A provincial Code Red sounded at the government health committee meeting Thursday.
MLA Tammy Martin asked paramedics union executive Terry Chapman what happens if someone calls 911 from New Waterford for a loved one in cardiac arrest and the nearest ambulance is in Baddeck.
“You wait, you wait with a person that will probably be not living when they arrive,” Chapman responded.
“To make people who pay taxes aware of the probability that there may not be an ambulance when you need it,” he said of the paramedics’ immediate goal after more than a year of “poking the bear,” the Liberal government.
“When we met with Minister (Randy) Delorey a little over a year ago when this was becoming the issue, we shared with him that we would like to see some movement to somehow alleviate this problem, and failing that, we would have to have the public help us do that,” Chapman said.
He said the problem is that ambulances are stuck at hospital emergency departments, waiting to offload patients.
“The offload delays are caused by patients arriving at the hospital and ... nowhere to put them,” Chapman said. “They stay on our stretchers and we can’t get back on the road.”
He estimated that 30 more ambulances, which would account for a 30 per cent hike in the provincial fleet, and 200 additional paramedics would be required to alleviate the problem in the short term.
“That would be a minimum just to take some of the weight off.”
"How that doesn’t infuriate the people of this House boggles my mind"
An emotional Martin, the NDP representative for Cape Breton Centre, said the scenario of calling an ambulance in Cape Breton Regional Municipality and waiting for paramedics to arrive from Baddeck or Antigonish is scary.
“How that doesn’t infuriate the people of this House boggles my mind each and every day,” she said at the meeting held in the legislative chamber at Province House, where Delorey has been bombarded with health-care questions for the past two weeks. “Who in this government thinks that this is acceptable?”
Chapman said the root of the ambulance availability problem is offloading patients at emergency departments, an issue that has randomly existed in the province for a long time “but never to this degree, never where 60 to 70
per cent of our staff were tied up at any one time.”
Jeff Fraser, director of Emergency Health Services in the province, explained that the emergency department delays for paramedics persist because Nova Scotia paramedics do not leave patients unattended at emergency, as happens in other jurisdictions.
“We are a very patient-safe organization,” Fraser said. “The challenges in the system are not the patients’ fault. We’re not willing to just offload the patients and leave them vulnerable in the hallway. We are not going to do anything that is going to put a patient at risk.”
Fraser said the system is working through a number of pilot projects to improve patient care. One is the way paramedics hand over patients because none of the five largest emergency departments in the province — in Halifax, Dartmouth, Sydney, Truro and Kentville — meet the 20-minute handoff standard. A pilot project that has been running at the Dartmouth General Hospital and is being implemented at the Valley Regional has two nurses accept care of the patient from the ambulance crew and look after that patient in a designated emergency room space. The problem is that not all emergency departments have the necessary space.
“Even if the offload issues are all removed, there are going to be challenges in delivering provincial services,” Fraser said. “Based on my experience, if you have 50 resources, there will be a time when you will need 51.”
Fraser wouldn’t speculate on how many times the standards for ambulance arrivals for patients after 911 calls are not met. In light of the fact that only one ambulance is available in Halifax much of the time, Chapman suggested the target arrival times of nine minutes in urban areas, 15 minutes in suburbia and 30 minutes in rural areas are rarely reached.
“I’ll bet you dollars to doughnuts that it is not very often,” Chapman said.
Chapman said paramedics have been consistently requesting improvements and he said the government says its listening.
“People get tired when you are on the job for 12 hours with no meals and no breaks and you are into three or four hours of overtime and you still have 300 kilometres to drive,” he said of the province’s paramedics. “One day there was a report of four ambulances going off the road. To be fair, the conditions weren’t good but to be fair to those who were working, you can’t do a perfect job when you are not physically or mentally well enough to do that job.
“I can see people leaving, not wanting to be a paramedics anymore. It’s going to happen. When one leaves, the people who see the green grass are going to leave, too.”
Denise Perret, the deputy minister of health, told the committee meeting that the department wants to make the system better.
Below: Tammy Martin and Randy Delorey trade words over Cape Breton healthcare on March 7.
“We’re aware of those disconnects or the gaps in the system and I just want to assure everyone that we care about it as much as anyone. We are really focused on bringing forward options and bringing forth the talent that knows how to fix it. ... The minister has been quite a leader in bringing us all together.”
Karla MacFarlane, the Progressive Conservative health critic from Pictou West and a member of the health committee, wasn’t buyng the togetherness sentiment.
“The real disappointment that came out of this meeting was the fact that the Liberals once again turned down a motion for us to collectively come together,” she said of her motion at the conclusion of Thursday’s meeting that the committee formally request for Delorey and Premier Stephen McNeil to personally meet with paramedics, EHS representatives and committee members.
The Liberal committee members used their majority to shut down the motion.
Fraser addressed Nova Scotians’ confidence in the EHS system.
“Although our system is under significant pressure, we are moving forward,” he said. “It is important for Nova Scotians to know that EHS is going to be there for them. Please don’t hesitate to call us. We will get you a resource (ambulance).”