The ambulance system is improving, health officials say, but the union fears it may not be moving fast enough

Officials from Nova Scotia’s health system and ambulance service say recent changes are increasing efficiency, but the union representing paramedics and opposition politicians are still concerned about working conditions.

MLAs at the Legislature’s Health Committee heard on Tuesday that the time it takes for paramedics to transfer a patient to the care of emergency department staff after arriving at the hospital is improving.

The provincial average this week is 75 minutes, well above the target of 30 minutes. That time is even highest in the central and eastern zones with 94 and 89 minutes respectively.

Jeannine Legassé, the deputy health minister, said she is confident that new measures, including a command center monitoring the availability of hospital beds across the province, along with recruitment and retention of nurses, will all help, though she can’t say when the county will meet the 30-minute goal.

“I think it will depend on a number of factors and a big one is our health staffing challenges and making sure we can get good staffing and a consistent level of staffing across all locations,” Legassé told CBC.

Charbel Daniel, the executive director of operations for ambulance service provider Emergency Medical Care Inc., said it will be some time before the public sees the benefit of moving stable patients with airplanes or non-emergency hospital transport vehicles. But he is convinced that they are on the right track.

Those changes mean that ambulances and paramedics will only be reserved for the most urgent cases. The new resources should mean paramedics will only be responsible for about 10 percent of patient transfers, he said in an interview.

“Which means ambulances will only make transfers that are critical and time sensitive and all other scheduled transfers can be made through a separate source.”

About 70 percent of calls received are not serious enough to require an ambulance, Daniel said, and call centers are trying to determine the most appropriate response. That could mean sending a care team to treat someone at home instead of transporting them to an emergency department.

Daniel compared how the ambulance service traditionally operated with a police force.

“They have their SWAT teams and they have their police cars and what we’ve been doing for years is sending our SWAT team to every call and it’s not the best use of resources because it’s not required,” he told the commission.

Waiting times for offload are increasing in two years

But opposition MLAs were less confident in the changes, at least in part because they are yet to see tangible results.

Liberal leader Zach Churchill noted that wait times to transfer patients to hospital staff have risen province-wide over the past two years and have become a problem in emergency departments from one end of Nova Scotia to the other.

“That was only a problem two years ago in two hospitals here in Halifax,” the former health minister told CBC.

Figures quoted by Churchill at the meeting show that Aberdeen Hospital in New Glasgow is the only regional hospital in the county to regularly meet unloading targets. Hospitals in Sydney, Lower Sackville, Halifax and Dartmouth have average wait times of 100 minutes or more this year.

NDP health critic Susan Leblanc said while officials wait for changes, the government must take short-term steps to improve working conditions and pay paramedics, which are among the lowest in the country.

“It’s insulting to us to expect so much from paramedics, to be there when we need them and pay them poorly,” she said in an interview.

Kevin MacMullin, business manager for Local 727 of the International Union of Operating Engineers, said contract talks are underway, but the system is losing people in the meantime. Fifty-three paramedics have been hired this year, but 49 have left the system, he said. Sixteen of the people who left were advanced care paramedics.

“You have to manage the resources you have before you don’t have the resources to manage,” he told the committee.

“We are losing many highly valued, experienced paramedics at this time.”

With more emergency departments closing at community hospitals, MacMullin said paramedics have to travel greater distances to get patients to regional hospitals. That means longer waiting times for teams at the hospitals and means those still on the road have to log more miles.

MacMullin said he is confident the changes being made will improve the system for its members and the public, but what happens in the meantime worries him.

“It takes time and we are practically running out of time because we are increasingly seeing staff shortages.”

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