The Regional Health Authorities Act legislation came into force in 1997. It sets out the conditions under which the RHAs are incorporated, and defines their duties and responsibilities for ensuring effective health planning and delivery. The decision to regionalize the operation and administration of health in Manitoba was a major change in the way that health care is planned and delivered.
While regional governance authorities were tasked with decision making related to most health planning and delivery, some core health services remained the primary responsibility of central agencies or Manitoba Health. The belief was, and I expect still is, that certain specialized health services could be more safely or efficiently administered centrally, and as such needed to remain outside of the regional governance model. Angiography, radiotherapy, some mental health services and Lifeflight air ambulance are all examples of health services that remained directly funded and administered provincially. Certain health facilities such as Addictions Foundation Manitoba and the Riverview Health Centre also operate outside of the regional health authority governance model.
Emergency health, including ground ambulance service, is identified as a core health service for which RHAs have been legislated direct responsibility. The decision to include EMS in the list of RHA services was probably given very little thought. I don't mean that to sound negative or critical...but the reality is that EMS was already void of central administration in that each municipal government had responsibility to ensure ambulance service availability. In the process of trying to de-centralize most other health services I doubt anyone gave much thought to centralizing EMS administration and delivery...that just wouldn't fit the mold under consideration at that time.
Today Manitoba has eleven regional health authorities and each is very distinct in their approach to the delivery of emergency medical services. As result, staffing models, alternatives to improve system efficiencies and even the level of care provided by paramedics across the province is very inconsistent. In an effort to assist the RHA External Review Committee with their examination of RHA operations and subsequent recommendations to Government, the Paramedic Association of Manitoba prepared a written submission for consideration. This report outlines current system challenges and recommends the committee consider the benefits of operating Emergency Medical Services within the context of a provincial model that includes regional input. It's an administrative model that has already proven very effective with many specialized health services, and one that EMS across this province would benefit from.
The PAM submission to the RHA review committee is available on our web site and can be found using this link - PAM Sumission to RHA External Review Committee.
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