Rural Emergency Medical services (EMS) hit the news on October 25 when the Health Sciences Association of Saskatchewan (HSAS) held a press conference to raise issues with adequate ambulance services.
The union that represents EMS employees in the province, HSAS, is currently in negotions with Saskatchewan Association of Health Organizations. The contract expires in March of 2009.
Bill Fischer, HSAS Chair of the Negotiating Committee said, “In Rural Saskatchewan, the staffing situation has reached crisis proportions for many ambulance services and there are obvious reasons why. Ambulance crews in most rural communitieis work six days straight, where they ar on-call for all 24 hours of each day at a rate of $4.12 per hour or less than half of the Saskatchewan Minimum Wage.”
Angela Gent is a Primary Care Paramedic with the Coronach Ambulance service. According to Gent, the Coronach service employs five people - two ICPs (Intensive Care Paramedics) herself, an EMT (emergency medical technician) and an EMR (emergency medical responder). Gent believes the service is short one or two ICPs or PCPs which are able to provide the type of care needed for patients who are at least one hour from a hospital.
“In our town and a lot of small towns that we know of there is no doctor so the ambulance is the only pre-hospital care that patients get before they get to the bigger centres.” said Gent.
Gent said, “The basic problem with our rural EMS is recruitment and the reason we can’t recruit people is because there really isn’t alot of incentives. We can’t leave town. . . it’s a big commitment for people with kids, ‘cause they don’t want to be tied down. It’s hard to be tied down for $4.12!”
Gent also believes the absence of any kind of health benefits or retirement package is a big deterent for recruitment.
“Recruitment and retention of more highly skilled staff is directly related to the ability of the service to offer full-time employment,” Fischer said at the press conference.
Fischer explained, “They receive the normal Health Sciences contract rate only for those hours they are on an emergency calls. Because they are listed as on-call for most of their work time, many of the full-time ambulance crews do not receive enough work hours in a year to qualify as full-time employees. Therefore they do not receive basic benefits such as health benefits or pension. Is it any wonder rural Saskatchewan communities are finding it more and more difficult to recruit or retain ambulance crews?”
Gent estimated an average of 10 emergency calls a month, but over the past three months there have few calls.
Gent believes it is imperative to have a dependable, qualified, properly compensated ambulance staff. The local service would like to see paid training available for those interested in upgrading their designation or in joining the service.
According to Gent, Coronach is one of few places in the province that does not employ full time staff and that would be the best situation. At the very least, Gent would like to see the on-call pay increase, “To see an increase in the on-call pay so that more people would be interested in being a part of our service.” she said.
At the news conference, Fischer also pointed to the outcome of a 2009 provincial review of Saskatchewan’s road ambulance services which found that about 15 per cent of rural and remote calls had wait times in excess of 30 minutes.
Gent also raised her concerns over the occasional situation when, due to lack of staff, the Coronach service has to have the Assiniboia ambulance service cover. “The wait time for a patient that calls 911 is one hour.” said Gent.
In a article in Regina’s Leader Post, Susan Antosh, president and chief executive of the Saskatchewan Association of Health Organizations (SAHO), the body that bargains on behalf of the health regions, said the union has some 200 proposals on the table that need to be reviewed.
“If we agree to some of those other things, the total cost of the collective agreement is one of the things that the employer needs to look at, so a financial offer comes as a total package, not when you’re dealing with individual proposals,” Antosh said, adding some of the specific recruitment and retention issues around EMS workers have yet to be detailed to SAHO.
Issues such as on-call pay are negotiated and would need to be brought forward by the union, she said.
“We’d want to do some comparisons to see how do we compare to other jurisdictions and things like that,” she said.
Staff of the Coronach Ambulance Service feels that their service is at risk and that this contract is critical. “Without a doctor for two years, and with no doctor in sight, we believe now is the time for our province and our communities to invest in our ambulance service. I believe that whether you live in Coronach or Regina, you have the right to the same medical care. I encourage our residents to call their MLA and demand training and fair compensation for our ambulance service.” concluded Gent.