October 06, 2014 at 1:35 PM
Metro Vancouver mayors are demanding B.C. Emergency Health Services freeze its plans to press ahead with the next phase of reforms to 911 emergency dispatch in light of deep concern over longer ambulance wait times and rising costs for municipal fire departments.
Cities have complained for months since BCEHS downgraded the B.C. Ambulance Service priority for less urgent cases in an effort to speed the response to critical emergencies. Ambulances now roll at routine speed without lights and sirens to dozens of reclassified call types.
The next round of changes through its controversial Resource Allocation Plan may further shift call priority and potentially alter how fire department first responders are dispatched to emergency medical calls.
Metro mayors passed a motion Friday opposing the reforms to date and urging BCEHS to make no further changes without consulting municipalities.
They also accused the province of underfunding the ambulance service and leaving local fire departments to respond first to more medical emergencies.
"The province is derelict," White Rock Mayor Wayne Baldwin said. "It's pretty obvious they're depending on the fire halls to get to the patients first to do the critical care quickly and ambulances are being used more as a backup."
Baldwin said a misclassification by dispatchers of the seriousness of a 911 call can decide "who is going to live and die" because a lower priority may mean a long wait for an ambulance while on-scene firefighters are unable to treat or transport the patient.
"Quite clearly, the province is failing in this and they're leaving the residents exposed."
Metro board chair and Port Coquitlam Mayor Greg Moore said the province "gets away with" ambulance service underfunding because local firefighters still show up first in uniform with lights and siren.
"They can get away with it and we keep taking it on the chin," he said.
Moore predicted it would take cities agreeing together to halt firefighter response to medical calls to precipitate a crisis and force the province to acknowledge ambulance underfunding.
"Then you'd really see an uproar," he said, but added a municipal revolt is unlikely.
Delta has gone in the opposite direction, proposing instead to train its firefighters to handle more on-scene medical care.
Baldwin called Delta's strategy "the worst thing we can do" in light of the premier's recent challenge to cities to cut their municipal costs and rein in wages.
"Taking on ambulance care is not going to do that," Baldwin said. "I think we should throw the ball back to the premier and the province and say this is your problem."
Several mayors said they're concerned with the rising cost of municipal firefighting.
Surrey fire chief Len Garis said 50 to 70 per cent of fire department calls are medical emergencies.
Burnaby Mayor Derek Corrigan said firefighters are waiting longer for paramedics to arrive and take over an emergency medical patient, adding the delays flow to the city's bottom line.
"If they're held up for 40 minutes waiting for an ambulance to attend because it's not the ambulance's priority, that's costing us more money and it's eventually going to cost us more firefighters."
Mayors also received a report on the issue from University of the Fraser Valley professor Martha Dow.
Her analysis of response times shows fire department first responders in most Metro Vancouver cities typically arrive within six minutes of a call but now wait a further six minutes and 32 seconds, on average, for an ambulance to arrive.
That's up from an average wait of five minutes and 10 seconds prior to the RAP reforms a year ago, and the gap between firefighter and ambulance arrival was longest at an average of around 10 minutes in Port Coquitlam and Burnaby.
However, Dow's findings show the delays are more dramatic when the most urgent 10 per cent of calls are excluded.
The remaining 90 per cent of lower priority calls see firefighters typically wait on scene between 10 and 22 minutes for an ambulance to arrive, and much longer waits have been recorded. Prior to the RAP changes, the corresponding wait for 90 per cent of the calls ranged from five to 13 minutes among Metro cities.
Dow said the delays are "a symptom of the issues that need to be explored as opposed to the core problem."
BCEHS officials have previously defended the priority reallocations as appropriate, providing better use of resources for urgent calls and reducing the risk of crashes involving ambulances that no longer speed to as many calls.