Crisis Management

I received a call from CBC TV this afternoon..."would I consider doing another interview regarding service shutdowns and staffing problems...apparently Falcon Lake was having problems and would the recent hirings by Winnipeg EMS have much impact on rural staffing?"

As I mentioned a few blogs ago, the fact that Winnipeg has made employment offers to 16 rural Manitoba paramedics should be viewed as a boost for the profession and our EMS system. I have long argued that career progression is absolutely essential to recruitment in rural services. Without evidence that these opportunities are on the horizon, young students and potential paramedics look elsewhere for both education and employment.

What is frustrating, however, is the fact that we really don't have any resource plans in place to ensure that the loss of 16 paramedics from the rural setting won't cripple some ambulance services. Manitoba has 11 Regional Health Authorities with 11 different management structures and philosophies which results in 11 different EMS systems. And I'm not blaming any RHA manager or executive team for the disparities...they inherited a very fragmented system that had been severely underfunded for the better part of two decades. They had very little understanding of what EMS was or how it operated. For the most part they were facility and program administrators...they could see and feel what they were dealing with and plan appropriately. EMS didn't quite fit into that mold.

Manitoba Health initiated the EMS Framework Project in January 2004. Quite frankly, I was excited by the fact that the RHAs, government and other stakeholders recognized the disparities that existed within our EMS system and wanted to develop a blueprint to address future development. Included in the terms of reference for the work to be conducted by the Project Team (PAM had a seat on this committee, which would in turn make recommendations to a senior Steering Committee) was direction to "explore a range of potential EMS system models, including regional, provincial and hybrid models". Unfortunately that portion of the review became far too political and was never completed.

Without more centralized direction about staffing and service delivery, the disparities will continue to exist. Some regions, like SouthEast and Interlake which have primarily opted to staff services on a 24 hour basis, will fare better than others. But overall the system will be managed by reacting to crisis. It took great political will ten years ago in Nova Scotia to affect very positive change. I wonder what crisis needs to occur here at home before our decision makers will be prepared to take that plunge.