Public Pressure needed on ambulance coverage issue
Earlier this month, I attended a community meeting about ambulance coverage in the Bow Valley.
It was held by those concerned with how Alberta Health Services (AHS) dispatches ambulances in rural communities like ours. The people speaking out on this issue are doing so despite the risk to their employment – and I commend them for their courage.
To summarize the problem, sometimes all of our local ambulances are being sent to Calgary to support that city's emergency service response and leaving our communities without coverage.
This is putting lives at risk and increasing the pressure upon our emergency medical staff at local hospitals. This issue has been a longtime in the making, after AHS took over ambulance services from municipalities in 2010.
Prior to that, it was the policy of the Town of Canmore to always keep one ambulance in our community. This is not a new issue; it has been percolating for a decade. Increased call volumes throughout the entire region have pushed the problem to a crisis point.
Council has been lobbying the province to address this issue. According to those who presented at the meeting earlier this month, so have emergency room doctors and paramedics throughout the region.
Since 2010, council has also approved an advanced life support capable service level for Canmore Fire Rescue. When there is no ambulance, or when an incident is deemed critical, our municipal fire department is dispatched automatically.
Typically in Alberta, fire departments provide a basic life support response. The difference between ALS and BLS is that within the advanced category there are more interventions available to provide to a patient to save their life. This requires additional training, supplies and a medical director – all considered as part of the annual budget.
I covered this issue over the years and the decision by Canmore council to support this ALS-capable service delivery model has been a political one done in an effort to fill the gap of how AHS dispatches ambulances out of our community on a regular basis.
Canmore heading towards stand alone fire department – May 2011
Fire department keeps advanced life support capability for a year – April 2012
Canmore fire to continue with ALS capable operations – June 2013
Canmore Fire Rescue advanced response sparse – December 2014
Canmore Fire-Rescue to maintain advanced life support – June 2015
At first, this ALS capable response was dispatched a few times a year. From 2012-15, an ALS crew was sent out six times. In 2017, an ALS crew was dispatched six times and by 2020, that number increased to 13.
A better understanding overall of how often our municipal first responders are being called to respond to medical assist requests for AHS is interesting from a cost recovery perspective. Unlike when our firefighters respond to highway incidents, or fires in other communities, and we bill Alberta Transportation or the MD of Bighorn, for example, we are not compensated as a municipality by AHS for this service.
Canmore Fire-Rescue call volumes from 2014-20 from the March 2020 Committee of the Whole report.
Canmore Fire-Rescue responded to 662 calls in 2020, a 30 per cent increase in six years.
While this chart does not tell us how many times Canmore Fire-Rescue responded when there was no ambulance available, it does give a better understanding of how often the ALS response has been used over time.
Compounding the issue of ambulance availability is the lack of diagnostic imaging resources in the valley. When a patient requires a test available only in the city at that time, it requires use of these crews for transfers.
Canmore Hospital has a catscan, but it is not staffed on evenings or weekends. Given the outdoor recreational pursuits in the region, it makes sense to spend the money on the staffing this machine at the hospital, rather than constantly sending our ambulances to the city.
Once our EMS crews are in the city, they can be dispatched to other calls there. Even when they are in Canmore, they have been sent to the city or elsewhere in the region to respond to emergencies.
The lack of ambulance coverage is affecting our emergency room doctors, first responders and the people who call 911 for help and expect there to be a nearby ambulance to respond.
What can council do? It can keep lobbying for change. We can all keep lobbying for change. The pressure is already working. MLA Miranda Rosin is involved and having conversations about the catscan issue.
It was suggested that the next council could create and approve a policy that would require an ambulance to stay in our community at all times. Unfortunately, this would not be within the power of our locally elected officials.
What we can do, however, is contribute towards informing the community about this issue by tracking the data around when there are no ambulance in Canmore, or the Bow Valley. There is regular reporting of statistics from Canmore Fire-Rescue to council in the Committee of the Whole report each month and would be publicly available.
And the more voices that call upon the system to address this issue, the better. If elected, I would be a voice on council that speaks for AHS to take action to address this issue. I would also continue to support the ALS capable service we provide to residents and the millions of visitors to this valley.
A citizen action group is being formed to help advocate on this issue as well. I look forward to working with the community and speaking up for public safety issues like this.