Essential services

Sarah Rennie – LJI reporter

The government’s recently announced action plan to improve the province’s prehospital emergency system provided a glimmer of hope for Huntingdon paramedics, who are alone in the Montérégie working on-call shift hours.

The province announced it will spend nearly $630 million over the next five years on ambulance services, including at least $1.3 million that will be directed to the Montérégie-Centre region to convert shift schedules or add hours of service. All ambulance services in the Montérégie are directed through the Centre integré de services de santé et de services sociaux de la Montérégie-Centre (CISSSMC), including those based in Huntingdon.

According to the Ministry of Health, these funds will be allocated in addition to funding released in 2022 that allowed for the conversion of 46 shift schedules to set hourly schedules, including those worked by paramedics in Hemmingford. On-call shift work has now been abolished in all areas of the Montérégie except for Huntingdon, where Paraxion provides prehospital services to the town as well as the western territory of the Haut-Saint-Laurent including Godmanchester, Hinchinbrooke, Elgin, Sainte-Barbe, Saint-Anicet, and Dundee.

“Huntingdon is in a particular situation,” says Mathieu Lacombe, a spokesperson for the Syndicat des paramédics et du préhospitalier de la Montérégie (SPPM-CSN). On-call paramedics are on duty 24 hours a day for seven consecutive days at home and must first get to their ambulance before leaving to respond to an emergency, while those working set hours are already at a station or in their ambulance waiting for calls, he explains.

“Right now, we have good service in Huntingdon,” says Lacombe. The closure of the Larocque Bridge linking Saint-Stanislas-de-Kostka with Salaberry-de-Valleyfield in January created a temporary situation in which shift work for Huntingdon paramedics was converted to an hourly schedule. Presently, there are two regular ambulances available during the day as well as one ambulance overnight, he explains. This exception is set to end on April 7, when paramedics will return to shift work.

Lacombe says the situation is unfortunate, both for the paramedics and for the local population. He reports that on February 5, paramedics were called to an emergency in Huntingdon involving a 61-year-old patient. The 9-1-1 call was received at 11:32 a.m. and because paramedics were already in place, they arrived on scene at 11:40 a.m. The team worked quickly, and the patient was resuscitated by 11:43 a.m.

According to Lacombe it was the second ambulance that intervened, as the first was responding to another call. He says there is no doubt the paramedics were able to respond as quickly as they did because they were working regular hours and were not at home when the emergency call was received.

According to The Last Ambulance Project, which tracks the average response times for ambulances for the most critical emergencies, the average wait time for a priority 0 call in Huntingdon is 18.03 minutes, 19.67 minutes in Godmanchester, 22.5 minutes in Hinchinbrooke, 24.12 minutes in Saint-Anicet, and 38.5 minutes in Dundee. Times in Ormstown, where there is a station, average 15.62 minutes, and similarly, those in nearby Haut-Saint-Laurent municipalities served by Ormstown, including Franklin, Havelock, Howick, Saint-Chrysostome, and Très-Saint-Sacrement, are lower averaging 16.7 minutes.

“Shift work can be effective in very rural areas, but the population is growing, and this no longer applies to Huntingdon,” says Lacombe, noting the delays in shift work create added stress on paramedics, who are all too aware of how every second can count when responding to an emergency.

The Huntingdon paramedics are also important to the regional network, which he says is currently overloaded. “Each zone is backed up by another,” he explains, suggesting Huntingdon could be called to Ormstown or Valleyfield, or vice-versa, depending on where there is a need.

He adds that there has been no indication whether the funds announced by the government to convert shift schedules will apply to Huntingdon. The SPPM-CSN has asked for an urgent meeting with Huntingdon MNA Carole Mallette to discuss the situation. The town of Huntingdon and some neighbouring municipalities have also passed resolutions in support of the local paramedics.

“We hope to receive good news,” says Lacombe.

Sarah Rennie – LJI reporter

Quebec Health Minister Christian Dubé followed through on a promise to provide an action plan to improve ambulance services, after pronouncing earlier last month that the current wait times were simply “unacceptable.”

Dubé announced on February 29 that investments totalling nearly $630 million would be provided over five years to improve the province’s prehospital emergency system. The plan includes several concrete actions to address the situation, such as increasing the number of automated external defibrillators accessible to the public and extending first responder services to more areas. There are also up to $5.9 million to improve ambulance services in the Laurentides, Mauricie-Centre-du-Québec, Montérégie-Centre, and Chaudière-Appalaches regions.

In a statement, Dubé noted that in the context of an aging population and growing health needs the government is reviewing its front-line services. The plan aims to modernize pre-hospital emergency services while bringing about a change in culture to optimize the role of paramedics and improve such services in the regions.

For example, a total of $7.65 million over five years will be dedicated to reducing the time spent by paramedics in hospitals. According to the Ministry of Health, paramedics spend on average 100 minutes during a pre-hospital intervention, of which 50 minutes are spent in hospital. The ministry has set a target of 45 minutes by 2026 and says this could recover the equivalent of 50,000 hours of ambulance availability.

The government has also announced the creation of four helipads, which will be located at the Centre hospitalier régional de Lanaudière in Joliette, the Hôpital de Roberval, the McGill University Health Centre, and the Hôpital du Sacré-Coeur in Montreal.

No new ambulances 

Montérégie paramedics, while welcoming the additional funding and resources, are sounding an alarm over the lack of financing in the action plan for any new ambulances.

The territory served by the Coopérative des techniciens ambulanciers de la Montérégie (CETAM), which covers Salaberry-de-Valleyfield, Vaudreuil-Dorion, Chateauguay, and municipalities along the South Shore, is among the most overloaded in the province according to the provincial classification of workloads by ambulance zone. Between April 2022 and April 2023, over 93,000 calls were assigned, and paramedics worked over 4,221 overtime hours, mostly at the end of their shifts. The Syndicat des paramédics et du préhospitalier de la Montérégie (SPPM-CSN) says they have been calling for years for an additional seven vehicles to adequately respond to the growing number of calls.

Instead of seeing their fleet grow, however, the SPPM is currently waiting to learn whether cuts to the number of ambulances will take place this spring within the territory served by the CETAM.

Since 2021, the Centre integré de services de santé et de services sociaux de la Montérégie-Centre (CISSSMC), which coordinates the ambulance services for the entirety of the Montérégie region, has authorized the temporary addition of four ambulances to help cover the territory. The organization evaluates whether to keep the additional vehicles each year at the end of March. Last year, the CISSSMC announced it did not have the finances to maintain the ambulances, though the organization reversed its decision soon after.

“The deadline is fast approaching, and despite this, the CISSS and the ministry are still unable to confirm that the temporary additions to the fleet will be continued,” said Gaétan Dutil, the president of the SPPM-CSN. “Year after year, we’re asked to add vehicles, and year after year, we’re offered temporary and inadequate half-measures,” he added.

“This situation is putting enormous pressure on our paramedics, and does not bode well for services to the population in areas where access to an ambulance within a reasonable time is already difficult,” he added.

“It would be catastrophic if we lost an ambulance,” said Mathieu Lacombe, a spokesperson for the SPPM-CSN. The fact there has been no indication of where the government funds will be invested in the Montérégie is a concern, he added.

“We have no idea,” he said. “It is really uncertain right now – for paramedics, but for the population as well.”