Have you ever had to dial 911? We certainly hope not, but if you have, you do not need us to tell you how frightening and potentially life-altering this situation can be. Currently, Alberta has seven 911 ambulance dispatch centres, four of which operate from regional hub communities: Red Deer, Lethbridge, Regional Municipality of Wood Buffalo (RMWB), and Calgary. Alberta Health Services (AHS) announced its intent to cut the total number of Provincial dispatch centres from seven down to three.
We have been strongly advocating to the Provincial Government and engaging with Albertans on this issue because it is a matter of life and death, not just for the people in the communities we represent, but for every Albertan.
The consolidation of ambulance dispatch means three potential emergency response changes for all Albertans:
1) The end of integrated emergency response (a partnership between fire and ambulance that Alberta was once a leader in),
2) A degradation of emergency response (dispatch calls will take longer and fire medics will no longer be quickly dispatched to attend emergency scenes when ambulances are unavailable),
3) Albertans will be left to wonder what future emergency service changes will be on the heels of the imminent cuts to 911 ambulance dispatch.
One only has to look at the tragic example from British Columbia where a woman died because the ambulance was delayed and firefighters were not immediately sent to the emergency, and Ontario, which is now realizing the negative outcomes of their centralized model. An external review of pre-hospital emergency care in BC recommended that the Government return to an integrated ambulance and fire dispatch model. The devastating consequences in other Canadian provinces should be enough to give our Premier, Cabinet and every Albertan pause. This can be stopped before it is too late.
For our communities, this issue is not about politics, partisanship, or, as some have speculated, the money. It is not even about preserving the status quo, as we are willing to help the Province improve inefficiencies in this critical service. It is about life and death. In fact, we believe in integrated emergency service so strongly that Lethbridge, Red Deer, and RMWB are willing to pay from municipal funds to safeguard local integrated emergency dispatch. We made a formal offer to the Premier, and our letters of offer have yet to be formally responded to.
In our communities, the Advanced Life Support (ALS) fire truck arrives before the ambulance 40%, 19%, 60% and 22% of the time, respectively, and our local dispatch centres consistently answer the 911 calls faster than the Province's centralized AHS dispatch centres (which, notably, do not always meet their own service standards for emergency dispatch). While it might not seem like much difference on paper, in critical incidents, seconds count. The importance of local, timely call answering is essential in emergencies.
Losing integrated dispatch means ultimately losing integrated emergency service response; there are Albertans alive today because fire medics responded when an ambulance was 15 to 20 minutes away. It does not make sense for fire medics to be at the fire station when they can be on an emergency call. Losing dispatch means that fire medics will not be immediately dispatched in critical emergencies. This unnecessary emergency health care cut will impact patient care.
Here are a couple of recent, real-life examples of how the current coordination between ambulance and fire dispatch protected timely emergency response for Albertans. Under the Province's proposed siloing of ambulance dispatch, these AHS dispatch errors would have had highly detrimental consequences for the patients.
- The Province's North AHS dispatch incorrectly entered a stroke patient's location in RMWB 13 kilometres away from the actual location. The AHS dispatcher later updated the location, again in error, this time 2.7 km away from the patient's actual site. An RMWB municipal dispatcher finally intervened to direct the ambulance to the patient's actual location, but the two AHS dispatching errors added four minutes to this response.
- AHS dispatch routed the nearest ambulance to a Red Deer call (the nearest available ambulance was 25 minutes away in Lacombe); when local dispatchers reviewed the call, they immediately dispatched an ALS fire truck onto the scene in under four minutes to begin medical treatment.
- This past summer, Calgary 911 received a call for a water rescue on the river. The computer system failed and the Calgary 911 dispatcher realized the system failed but was able to coordinate in the room with fire, EMS and police to organize an emergency response. Under the AHS model, the in-room coordination cannot happen.
- In Lethbridge, in August of 2020, a 911 call was routed to the provincial dispatch centre. The caller reported that her friend had collapsed and was unconscious in Henderson Lake Park, one of three large regional parks. The dispatch centre wanted to know what city Henderson Lake Park was in. When told it was Lethbridge, the dispatcher requested the physical address. The caller responded "Gunnery Point", a location within the park familiar to Lethbridge residents. The dispatcher asked "What is the street address?". This example illustrates the delays that will occur when dispatchers are not familiar with local geography. When seconds matter and lives can be saved, this is crucial.
If the Province follows through on their plan to cut local dispatch, local medical 911 calls will only be responded to by ambulances, which are often tied up at local hospitals or are away in other communities. The Advanced Life Support-trained fire medics, which are only four to six minutes away, would remain at their fire stations because AHS dispatchers will not immediately send the fire truck to an emergency resulting in patients waiting longer to receive emergency care. This is wrong and a waste of local public resources – and it takes our province back 30 years in time in terms of emergency response times and patient care.
Four previous Ministers of Health have overturned this reckless plan in the past. The current Health Minister has indicated he will not be overturning as his predecessors, who served under four different Provincial Governments, have. As a result, we now appeal to the Premier and the Cabinet Ministers, who went on public record against consolidation when they were the Official Opposition in 2016 (Hansard reflects the impassioned debate by some current cabinet ministers who spoke against the “substandard” of dispatch consolidation).
To date, we have been told that this seismic shift in the emergency services landscape in our province is about "patient outcomes." However, based on actual scenarios of AHS ambulance delays and mapping error that our fire medic crews frequently encounter, this change cannot defensibly be stated to be about patient outcomes.
Fellow Albertans, we understand that this issue might not affect you directly today, but we assure you it will affect you in the near future. This issue affects all 4.4 million of us. Alberta was once modelled after and led the way on emergency response best practice. Through the municipal and provincial partnership, we had integrated, Advanced Life Support, public emergency response. Our concern is not just that removing local dispatch is the death knell for integrated emergency service response, but that the integrated, Advanced Life Support, public emergency response system our province was once respected for, will become siloed, Basic Life Support, private emergency response. The first two have already come to pass, and we hope we are wrong about the latter.
People often ask us if their calls, emails, letters, visits in grocery stores and in-line at the bank regarding the day's issues with elected officials matter. We can, without hesitation, tell you that they do. If the people do not speak, the real-life impact of one line in a report that might look good on paper is unknown, often until it is too late to change course. Without Albertans' voice, the switch will be flipped on January 12th and integrated emergency service as we know it will cease.
AHS officials have stated that dispatch centralization will not result in a degradation of service. This commitment was also made in previous consolidations, but to date 39 Alberta communities have gone on record that their communities experienced a degradation of service, both in timing and coordination of emergency dispatch, and in the number of ambulances available in their communities. In the words of a fellow Alberta Mayor whose community dispatch was consolidated into the provincial system in 2014, “We should have fought with you harder in 2013”. In other words, had they known what was going to happen, instead of believing the appeasing assurances that emergency ambulance service would not degrade for their community, they would have done what we are doing now: sound the alarm.
Our fellow Albertans, we want to unequivocally go on public record; this mistake is entirely preventable. The experience of other Canadian provinces who consolidated dispatch proves that this change will fundamentally dismantle an integrated public service we once led the way in our federation on. Our communities implore our fellow Albertans to speak up, with us, before it is too late.
Past centralizations have degraded emergency response, but as this is the final consolidation, the real consequences, intended and unintended, have yet to be experienced by Albertans. May we learn from other provinces' life and death experiences, instead of being forced to learn through the consequences that are on the horizon for Albertans.
Premier, there is still time to do the right thing.
Chris Spearman, Mayor of Lethbridge
Tara Veer, Mayor of Red Deer
Don Scott, Mayor of Regional Municipality of Wood Buffalo