Private ambulances understaffed, paramedics on standby 80 hours a week: operators
Association says paramedics are paid for about half the time they're on call
Private ambulance operators don't get enough wage funding from the provincial government to staff their ambulances 24/7, despite being contractually obligated to do so, says the head of an organization that represents operators.
To make it work, medics assigned to primary ambulances work flexible shifts that require them to be on standby for roughly 80 hours a week, every week, according the Newfoundland and Labrador Association of Private Ambulance Operators.
Staff are paid for 40 hours of the about 80 hours they're on call, said Wade Smith, president of the association.
When on standby, medics can't be more than 10 minutes away from wherever the ambulance is parked.
Standby is able to happen because of that standard known in the industry as chute time.
"In order to [change] that, and to keep staff levels up, you're probably going to get into funding and to pay people a little bit better," said Smith.
He estimates that private ambulances are understaffed "90 per cent of the time," which he attributes to an extra, expensive and rarely offered exam paramedics have to write in order to work in the province.
According to Smith, there's a double standard in the funding for private ambulances and those run by regional health authorities.
The Department of Health budgets for upwards of 10 full-time medics when a health authority ambulance is operated on a 24/hour basis, Smith said.
According to the contract with private operators, private primary ambulances receive funding for four, full-time staff at 40 hours per week each.
The 80-hour math
With both public and private services, two staff members have to head out on a call at a time.
That means the four medics with a private ambulance have to be divided into two groups of two.
With two medics required to be working on the same shift, funding covers 80 hours of the 168 hours in a week.
Smith said the remaining 88 hours are covered by having each of the two shifts take on half as standby — an extra 44 hours a week on top of the 40 hours each medic is paid for.
He said operators make up their own schedules, but when asked if there was a way around standby Smith said, "no, you wouldn't have your ambulance covered."
How standby works
Unless time spent next to the ambulance is required by the operator, medics can technically wait where they want while they're being paid and while they're on standby so long as they can reach the ambulance within the 10 minute chute time, 90 per cent of the time.
As an example, with his company in Whitbourne, Smith requires medics to be on call for 24 hours on the days they work but he only requires they wait at the ambulance bay from 9:00 a.m. to 5:00 p.m.
A lot of the operators... are working five, seven and nine days straight.- Wade Smith
Staff aren't paid overtime unless they're out on calls for more than eight hours in a day or they're called in to work on a day off Smith said.
"A lot of the operators, especially in areas where the call volumes are low, are working five, seven and nine days straight because the staffing levels are not there and the money is not there to actually promote the service the way it should be," he said.
Paramedics make $21.50 an hour and while the hourly rate isn't specified for emergency medical responders, Smith said it's usually about $15.
Wages come out of the block funding that private ambulance operators receive from the Department of Health to run their service.
For the a region's first primary ambulance, block funding is $235,000 a year, for a second it's $202,000 a year.
Reaction to mistrust
The Department of Health is currently investigating the private ambulance system as a whole.
With the existing way of doing things, there is a potential conflict of interest in that medics themselves write down all their own response times — including how long it takes them to mobilize on a call when they're on standby, away from the ambulance.
Internal documents obtained by the CBC show at least one government official doesn't trust that process.
Wayne Young with the Department of Health's air and road ambulance division wrote to a colleague that he takes the self-reported response time data with a "very large grain of salt."
Smith acknowledges the current pen-and-paper method isn't entirely accurate.
"Is there some variances? Well, my watch might probably be a little bit different than yours so there might be a minute or two but if they're recorded right, there shouldn't be a problem," he said
"And yes, it's suspicious on how it can be done but really this is a legal document and all our staff members know this is a legal document and they do the best they can to fill these out."
Contract up for renewal
Citing the ongoing investigation, the Department of Health said it wouldn't comment on how ambulances are funded, but did say it's looking to implement a central dispatch system.
Instead of electronically tracking chute times, Smith would rather funding be increased so chute times could be shortened or removed.
"Unfortunately, you're dealing with people in there who haven't got a clue about how an ambulance should operate. I mean, you're looking at ambulance operators with 20 and 30 years experience in the ambulance field who know how this system should run," he said.
"Until government starts to listen and really starts to put people first ... it's not going to change."
The private ambulance operators' contract is up for renewal.
Smith says his association hasn't heard anything on negotiations from government since March.
ABOUT THE AUTHOR
With files from Labrador Morning