, concerns or complaints regarding the Ambulance Service in the North Westside Road area, please make a comment to the community by filling out the form below and/or comment directly to the Regional District of Central Okanagan.

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If this form does not work please,

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Comment Form

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(If your community is not listed above, please type it in below and choose "other community" above)
 
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Westside Road Gossip
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INDEX WR ] INDEX ALL ] Advis. Plan Comm ] Alt Approval ] [ Ambulance ] Argo Road Maint. ] BC Hydro ] Budget 2010 ] Budget 2011 ] Budget 2012 ] Budget 2013 ] Budget 2014 ] Budget 2015 ] Building Inspect ] Build Laws - BC ] Build Laws - RDCO ] Building Violations ] Bylaw Anon ] COW Elect. 08 ] COW Elect. 11 ] Director Edgson ] Dogs ] Easement Rds ] EDC ] Elect. Boundary ] Environ. Advisory ] ESS ] Finances ] Fintry Develop ] Fintry Park ] Fire Anon ] Fire Boat ] Fire Bylaws ] Fire Dept. ] Fire Dept FOI ] Fire Hydrants ] Fire Minutes ] Fires  House ] FOI Act ] Friends Fintry ] Garbage ] Garbage Area ] Garbage Bylaws ] Garbage Com 08 ] Garbage Contracts ] Garbage Finance ] Garbage FOI ] Garbage FOI ] Garbage LaCasa ] Garbage Locker ] Garbage Minutes ] Garbage NOWESI ] Garbage Ombudsman ] Garbage Prob ] Garbage Secret ] Garbage Solution ] Garbage Survey ] Garbage Traders ] Governance Wide ] Government ] Grants-in-aid ] Helicopters ] History ] Killiney Beach Park ] Killiney Hall ] LaCasa ] Motorized Rec. ] NWCA ] NWCA FOI ] NW OCP ] NW Parks ] OKIB ] OKIB Logging ] OKIB Road ] OKIB Tax ] Peacocks ] Police Tax ] Property Tax ] RDCO ] RDCO Dog Minutes ] RDCO Jokes ] RDCO Policy ] RDCO Regs ] Report Animals ] Residents Network ] Septic Systems ] Subdiv. History ] T. Mnt After Fire ] Terrace Mount. Fire ] Trench Burner ] Vote Boxes ] Water Budget 08 ] Water Budget 09 ] Water Budget 10 ] Water Bylaws ] Water Construct ] Water FOI ] Water Grants ] Water Judgement ] Water L Fintry ] Water Laws ] Water Meters ] Water Minutes ] Water Rates ] Water Right-of-Way ] Water Survey ] Water System ] Water Systems ] Water VOS ] Water VOS Pics ] Water Wells ] Water Well Data ] Westshore Playgrnd ] Westshore Sports ] Westside Rd. ] WR Development ] WR Incorporation ] WR Overpass ] WRIC ] Zoning Bylaw 66 ] Zoning Bylaw 81 ] Zoning Bylaw 871 ]

Blue Divider Line

Westside Road Gossip
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Adv. Plan Comm. ] Alt. Approval ] Ambulance ] Argo Road ] BC Hydro ] Budget 2010 ] Budget 2011 ] Budget 2012 ] Budget 2013 ] Budget 2014 ] Budget 2015 ] Building Inspection ] Build Laws - BC ] Build Laws - RDCO ] Building Violations ] COW Elect 08 ] COW Elect. 11 ] Director Edgson ] Dogs ] Easement Roads ] EDC ] Elect. Boundary ] Environ. Advisory ] ESS ] Finance ] Fintry Develop ] Fintry Park ] Fire Boat ] Fire Bylaws ] Fire Dept. ] Fire Dept FOI ] Fire Hydrants ] Fire Minutes ] Fires House ] FOI Act ] Friends Fintry ] Garbage ] Garbage Area ] Garbage Bylaws ] Garb Comment 08 ] Garbage Contract ] Garbage Finance ] Garbage FOI ] Garbage FOI ] Garbage La Casa ] Garbage Locker ] Garbage Minutes ] Garbage NOWESI ] Garbage Ombudsman ] Garbage Questionaire ] Garbage Secret ] Garbage Solution ] Garbage Survey ] Garbage Traders ] Governance Wide ] Government ] Helicopters ] History ] Killiney Hall ] Killiney Park ] La Casa ] Motorized Rec. ] NW OCP ] NWCA ] NWCA FOI ] NW Parks ] OKIB ] OKIB Logging ] OKIB Road ] OKIB Tax ] Peacocks ] Police Tax ] Property Tax ] RDCO ] RDCO Dog Minutes ] RDCO Jokes ] RDCO Policy ] RDCO Regs ] Report Animals ] Septic Systems ] Subdiv. History ] T. Mtn After Fire ] Terrace Mnt. Fire ] Trench Burner ] Vote Box ] Water Budget 08 ] Water Budget 09 ] Water Budget 10 ] Water Bylaws ] Water Construct ] Water FOI ] Water Grants ] Water Judgements ] Water Laws ] Water Meters ] Water Minutes ] Water Rates ] Water Right-of-Way ] Water Survey ] Water System ] Water VOS ] Water VOS Pics ] Water Well Data ] Water Wells ] Westside Road ] WR Development ] WR Incorporation ] WR Overpass ] WRIC ] Zoning Bylaw 66 ] Zoning Bylaw 1981 ] Zoning Bylaw 871 ]

Blue Divider Line

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In Other Towns

INDEX ALL ] Boucherie Rd ] Kaleden ] Kelowna ] Naramata ] Oyama ] Peachland ] Penticton ] Summerland ] Vernon ] West Kelowna ] Westside Road ] Winfield ]

Blue Divider Line

Index

Boucherie Road ] Kaleden ] Kelowna ] Naramata ] Oyama ] Peachland ] Pentiction ] Summerland ] Vernon ] West Kelowna ] Westside Road ] Winfield ]

You will find local North Westside Road BC businesses, services, classifieds, local arts and crafts, vacation waterfront rentals, plus much more located near and around Okanagan Lake BC.  We will be adding to this site, so come back and check it often.

Blue Divider Line

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