Friday, August 23, 2013

Concerns aired about changes to rural ambulance services

Rob Vogt, Local Press Writer, Claresholm Local Press

  • MD of Willow Creek hears about ambulance concerns from insider
A long-time ambulance worker has come forward with serious concerns about the inability of ambulances to respond to emergencies in rural Alberta because they are busy transporting patients in non-critical situations.

George Porter, who has been working in ambulance service 40 years, appeared as a delegation at the Aug. 14 meeting of the council of the Municipal District of Willow Creek.

He opened by joking that day could be his last working for Alberta Health Services because he had been directed not to talk to elected officials – so he spoke with the local MLA and Councilor Neil Wilson.

“I’ve had some very serious concerns about EMS since Alberta Health Services took over,” Porter said, adding he has not been quiet about it.

“For almost two years I got not a single response.”

Porter admitted he does not have all the answers, but he recognizes the problem and it is not hard to fix.

At times there have been no ambulances available in Claresholm or Calgary as examples, because every one is doing an inter-facility transfer. That means transferring patients from one medical facility to another.

“It’s leaving huge areas, and sometimes this whole section of the province, without an ambulance to respond,” Porter said.

He noted there are a lot of managers but still a problem.

“We have no vision, we have no leadership,” he said.

Consequently, he was asked to do a deployment review. He agreed, but he wanted a plan of action in place to deal with his findings.

He submitted that report in February and there has been no change.

Porter has waited, and decided to talk to the M.D. council. When he advised AHS officials, he was sent an e-mail not to talk to the M.D.

“I don’t know what else to do,” he said.

“We’ve had people die.”

Porter cited an example of the closest ambulance being an hour away when a patient’s chest collapsed.
“There have been several instances where patients have been compromised,” he said, adding he is not sure if some patients would have survived with an ambulance responding sooner.

Porter warned there will be a high-profile incident where an ambulance is too far to respond. “In my opinion they (AHS) are in an undefendable position,” he said.

He then cited an example of an ambulance in Vulcan used to take someone to the hospital to have the insoles of their shoes fixed. It left the area with no ambulance for six hours, because there was no back-up.

Porter also reported he talked to an AHS official who admitted 60 per cent of the calls coming from High River don’t need an ambulance. That number climbs closer to 80 per cent in communities such as Claresholm and Black Diamond.

“Why are we taxi-ing people around?” Porter asked, emphasizing it is leaving areas without emergency service.
And, he has been delivering a simple message to AHS.

“You need to fix this coverage now,” he said, noting the Nanton ambulance is hardly in Nanton, because it is backing up High River.

Interestingly, Calgary ambulances will not leave the city empty. One time, Porter was in the dispatch centre and saw seven ambulances idle in Calgary, while there was one for this entire area.

He referred to every memo he receives from AHS containing the same message: everything is done in the best interest of the patient.

“That’s not true in my opinion,” Porter said.

He keeps asking why hasn’t the problem been fixed.

“I’ve never got an answer,” he said.

“We’re on the same page,” said (MD of Willow Creek) Reeve Henry Van Hierden. “We’ve been letting them (AHS) know for two years.”

Coun. Neil Wilson asked Porter how should ambulances be deployed?

Porter replied the process does not need to change a great deal, because there is already a protocol in place. It is called the “system status management plan”, and it is just not being followed.

He cited another example of responding to a call to a hospital, only to discover the patient walking around with no need of paramedic service. Several times, families have offered to take their loved ones to the hospital but were told not to, because an ambulance would be called instead.

Porter noted when AHS took over ground ambulance service, inter-facility patient transfers increased 30 per cent over night. Meanwhile, there were 40 per cent fewer ambulances as all the rural back-up units have disappeared.

Cynthia Vizzutti, the M.D.’s chief administrative officer, said the council has had the ear of the minister of health, but his direction gets stuck in the bureaucracy.

She went on to say the M.D. went to a lawyer for an opinion on whether to use M.D. fire department emergency response vehicles to transport patients to the hospital. She also asked AHS for permission to do these transports and was told no.

“Are we protected?” Vizzutti asked. “(Her) words were ‘no’. We can be sued for doing the right thing.”

“The fire departments have saved our butts time and time again,” Porter responded.

Vizzutti shared an example of a person she knew with chest pains in Stavely. They had to wait for an ambulance to come from Fort Macleod because none were available from Claresholm or Nanton.

Van Hierden said the problem is clear across rural Southern Alberta. For that reason, the issue of ambulance service is on the agenda of the next mayors and reeves meeting, and AHS has been invited to attend.

“It’s an easy fix,” Vizzutti said. “We’ve offered over and over to help fix it.”  She later added, the solution is a regional commission fully integrated with the fire departments.

Porter also pointed out AHS has 30 transfer vehicles in Calgary and they average four calls per day, so there is capacity in the system, but they have no flexibility.

He referred to a situation in Vulcan where he was called to transfer a patient to Calgary. There was an ambulance in Vulcan already that was headed back to Calgary empty. Porter requested this ambulance do the transfer to Calgary so he could stay in Vulcan in case there was an emergency.

He was told no, but did not let that ambulance leave until the situation was resolved.

Porter also explained he used to be critical of dispatchers, until he spent some time with them.  “Dispatchers are very frustrated because they see the whole picture,” he said. “There’s days they’re in tears.”

Another problem is that once a rural ambulance is in the city, it gets caught doing transfers instead of returning home where there is no coverage.

Coun. Earl Hemmaway brought his own unique perspective.  “I commend you for coming forward and talking,” he said, adding he has never agreed with the gag order put on AHS staff. “I think it’s wrong.”

Moreover, Hemmaway sits on the board of the local transportation society who does transfers, and would do more in a second.

“This system is wrong, it’s all broken,” he said. “I don’t know why it’s taking so long to fix it.”

Hemmaway cited the example of his son who was run over. If the fire department had not responded, he would have had to wait for an ambulance to come from Pincher Creek.  He concluded by asking about the use of alternate transportation.

Porter replied there was a company called Genesis that handled transfers and was well regarded, but AHS scuttled that contract when they took over.  Another experience he shared was being called from Nanton to Black Diamond to do a transfer, from a facility next door to the hospital to the hospital.  He again reiterated, if transfers were taken care of properly, there would be no problem handling emergencies.

“Where do we go from here?” asked Coun. Ian Sundquist. “Who do we beat on the head?”

“I don’t know if I have an answer,” Porter responded, adding he has been riding his white horse and getting saddle sores.

“I’m not going away until it gets fixed,” he said.

Vizzutti suggested Porter attend the Foothills-Little Bow Association meeting, which is a group of municipal districts and counties from across Southern Alberta, as well as the Southern Alberta mayors and reeves meeting.  “Absolutely, I’ll show up,” Porter said.

He concluded by pointing out he has been upfront with AHS with his concerns since day one of AHS’ involvement.

“There’s an awful lot of ambulance (workers) who are frustrated and afraid,” he said.

Note:  Although this article is based upon concerns raised to the council for the MD of Willow Creek, similar concerns have been raised off the record here in Pincher Creek.  However, due to the sensitivity of the issue and the perceived risks of talking about it, many are unwilling to go on the record to discuss these issues.  We invite anyone who wishes to comment about the issue to contact us here at the Pincher Creek Voice via email to or by phone at 403-904-2666.
Thank you to the Claresholm Local Press for allowing us to reprint this article.

Related links:
Letter to the Editor by Jim Nicol
PCES Chief Dave Cox comments on ambulance service issues
AHS responds to ambulance concerns


  1. Anonymous23/8/13

    Thankfully Pincher Creeks EMS is local, and we have a contract to ALWAYS have an ambulance in our community. Also, our fire department often can cover a third ambulance if the first two are out!

  2. Joey McLeod23/8/13

    Thanks to the truly dedicated members of PCES/Fire Department and the councils of the M.D. and Town of Pincher Creek, our community continues (and is one of the few remaining) fighting the utter nonsense that is AHS.

    I have sat in my home on more than one occasion, listening to our ambulances be dispatched to Claresholm, the Crowsnest Pass, and Fort MacLeod on emergency level calls. Never has it been such a luxury to have the level of service that we still possess. Much of our residents are not even aware of these issues in our province because of the little change that has occurred in this town. Do not take it for granted.

    I can sleep soundly at night, knowing that in our community, when my friends, family, or I call for help, there is a dedicated bunch that are always minutes away.

  3. Anonymous25/8/13

    There is a gag order inplace. This problem of unnecessary transfer is provincial wide. It is because we live in a highly litigious society, and Physicians are trying to protect themselves, so they send out people with =cut hands= or =needing shoes repaired= out on long distance ambulance transfers. The problem starts there and then get amplified by poor distribution of resources... aka a transfer fleet. Privatize the transfer fleet, and make the ambulance service provincial.

  4. Concerned Citizen and EMS Practitioner26/8/13

    Below is a link to an article which deals with Fire Based EMS.
    Fire Based EMS is the right choice for some of our communities in Alberta.
    Some way, some how our government needs to realize and understand the value of this type of service, and let communities decide the type and level of service they would like to provide to their citizens.
    There is not a single model service that fits all communities. Alberta is in the process of going from the Best EMS system in North America to the worst in a very short period.
    Thanks for your time.

  5. Anonymous26/8/13

    Back in the late 90s early 2000, I sat on an ambulance operators group through the then Chinook Health Region, there were 18 services represented on the commitee. We shared resources, equipment, training, even going so far as to pool funds to insure that everyone received the funding no matter what size their service was. we all worked together for the welfare of the patients and ultimately our communities. There always seemed to be enough ambulances to take care of the calls, and the cost of operations was no where close to what it is now. Then in it's infinite wisdom the province took over and we have the disaster we're in now. I've been in this business since the early 80s and there has always been some provinically sponsored push to fix EMS,maybe they should have checked to see if it was broken first.

  6. Anonymous29/8/13

    I see AHS has responded to George's presentation using AHS speak. When AHS reports response times they are referring to the time it takes for an ambulance crew to get in their unit and start driving. Is does not count for the time it takes for the ambulance to drive from Fort MacLeod to Charesolm or from Back Diamond to Nanton. It does not cover the times when the ambulance in Claresholm is not in service because there is no staff to run it. Smoke and mirrors as usual.

  7. Anonymous30/8/13

    As with many things there appears to be a bias. Pincher Creek has been very fortunate, thanks to some dedicated volunteers, to actuallu have a third ambulance, not mechanical backup that can and ofton does respond to emegencies in the town and MD. Prior to AHS EMS taking over ambulance services in neighboring communities our service was not asked to respond to communities that had an ambulance.
    since AHS took over the Pincher Creek ambulances have been called to several communities several times for emergencies in these areas. As George has said perhaps there will be a high profile case and a law suit will follow. I have told my family to be extra diligant when travelling rural Alberta as there may not be an ambulance available when they need one in a timely fashion.

  8. Anonymous31/8/13

    Sadly most people are not concerned with the state of EMS in the province as is doesn't impact them until they use it. The profesionals working within the system have been placed under a gag order so their comments can be made public, I appalude Georges courage for stepping up and making his information known. Unfortunaley when this started AHS had their stories in place and they snowed everyone, just as they did with the hospitals, E.R.s etc. Once they set their minds on something nothing, including common sense, will sway their progress. Sadly I feel this is too little too late. Been invloved with the process since Day 1 and it was made abundently clear that nothing was going to stop the process.


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