N.S. government has twice warned ambulance provider about poor service, says health minister

The Nova Scotia government has issued two warnings in recent months to Emergency Medical Care, the company that has provided ambulance service to the province for almost 25 years, that it's dissatisfied with the level of service it is providing.

Health Minister Michelle Thompson told reporters about the formal warnings on Friday following question period at Province House, where she was asked about a two-hour wait for ambulances after a serious accident on a highway near Annapolis Royal. A driver and three children were seriously hurt in that crash, on Feb. 15. 

"There have been two letters of warning issued to [Emergency Medical Care] in the last number of months," Thompson said.

She described the relationship between her department and EMC as a partnership, but maintained her department would not shy away from its responsibility as a "regulator," including fining the company, if need be. It's a threat that's been levied before but, to date, the department has not fined EMC. In fact, the company has never been fined for failing to meet its contractual obligations. 

Still need to hire more staff

Jeff Fraser, the person in charge of Emergency Health Services at the Department of Health, later told reporters the warnings came last August and October. He said the first one was resolved but the most recent one, related to an inadequate supply of available ambulances, remained a work in progress.

Fraser said the problem is a lack of staff, a problem not unique to Nova Scotia.

"The government has helped out here by providing a fair package for paramedics, that EMC and the union negotiated, and we really need to dig in and lean in on what's happening around recruitment and retention," said Fraser. "That is clearly EMC's responsibility to staff the system."

Over the past several years the province has spent tens of millions of dollars, upgrading the ambulance fleet, beefing up air ambulance services and taking most hospital transfers away from paramedics. There has also been an increased number of training spots for paramedics.

Despite the significant influx of money and addition of resources, Fraser told reporters he hadn't expected to see major improvements by now.

"It's like turning an aircraft carrier with a paddle," said Fraser. "One piece at a time."

He called the recent contract settlement between paramedics and  EMC "absolutely key" to retaining and attracting new employees.

"We've planted the seeds, we just need some time now to let things grow a little bit."

Nova Scotia's opposition party leaders were less patient, calling on the province to get tough with EMC.

"I don't think they're being taken to task," said NDP Leader Claudia Chender, who laid blame on the Houston government. "They've spent lots of money on the health-care system but all of those ambulances are still lined up outside of the emergency rooms, people are still waiting for ambulances to arrive.

"We're not seeing material improvement in any of that."

Confidence being eroded

Liberal Leader Zach Churchill said the ongoing problems with the ambulance service have eroded the confidence Nova Scotians had in the service.

"The public, I don't think, has confidence right now, nor can they," he said. 

But the health minister tried to sound reassuring, urging people who needed medical attention to continue to seek help. Thompson said that care would start well before an ambulance arrived.

"I just want to assure Nova Scotians when they call 911 your support starts immediately when the dispatchers answer the phone."

For his part, Houston told reporters that the public has a right to expect care to be there when they need it and he believes things are beginning to improve.

"There's work to do for sure, but I can tell you this: my [email] inbox on sad health-care stories when we first came to government was exponentially larger than what it is now," he said.

Houston encouraged first responders who have concerns about the system to come forward and share them.

"We encourage them to speak up and show where improvements can be made. I'm grateful that they do that."