Ambulance New Brunswick to operate all ambulance services (07/06/12)
June 12, 2007
FREDERICTON (CNB) - All ambulance services - land, air and dispatch - will be consolidated within the next six months under a new public sector company, Ambulance New Brunswick, Health Minister Michael Murphy announced today.
"Having these services under a single public sector company will enhance ambulance services for all New Brunswickers through consistent training of paramedics, standardized emergency response times, round-the-clock ambulance coverage and uniform consistency of care," Murphy said. "This fulfils a commitment made in the Charter for Change to develop a single provincial ambulance system."
Land ambulance service in New Brunswick is now delivered through more than 50 separate contracts with over three dozen different contractors, including for-profit operators, regional health authorities, municipalities, non-profit organizations and First Nations. Air ambulance service is also contracted to a private sector company.
The ambulance system has three call-taking and dispatch centres and several dozen medical directors working for the various ambulance services who have their own individual protocols covering patient care.
The goal is to have all these operations under Ambulance New Brunswick by mid-November.
Murphy said all paramedics and emergency medical technicians currently employed in the province will be offered employment with Ambulance New Brunswick as public sector employees. They will be represented by CUPE Local 1252, which is the bargaining agent for paramedics now working in the public sector with the regional health authorities.
"In fact, we need to add another 200 paramedics over the next three years in order to achieve the major enhancements in pre-hospital care that we want from the new provincial ambulance service," the minister said.
The main enhancements include:
Currently, there is a mix of certification and skill levels among New Brunswick's paramedics and ambulance staff. The majority are trained as Emergency Medical Technicians while some are Primary Care Paramedics. Most have training in Advanced Life Skills.
In keeping with national standards, Murphy said Primary Care Paramedic (PCP) will become the basic entry level for all new paramedics working in New Brunswick. PCPs are trained to perform interventions to treat cardiac and respiratory emergencies, as well as other conditions and injuries. Current paramedics working in the system who do not have PCP training will have the opportunity to train to this level.
Murphy said government also intends to introduce Advanced Care Paramedics.
"Paramedics trained to this level are considerably more advanced in terms of the types of procedures and medications they can provide," he said.
New Brunswick currently has no standard response times.
The minister said Ambulance New Brunswick will establish standardized response times for emergency calls of within nine minutes, 90 per cent of the time, for urban areas and within 22 minutes, 90 per cent of the time, for rural areas.
"A paramedic is often the first caregiver many patients will see so lives can depend on how fast they can get to you along with their skills and training," Murphy said. "Achieving our standardized response times will require more resources -- more paramedics and more ambulances -- as well as a carefully designed, well-implemented and flexible deployment plan."
At present, on-call service, in which ambulance personal are called into work to respond to a call, is used by a number of ambulance services throughout the province.
The minister said Ambulance New Brunswick will move towards round-the-clock ambulance coverage, which means eliminating on-call coverage.
"This will be done over a period of several years as more paramedics are recruited or trained and brought into the provincial ambulance system," he said.
Currently, there are 35 medical directors working with the various ambulance services who establish their own protocols for patient care.
"Standardized consistency of care will be achieved through uniform medical direction provided by our new provincial Medical Director for ambulance services," Murphy said. "We will also have doctors available on a real-time basis to assist paramedics in the field and trained paramedics at our medical and communications centre to provide advice to New Brunswickers who call for an ambulance in an emergency."
Recruitment and retention of paramedics has been a challenge for a number of years, especially for the private sector operators.
Murphy said the new system needs 200 more paramedics - an increase of about 25 per cent - over the next three years.
"To reach this goal, we have worked with the Atlantic Paramedic Academy to expand training programs to accommodate more students," he said. "We are also developing a recruitment and retention program for paramedics, and I would tell New Brunswickers considering a career as a paramedic, that now is the time to act."
As public sector employees, paramedics employed by Ambulance New Brunswick will have wages and other benefits paid according to the contract that covers paramedics now employed in the public sector by regional health authorities.
"For most, if not all, private sector paramedics, this will mean higher wages and this will help us recruit new paramedics and retain the ones we have now," Murphy said.
While Ambulance New Brunswick is a public company and its paramedics will be public sector employees, Murphy said a private company, New Brunswick Emergency Medical Services Inc. (NB EMS), has been hired to manage day-to-day operations.
A 10-year performance-based contact has been negotiated between Ambulance New Brunswick and NB EMS, which is a subsidiary of Medavie Blue Cross. The company will be paid an annual management fee and any savings it realizes through efficiencies will be shared equally between Ambulance New Brunswick and NB EMS.
If the day-to-day operator does not meet performance targets, such as the standardized response times, it can be penalized financially.
Murphy said Medavie Blue Cross has gained invaluable experience operating the provincial ambulance system in Nova Scotia since 1997.
"This experience will help us achieve the major enhancements we want and expect from Ambulance New Brunswick," he said.
NB EMS has been mandated to immediately begin talks with current for-profit ambulance service operators to acquire assets needed for the new provincial service.
"Under the contract with operators, there is a six-month period for these negotiations to take place, after which Ambulance New Brunswick will become the sole operator and employer of ambulance paramedics working in our province," he said.
Murphy said the goals set for Ambulance New Brunswick cannot be done overnight or without cost.
"That's why our government has budgeted $77.6 million this year for ambulance services -- an increase of $13.7 million in one year -- to hire and train staff, to buy new equipment and to acquire assets from current private sector operators," he said. "Clearly, this shows we are committed to providing New Brunswickers with a truly world-class ambulance system, delivering pre-hospital care that is second to none."
MEDIA CONTACT: Johanne LeBlanc, communications, Health, 506-457-3513.