Quebec is still the only province without a helicopter ambulance system. What's the holdup?
Almost a year after Quebec announced funding, details about when service will start still vague
UPDATE: On March 1, 2024, the McGill University Health Centre announced it had been chosen by the Health Ministry to be one of four sites in Quebec to have a helipad built as part of the government's action plan for Quebec's pre-hospital emergency system.
The lawyer for the family of a seven-month-old baby who might have survived if it hadn't taken so long to get her to hospital hopes the province won't postpone the introduction of an emergency air ambulance service any longer.
Last March, the CAQ set aside $125 million for a helicopter medical transportation service to provide emergency transport to critically ill or injured patients living between 75 and 275 kilometres from major hospital centres, easing the burden on ground ambulance services.
But nearly a year later, details about when it will start or where it will operate are still unclear.
"There have been a number of deaths and tragic situations over the years where the existence of such a service would have probably prevented or at least increased the chances of a better outcome for these patients," said Patrick Martin-Ménard, who represents Niteïyah Chilton's family.
Niteïyah was from Manawan, an Atikamekw community located about 250 kilometres north of Montreal. She died in April 2022 from bacterial meningitis.
In the report looking into her death, Coroner Géhane Kamel said the delay for a ground ambulance and long travel times before Niteïyah arrived at a major hospital likely contributed to the infant's death. More than eight hours passed between the initial call for an ambulance and the baby's arrival at Sainte-Justine Hospital in Montreal.
To avoid more deaths, Kamel urged the province to introduce an emergency helicopter transport program as soon as possible, echoing a recommendation made by other coroners in the past.
While airplane transport is available in some communities, helicopters would be "more versatile" for patients in remote areas, she said.
Quebec is the only province in Canada that does not have an organized, pre-hospital emergency air ambulance system.
In Chilton's case, it could have improved how quickly she received specialized care.
"It's an illustration I think of the fundamental injustice we see in a lot of these remote communities where there does not seem to be any significant political will to put in place proper services to ensure that the access to emergency first line care is afforded to people who live in these communities in a timely manner," said Martin-Ménard.
Jolianne Ottawa worries more people may die before the province acts.
It took two decades of lobbying for Manawan to get its own ambulance service, said Ottawa, the community's director of health services at the Masko-Siwin health centre.
It's also asked for a new road into the community for years, as the main logging road is bumpy and dangerous, making ambulance transport difficult and uncomfortable.
"I hope we don't have to fight for 20 years to get a helicopter (service)," said Ottawa.
Parti Québécois health critic Joël Arseneau finds the province's lack of action troubling.
"At least make a move and give yourself a plan," said Arseneau, who was at the PQ's caucus meeting in Alma, Que.
"Maybe you don't have to implement that measure everywhere in Quebec at once, but at least make a step and move forward."
Pilot project scrapped in 2018
This is not the first time the province has tried to launch a helicopter ambulance program.
A $3-million pilot project was announced by the former Liberals back in 2018.
The government planned on using Montreal's Sacré-Coeur Hospital, which is a Level 1 trauma centre and has a helipad, to receive patients from six hospitals in the Laurentians, Lanaudière and central Québec-Mauricie region.
But a few months later, the Liberals lost the election to the Coalition Avenir Québec (CAQ) and the program didn't proceed.
"We were a signature away," said Jean-Patrick Laflamme, director of communications, public and government relations for Airmedic, the private helicopter air ambulance company the province partnered with back in 2018.
Since then, several studies have looked into the viability of a helicopter medical transport program in Quebec, including a 2022 report by Quebec's health research institute, INESSS.
For patients with time-sensitive medical conditions, the study estimated how many people could potentially benefit from inter-hospital transfers in communities located 75 to 275 kilometres away from major hospitals in Montreal and Quebec City.
The study found hundreds of heart attack, stroke and trauma victims could be helped by an air ambulance system that could quickly transport them to a specialized hospital.
2022 election promise
During the CAQ's re-election campaign in the fall of 2022, Premier François Legault promised to set up a helicopter medical transport service that would serve several regions including Mauricie, Saguenay-Lac-Saint-Jean, Lanaudière, the Laurentians and Outaouais.
He pledged to build helipads in these regions.
"When we have people with traumas, heart attacks, strokes, burn victims, we have to act quickly," said Legault, who made the announcement in Roberval, Que.
A quicker response time can sometimes make a major difference in the long-term health of these people, he said.
Last summer, a private aviation consulting company — GroundEffect Aerodrome Consulting Ltd. — completed a report for the province that looked at the feasibility of helipads at hospitals in Montreal, Quebec City, Rimouski, Trois Rivieres and Sherbrooke.
The study, which was shared with CBC Montreal, examined everything from the necessary certification to the complexity, design and potential cost of building a heliport or redeveloping an existing one.
At the end of December, the Health Ministry posted a job that would oversee the helicopter air transport program. The posting closes next Monday.
After years of publicly pleading for a program of this kind, Dr. David Mulder is encouraged to see there is progress.
"I think it would be phenomenal," said Mulder, a renowned trauma specialist and former head physician for the Montreal Canadiens hockey team.
"I think this will be a tremendous benefit to the health-care system in terms of trauma, obstetrics, pediatrics, all sorts of high level tertiary care," said Mulder.
Although the process has taken time, Airmedic's Laflamme said what the province has envisioned this time around is much broader than what the Liberals proposed in 2018.
"It's a very complex issue," said Laflamme. "The regulations to build infrastructure such as helipads close to hospitals is very difficult and you have to go through a federal process."
Once the province hires someone to oversee the program, the next step will likely involve finding a company to operate it. If there's a call for tenders or a notice of intention, Airmedic says it plans to make a bid for the contract.
Laflamme believes the company has the infrastructure, expertise and personnel to hit the ground running.
"We are ready to step in," said Laflamme.
When CBC asked the government for more details about what may or may not be included in the project, the province would not comment, "so as to not interfere with the smooth progress of the work," said Marie-Claude Lacasse, a spokesperson for the Quebec Health Ministry.
She would only say a future emergency evacuation service would be phased in between hospitals in more remote areas and hospitals in Montreal and Quebec City.
It would complement Quebec's aeromedical evacuation program (EVAQ), which uses planes to transport patients located more than 275 kilometres away.
The heli-medical transport program is expected to provide between 800 and 1,500 interventions per year.
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