Head of union for Winnipeg's paramedics challenges city, province to rethink emergency response

Paramedic Ryan Woiden wants the city and provincial governments to take a big step back and re-imagine emergency services in Winnipeg.

"We need to have someone to take a look at this and get the right kind of system," said Woiden, the president of Manitoba Government and General Employees' Union Local 911, which represents approximately 350 ambulance paramedics in Winnipeg.

The spotlight on ambulance paramedic service in Winnipeg is bright these days. For more than four years, the city and the Manitoba government have been without a contract to fund the service.

Winnipeg operates ambulances in the city on the province's behalf. But the contract between the two levels of government expired in 2016. It was extended in 2017, and the city offered a draft proposal to the Progressive Conservative government in 2019.

Last year, the province paid the city $31.4 million to run ambulance services.

The latest financial outlook from the City of Winnipeg estimates that's a funding shortfall of $2.2 million from the province's Shared Health department. A portion of that shortfall is due to a cut to a provincial subsidy for ambulance trips by Indigenous and Inuit patients.

Meanwhile, ambulance paramedics are logging massive overtime, and the city hasn't purchased a new ambulance since 2011.

This week, Winnipeg Fire Paramedic Service Chief John Lane said he was at the "begging" stage in his pleas for the province to provide 10 new ambulances and 120 crew to staff the units.

The United Fire Fighters of Winnipeg weighed in on the issue this week as well.

Though that union doesn't represent ambulance paramedics, the UFFW said it supports having Shared Health, a provincial organization, take control of the service.

"We want to make sure that the citizens of Winnipeg get the best possible service at the most appropriate time, and we believe that a transfer may be that solution," UFFW treasurer Derek Balcaen said Tuesday.

"We've also heard from every labour group that's involved here, and everyone seems to be on the same page, being in favour of this move."

But Woiden said he isn't on the same page as the UFFW and he hasn't spoken to the firefighters union about it.

He doesn't think it necessarily matters who controls ambulance service, as long as someone takes a long, hard look at how it's run.

"We believe we can be under Shared Health or we can be under the City of Winnipeg, but the leadership has to commit to doing things differently, [in a way] that is cost-effective and better for the patient," he told CBC News on Wednesday.

That could mean an ambulance service that is run out of one or two "super stations" in Winnipeg, with control centralized but separate from fire operations, Woiden said.

A model could be Ottawa's paramedic services branch, which is independent and separate from other emergency departments, he said.

Montreal and Quebec City run paramedic services out of large super stations as well, he said.

Woiden also said he's not entirely sure Chief Lane's request for 10 new ambulances and crews is the only solution.

A revamp of ambulance service might include using several sport utility vehicles, staffed by paramedics whose goal is to keep as many patients as possible at home instead of being transported to hospital, Woiden said.

A community paramedic program with two units is already operating in Winnipeg and should be expanded significantly, he added.

"It's not sexy … but it's health care that works."

Some stations 'toxic'

Woiden says the new ambulances and crews Lane wants could help cut back overwork, stress and burnout for his members, but there are concerns around where they might be located.

"That solution probably ends up with us being deployed at fire stations, perhaps, and there are toxic workplaces within those fire stations that we don't need to continue," he said.

There are ongoing complaints of racism and sexism at some fire halls, Woiden said, which the city has not addressed. The city has only recently committed to install washrooms for female workers at fire stations, he said.

The fire-paramedic service's chief responded to concerns about a toxic environment at fire stations by acknowledging there have been recent complaints and that in any large workforce, "interpersonal conflicts will inevitably arise."

"On Sept. 18, I again sent out communication to all staff with my expectations on employee conduct as unacceptable reports have come in," Chief John Lane wrote in a statement. 

"We are actively managing the situation and this remains a high priority human resource matter."

Lane says washrooms designated for female employees are in place in all stations. As well, where possible, all-gender washrooms are also available.

He defended the service model used by the WFPS, saying "stationing ambulances and fire units together is the most efficient use of infrastructure" for all types of responses, and comes at a lower cost than comparative cities.

Regardless of the issues around ambulance service, Woiden pledged paramedics will get to all the calls that are life and death matters, "no matter how busy we are."

It's a matter, he says, of how effectively the governments want to deliver services, and that needs to be discussed thoroughly before decisions are made.

In a written statement, a spokesperson for Mayor Brian Bowman said "the mayor is certainly open to hearing Mr. Woiden out."

But Bowman "believes this should occur with [Health] Minister [Cameron] Friesen, since the future of ambulance service delivery is in the jurisdiction of the provincial government," the mayor's spokesperson said.

In a statement Tuesday, a spokesperson said Manitoba Shared Health "continues to work closely with government and our service partners to improve emergency medical care in Winnipeg and across Manitoba."