Premier Gary Doer put an end to speculation last evening by calling a provincial election that sees Manitobans go to the polls on Tuesday, May 22nd. I for one am looking forward to the next four weeks.
I suppose a downside to the election call is the fact that two bills in which the Paramedic Association of Manitoba had specific interest will most likely die on the order paper. Bill 22 was intended to establish memorials to honor fire fighters, peace officers and workers killed on the job. Bill 209 attempted to establish guidelines that would permit mandatory blood testing anytime someone lending aid to another person suffered a significant exposure to bodily fluids. But the fact that these bills will not proceed is not all bad. Regardless which party forms the next government, these issues have drawn attention and to a certain extent support on both sides. The opportunity should exist to have both reintroduced...and any necessary changes can be lobbied for ahead of time. That opens the door to a better outcome for paramedics in both areas.
One initiative that did not reach completion prior to the election call was the much anticipated approval for funding to establish a paramedic education program at Red River College. And that does concern me. The EMS network has expected Red River to be ready to begin PCP program delivery in September of this year, but because the provincial government dragged their heels on approval, that date cannot be met. The next window of opportunity for course commencement is January 2008. But unless Treasury Board procedure allows for consideration of matters when the legislature has been dissolved, and I doubt that it does, it may be unlikely that funding for any education initiatives will be dealt with until June at the very earliest. That could have a very negative impact on much needed paramedic resources, particularly in rural Manitoba.
But one benefit that an election campaign does bring with it is the opportunity to bring issues and concerns forward to all candidates, regardless of their status or accessibility in the previous government. Ex-ministers, back-benchers, up and coming MLAs and party leaders will all hit the campaign trail over the course of the next four weeks, and that provides paramedics across the province an excellent chance to ask them for their position on any number of issues. It allows each and every one of us to ask those seeking re-election to defend their actions over the past four years, and to tell us where they stand on issues that we hope to bring forth in the next four.
The Paramedic Association of Manitoba will be preparing statements and questions for all candidates. Funding, service delivery and education will be priorities as we challenge candidates from all parties for their position on matters related to emergency medical services and emergency health care. In a fashion very similar to the one PAM used during the last federal election, we will provide any candidate feedback we receive to our membership.
I encourage everyone involved in emergency medical service in this province to take advantage of the opportunity Premier Doer has given us to ask some very tough questions.
Saturday, April 21, 2007
Thursday, April 19, 2007
Proposed Blood Samples Legislation
On November 30th, of last year Manitoba Conservative MLA Kelvin Goertzen (Steinbach) introduced a private members bill in the provincial legislature entitled "The Mandatory Testing of Bodily Substances Act" (Bill 209). A copy of the proposed legislation can be downloaded here. Simply put, this Act would permit a blood sample to be ordered for testing purposes if a crime victim, good samaritan, or anyone rendering care in an emergency situation came into contact with another persons bodily fluids.
At first glance it appears that Mr. Goertzen's bill is very similar to the first blood samples legislation passed by the Ontario government almost 5 years ago. That Act relied on the province's Medical Officer of Health to determine if a significant exposure to bodily fluids had in fact occurred and order a blood sample to be taken from the patient or source individual. So too does Bill 209. Other provinces (Nova Scotia, Saskatchewan and Alberta) have opted for the courts to make the decision and order blood testing. Both systems are deserving of further investigation.
Since passing their initial blood samples legislation, Ontario has amended it in an effort to speed up the process. Under the old Act, delays of up to 70 days could take place before the sampling was ordered. Under the new legislation that delay has been reduced to approximately 17 days.
Today, representatives from the Paramedic Association of Manitoba were invited to meet with staff from the Departments of Justice and Health to review Mr. Goertzen's bill and hear comparative comments about the other provinces that have similar legislation. It would appear that our provincial government has reconsidered their decision of 2005 not to proceed with blood samples legislation and are now prepared to move in that direction. PAM has been lobbying for this type of legislation for some time now.
On closer inspection we may find that Bill 209 needs some revisions to meet our expectations in terms of ease of process and access. It's also almost certain that this Bill will die on the floor of the legislature if an election is called in the next few days or weeks. But the fact that Mr. Goertzen has generated government interest by introducing this Bill bodes well for the future. If the NDP continue to govern, they most likely will want to take the initiative away from the Conservatives by amending this legislation or introducing their own. If the Conservatives form a government in the next while, it should be quite simple to convince them of the importance to move forward in light of who re-ignited this process just a few months ago. Either way, the future looks promising on this front.
At first glance it appears that Mr. Goertzen's bill is very similar to the first blood samples legislation passed by the Ontario government almost 5 years ago. That Act relied on the province's Medical Officer of Health to determine if a significant exposure to bodily fluids had in fact occurred and order a blood sample to be taken from the patient or source individual. So too does Bill 209. Other provinces (Nova Scotia, Saskatchewan and Alberta) have opted for the courts to make the decision and order blood testing. Both systems are deserving of further investigation.
Since passing their initial blood samples legislation, Ontario has amended it in an effort to speed up the process. Under the old Act, delays of up to 70 days could take place before the sampling was ordered. Under the new legislation that delay has been reduced to approximately 17 days.
Today, representatives from the Paramedic Association of Manitoba were invited to meet with staff from the Departments of Justice and Health to review Mr. Goertzen's bill and hear comparative comments about the other provinces that have similar legislation. It would appear that our provincial government has reconsidered their decision of 2005 not to proceed with blood samples legislation and are now prepared to move in that direction. PAM has been lobbying for this type of legislation for some time now.
On closer inspection we may find that Bill 209 needs some revisions to meet our expectations in terms of ease of process and access. It's also almost certain that this Bill will die on the floor of the legislature if an election is called in the next few days or weeks. But the fact that Mr. Goertzen has generated government interest by introducing this Bill bodes well for the future. If the NDP continue to govern, they most likely will want to take the initiative away from the Conservatives by amending this legislation or introducing their own. If the Conservatives form a government in the next while, it should be quite simple to convince them of the importance to move forward in light of who re-ignited this process just a few months ago. Either way, the future looks promising on this front.
Tuesday, April 17, 2007
Paramedics Disappointed With Memorial Legislation
Proposed legislation paying tribute to fallen fire fighters, peace offices and other "workers" has paramedics across Manitoba incensed. The Manitoba EMS Discussion Board has pages of comments from EMS professionals across the province expressing disappointment and anger over the announcement and the perceived exclusion of paramedics...and rightfully so.
In August of last year, the Honourable Gord Mackintosh, then Minister of Justice, announced plans for a memorial on the legislative grounds to honor "police officers, fire fighters and paramedics" killed in the line of duty. The Paramedic Association of Manitoba wrote to the Minister and suggested a member of the paramedic community be included in the planning committee as they worked toward completion of this project. In December we received a call from the Premier's Chief of Staff, Mr. Michael Balagus, requesting I meet with him to discuss our request.
On December 14th I met with Mr. Balagus and was was given an overview of a very preliminary proposal for the memorial project. At that time, all that was known was that the government planned to dedicate a limited amount of space on the legislative grounds to house the memorials, and that whatever design these tributes took would have to meet strict criteria. He expressed concern that other interest groups might come forward also asking for memorial space, and that they would be unable to accommodate multiple requests. He also assured me that no government funds would be available to build and maintain the memorials...that would be the responsibility of the group or groups involved.
I indicated to Balagus that we would be prepared to be recognized as a component of the emergency services family on a single memorial if both fire and police were so inclined. He indicated that the fire fighters would not even consider such a concept...that they wanted a distinct memorial dedicated only to fire LODDs. Mr. Balagus then suggested we might want to consider partnering with other organizations, such as the Manitoba Federation of Labour or the Winnipeg Labour Congress, to participate in the process.
Although partnering with organizations that predominately represent non-professionals might be seen as some individuals as inappropriate, it seemed fiscally responsible, so I spoke with both the MFL and WLC. I suggested that we would be open to discussing options that would see paramedics killed in the line of duty honored in a group memorial. But I indicated to both parties, and also to the provincial government, that it would need to be done in a fashion that would ensure paramedics were recognized distinctly and as professionals...perhaps a separate plague on a larger memorial. The door was open to further discussions...and the government assured me that we would be involved in further consultation.
Well, unfortunately we were not included in any consultation or discussion with government officials leading up to last week's announcement. Not only were meetings obviously held without inviting our profession, but absolutely no mention of paramedics was made in the government press release or at the press conference. Numerous calls and emails to the Premier's Chief of Staff over the last couple of days have gone unanswered. And the comments made by UFFW President Alex Forrest have only served to fuel the displeasure of paramedics across the province. It's no wonder people are disappointed.
If I were a betting man I'd guess a provincial election call could come as soon as the end of this week. If that's the case, anyone candidate knocking on your door should be encouraged to give you his or her opinion on why paramedics don't deserve the same respect paid to fire fighters and peace officers in Manitoba.
In August of last year, the Honourable Gord Mackintosh, then Minister of Justice, announced plans for a memorial on the legislative grounds to honor "police officers, fire fighters and paramedics" killed in the line of duty. The Paramedic Association of Manitoba wrote to the Minister and suggested a member of the paramedic community be included in the planning committee as they worked toward completion of this project. In December we received a call from the Premier's Chief of Staff, Mr. Michael Balagus, requesting I meet with him to discuss our request.
On December 14th I met with Mr. Balagus and was was given an overview of a very preliminary proposal for the memorial project. At that time, all that was known was that the government planned to dedicate a limited amount of space on the legislative grounds to house the memorials, and that whatever design these tributes took would have to meet strict criteria. He expressed concern that other interest groups might come forward also asking for memorial space, and that they would be unable to accommodate multiple requests. He also assured me that no government funds would be available to build and maintain the memorials...that would be the responsibility of the group or groups involved.
I indicated to Balagus that we would be prepared to be recognized as a component of the emergency services family on a single memorial if both fire and police were so inclined. He indicated that the fire fighters would not even consider such a concept...that they wanted a distinct memorial dedicated only to fire LODDs. Mr. Balagus then suggested we might want to consider partnering with other organizations, such as the Manitoba Federation of Labour or the Winnipeg Labour Congress, to participate in the process.
Although partnering with organizations that predominately represent non-professionals might be seen as some individuals as inappropriate, it seemed fiscally responsible, so I spoke with both the MFL and WLC. I suggested that we would be open to discussing options that would see paramedics killed in the line of duty honored in a group memorial. But I indicated to both parties, and also to the provincial government, that it would need to be done in a fashion that would ensure paramedics were recognized distinctly and as professionals...perhaps a separate plague on a larger memorial. The door was open to further discussions...and the government assured me that we would be involved in further consultation.
Well, unfortunately we were not included in any consultation or discussion with government officials leading up to last week's announcement. Not only were meetings obviously held without inviting our profession, but absolutely no mention of paramedics was made in the government press release or at the press conference. Numerous calls and emails to the Premier's Chief of Staff over the last couple of days have gone unanswered. And the comments made by UFFW President Alex Forrest have only served to fuel the displeasure of paramedics across the province. It's no wonder people are disappointed.
If I were a betting man I'd guess a provincial election call could come as soon as the end of this week. If that's the case, anyone candidate knocking on your door should be encouraged to give you his or her opinion on why paramedics don't deserve the same respect paid to fire fighters and peace officers in Manitoba.
Wednesday, April 04, 2007
Budget 2007 Disappointing...But Not Unexpected
I was unable to attend the budget speech at the Manitoba Legislature today...I had to travel to Ottawa to attend meetings for PAC. Jodi Possia represented PAM in the legislative gallery, and I'm guessing that after the antics that took place before the budget was introduced (what should have been a 90 minute session lasted close to three hours) I should be happy Jodi agreed to attend!
Over the course of the past few years I have come to believe, rightly or wrongly, that what happens on Budget day really has nothing to do with setting government policy or direction for the upcoming year. Sure...there is a budget...and I expect that each government department is told how much money they can spend during the fiscal year. But for the most part, any major initiative outlined in the budget has already been announced in a much more public and politically acceptable venue. For example...before today's budget speech we already knew the government planned to build a new hospital in Selkirk, spend millions of dollars fixing provincial highways, put $3M into training and incentives for emergency physicians, add to medical diagnostic equipment outside of Winnipeg (and so on and so on)...because these initiatives had already all been announced. But still, every year as I sit down to listen to the Finance Minister outline government expenditures, I have that tingle of anticipation that suggests maybe this is the year. Maybe this year there will be an announcement that indicates a strong political will to invoke real change in EMS and health care in general. Wrong again.
I had hoped that funding for development of a PCP education program at Red River College would somehow be slipped into today's budget speech. I expected, at the very least, that there would be mention of the previously announced investment to build a new EMS facility is the St. Paul area, or that the government would continue with it's initiative to replace ambulances across the province on a six year cycle through the Fleet vehicle program. But unfortunately there was absolutely no mention of EMS in today's budget...not even within the context of further health care improvements.
And unfortunately (there's that word again) that's because there are still many within the political ranks, both provincial and municipal, that don't think paramedics belong in the health care arena. Putting more money into Manitoba's emergency medical services system is a divisive and contentious issue, regardless of how logical and necessary it may seem to us. If today's budget precedes a spring election call here in Manitoba, I would encourage you to ask the candidates running in your constituency where they stand on the issue of funding for EMS. There are elected officials out there who see the need for investment in pre-hospital initiatives and recognize the potential benefits associated with such change...they need to stand up and be heard. The others need to be educated.
PAM's reaction to the budget speech can be viewed on our web site.
Over the course of the past few years I have come to believe, rightly or wrongly, that what happens on Budget day really has nothing to do with setting government policy or direction for the upcoming year. Sure...there is a budget...and I expect that each government department is told how much money they can spend during the fiscal year. But for the most part, any major initiative outlined in the budget has already been announced in a much more public and politically acceptable venue. For example...before today's budget speech we already knew the government planned to build a new hospital in Selkirk, spend millions of dollars fixing provincial highways, put $3M into training and incentives for emergency physicians, add to medical diagnostic equipment outside of Winnipeg (and so on and so on)...because these initiatives had already all been announced. But still, every year as I sit down to listen to the Finance Minister outline government expenditures, I have that tingle of anticipation that suggests maybe this is the year. Maybe this year there will be an announcement that indicates a strong political will to invoke real change in EMS and health care in general. Wrong again.
I had hoped that funding for development of a PCP education program at Red River College would somehow be slipped into today's budget speech. I expected, at the very least, that there would be mention of the previously announced investment to build a new EMS facility is the St. Paul area, or that the government would continue with it's initiative to replace ambulances across the province on a six year cycle through the Fleet vehicle program. But unfortunately there was absolutely no mention of EMS in today's budget...not even within the context of further health care improvements.
And unfortunately (there's that word again) that's because there are still many within the political ranks, both provincial and municipal, that don't think paramedics belong in the health care arena. Putting more money into Manitoba's emergency medical services system is a divisive and contentious issue, regardless of how logical and necessary it may seem to us. If today's budget precedes a spring election call here in Manitoba, I would encourage you to ask the candidates running in your constituency where they stand on the issue of funding for EMS. There are elected officials out there who see the need for investment in pre-hospital initiatives and recognize the potential benefits associated with such change...they need to stand up and be heard. The others need to be educated.
PAM's reaction to the budget speech can be viewed on our web site.
Tuesday, April 03, 2007
Still No Money For EMS Education?
In June of 2006 the Memorandum of Understanding between Manitoba Health and the Manitoba Emergency Services College (Brandon) regarding EMS education expired. It was this MOU that outlined the expectations around EMS education programs (EMR and EMT) that were delivered by MESC in regions across the province. In lieu of re-negotiating this agreement with MESC, Manitoba Health began talks with Red River College in an effort to move PCP education into an accredited post secondary health faculty. It was good news for the profession, and government sources were optimistic that Red River would have a PCP course up and running by September, 2007. Unfortunately a delay in securing the necessary funding to develop the program has not only jeopardized that date, but perhaps the entire project.
A month ago the Paramedic Association of Manitoba learned the government funding for the development of the PCP program at Red River has not yet been approved, and that the College was now unable to meet the projected start date of September 2007 (Manitoba EMS Education in Peril). We expressed our concern to Manitoba Health and the provincial government, encouraging them to move swiftly to ensure funding would be available as soon as possible to ensure RRC could meet their next projected program start date of January 2008. I had hoped that we might see funding for the PCP program announced in the upcoming provincial budget (Wednesday, April 4)...but my optimism is waining.
The provincial government has made an unprecedented number of funding announcements over the course of the past two months, all of which I expect will be formalized when the budget comes down. Just last week Health Minister Theresa Oswald announced a $3 million investment in emergency medicine education...none of which is earmarked for EMS. According to Oswald, $1.7M will be used to increase the number of training seats in emergency medicine at the University of Manitoba, and $1.3M will be directed toward incentive programs that encourage current doctors to fill vacant shifts in hospital ERs. In the Minister's words, "This proposal responds directly to their (emergency physicians) concerns (recruitment and retention of ER physicians) and will raise the profile of emergency medicine in Manitoba".
I can certainly appreciate the need to address the shortage of emergency physicians in Manitoba. But what about the need for paramedics in our EMS system? What about the need for an appropriate post secondary education program for paramedics in this province? What about a strategy to address the recruitment and retention of paramedics in our EMS system? These are concerns that we have expressed on many ocassions.
We'll be watching intently as Finance Minister Greg Sellinger unveils his provincial budget on April 4th to see if this government finally has a proposal that responds directly to our concerns.
A month ago the Paramedic Association of Manitoba learned the government funding for the development of the PCP program at Red River has not yet been approved, and that the College was now unable to meet the projected start date of September 2007 (Manitoba EMS Education in Peril). We expressed our concern to Manitoba Health and the provincial government, encouraging them to move swiftly to ensure funding would be available as soon as possible to ensure RRC could meet their next projected program start date of January 2008. I had hoped that we might see funding for the PCP program announced in the upcoming provincial budget (Wednesday, April 4)...but my optimism is waining.
The provincial government has made an unprecedented number of funding announcements over the course of the past two months, all of which I expect will be formalized when the budget comes down. Just last week Health Minister Theresa Oswald announced a $3 million investment in emergency medicine education...none of which is earmarked for EMS. According to Oswald, $1.7M will be used to increase the number of training seats in emergency medicine at the University of Manitoba, and $1.3M will be directed toward incentive programs that encourage current doctors to fill vacant shifts in hospital ERs. In the Minister's words, "This proposal responds directly to their (emergency physicians) concerns (recruitment and retention of ER physicians) and will raise the profile of emergency medicine in Manitoba".
I can certainly appreciate the need to address the shortage of emergency physicians in Manitoba. But what about the need for paramedics in our EMS system? What about the need for an appropriate post secondary education program for paramedics in this province? What about a strategy to address the recruitment and retention of paramedics in our EMS system? These are concerns that we have expressed on many ocassions.
We'll be watching intently as Finance Minister Greg Sellinger unveils his provincial budget on April 4th to see if this government finally has a proposal that responds directly to our concerns.
Monday, April 02, 2007
Politics Mar the Edmonton Memorial Service
Diane Findlay and I traveled to Edmonton last week to attend the line of duty death memorial service for Alberta paramedic Michael Jolin. Jolin, 31 years old, was killed March 11th while at work, and leaves behind his wife and two young children. In his capacity as an EMT with HSE Integrated Ltd, which is a national safety services company, Michael was responsible for medical standby and treatment at an oilfield site near Fox Creek, Alberta.Although particulars surrounding Jolin's death are still under investigation by Alberta Workplace Health and Safety, it has been confirmed that he was killed after being struck by a vehicle working in the area. According to early reports, he had stepped out of his mobile treatment center to assist a driver that that was backing a truck into the area when he was hit. Jolin was in uniform and on duty at the time of the incident.
I don't think it's any secret that the events surrounding Michael's accident called into question whether or not it should be considered a line of duty death. But the bottom line is...he was in uniform, on duty and at work when he died. While the circumstances that led to his death may not seem quite as "glamorous" as dying while rushing Code 4 to the scene of a serious medical or trauma incident, it still none the less equates to a paramedic dying in the line of duty...plain and simple. The Paramedic Association of Canada considered in a LODD; so too did the Benevolent Society, the Alberta College of Paramedics and the Paramedic Association of Manitoba.
So I have to admit that I was surprised by the small number of paramedics in attendance at the service in Edmonton on Saturday. Less than 100 uniformed emergency services personnel marched the kilometer or so in the memorial precession for Michael. There were EMS representatives from Nova Scotia, New Brunswick, Ontario, Manitoba, and British Columbia. At least 20 uniformed EMT students from NAIT marched with us, and the Honor Guard included representation from BC and Alberta. But all in all, knowing that Alberta has about 7500 licensed EMS practitioners, I thought attendance was poor to say the least.
I questioned memorial service organizers about the attendance, thinking perhaps a lack of communication or, ironically, the number of line of duty deaths over the past twelve months might have affected the numbers. I was shocked by what I heard! According to those I spoke with, many EMS Chiefs did not think this incident warranted consideration as a line of duty death, and as such did not support staff participation in the service. Apparently others within our ranks question the validity of considering industrial work such as Michael had undertaken to be "paramedic duty". A strange position to take, I think, based on the varying roles and responsibilities our profession has sought over the past decade or so. Internal politics very clearly at play.
I appreciate, and in fact invite debate within our ranks...no matter what the issue. But there's a time and a place for those who disagree to make their arguments heard...and the memorial service for a fallen colleague is not an appropriate time or place. If, as a profession we can't come together at times like this...?
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