When Steveston resident John Roston fell down at home and required transportation to hospital, a fire truck and two ambulances with seven emergency personnel arrived at his home.
In the end, he only needed two paramedics to get him on a stretcher and transport him.
“Fantastic service, but I did wonder what it cost Richmond,” Roston explained in a letter to Richmond mayor and council a few weeks ago. “The Ambulance Service billed me $100.”
In fact, the latest numbers from Richmond Fire-Rescue from January show Richmond Fire-Rescue attending 365 medical calls, which comprised 43 per cent of all their calls (community safety reports have not come out since March).
In his letter, Roston advocates for more integration between the city’s fire department and the provincially run paramedic service.
City Coun. Bill McNulty told the Richmond News Roston’s idea is nothing new – it’s something he tried to push forward about five years ago and got “pooh-poohed” by city staff.
Even allowing fire fighters to administer Naloxone, which is used to resuscitate a narcotic overdose, was a fight, McNulty said.
But when the community safety committee reconvenes on Jan. 12 – after a nine-month hiatus because of the pandemic – McNulty plans to put the issue back on the table.
Community safety is his top priority, McNulty said and having emergency services available when they’re needed is “critical.” His first priority is having fire and police on the street, not necessarily fixing minor issues like potholes, McNulty said.
“…if you have a heart attack, I need to get somebody there and I hope you want me to get somebody there rather than fix the pothole,” McNulty said.
Emergency response a jurisdictional struggle
However, giving firefighters additional training and responsibility runs into the issue of jurisdictions and control.
To call it a turf war may be an overstatement, but there is clearly a tension between the fire department, which is controlled by the city, and ambulance which is under the purview of the province.
Fire fighters are “well-positioned” in the City of Richmond to provide life-saving medical interventions like CPR and managing airways, fire chief Tim Wilkinson told the Richmond News, calling them “value-added service” that they bring to the table.
Fire halls are located throughout the city to work best for Richmond, whereas ambulance stations are distributed to serve the province as a whole, he explained.
“Those things compete a little bit, but that’s where we can work together,” Wilkinson said. “This layered service makes a lot of sense.”
When there’s a critical incident, “every moment counts,” Wilkinson added.
Last year, Richmond city Coun. Carol Day initiated a letter to ask the province to allow firefighters to perform basic paramedic duties.
In a report to council, Wilkinson pointed out firefighters could move from being a first responder – their current certification – to emergency medical responder.
A five-day course would cost about $600,000 in tuition and staff time.
However, as Wilkinson pointed out in his report, firefighters wouldn’t be able to respond beyond their current first responder training. This is the purview of the provincial ambulance service.
More paramedics needed, not better trained firefighters
Troy Clifford, union president of Ambulance Paramedics of B.C., said having municipalities shoulder more emergency service costs adds to municipal budgets and downloads responsibility to local governments.
The true cost of having more fire fighters trained to a higher level will add up to more than just initial training, with a need for continuous recertification, equipment wear and tear and liability issues – the more calls they do, the more they put themselves at risk for liability, Clifford said.
Clifford said he understands municipalities are under significant pressure to provide services to their residents, but paramedic work falls under provincial jurisdiction.
“(The city needs) to put pressure on the provincial government if they have shortfalls in Richmond to provide those services or enhance them so that we have more ambulances,” Clifford said, instead of putting pressure on the fire department.
BCEHS told the News Richmond is a “coveted” location where many paramedics want to work, and, in fact, two new paramedics were hired in Richmond in September.
BCEHS calculates total number of hours when ambulances aren’t available for calls –this includes time spent at hospitals or on breaks. In October, ambulances were off the road for 445 hours and in November, 241 hours, according to BCEHS numbers.
BCEHS didn’t provide the number of shifts missed because of vacancies.
However, Clifford pointed out paramedics often work overtime shifts on their days off – they work a four-on-four-off schedule of 12-hour shifts – including paramedics in Richmond.
APBC sounded the alarm earlier this month saying paramedics are facing increased burnout and taking stress leave as they are constantly working overtime and are currently dealing with the added pressures of the COVID-19 pandemic.
He cites an example of a paramedic in the Lower Mainland who recently worked 68 out 76 days.
“That’s absolutely crazy amounts of work and that should not be allowed because that’s not safe,” Clifford said.
The shift patterns are designed to allow paramedics to rest and recover, he added.
“The amount of overtime they have to cover to sustain our service is not healthy, not good for rest and recovery,” Clifford said.
Time to rock the boat
Day, however, argues since fire fighters are already at the scene, they should be given extra training so they can help out more.
“If we’ve got these fire fighters ready, willing and able, why not give them the training and give them the ability to do the basics so we can make better use of our resources,” Day said.
Day said it must be “frustrating” for fire fighters to want to do more and not be allowed.
“They’re racing off to calls because they care – they want to help that heart attack victim, they want to calm down that person that’s having an incident and they can do that,” Day said.
For Day, this is a waste of resources that the province should take advantage of.
“Times have changed – we need to connect the dots better,” she said.
McNulty said he’d like to sit down with BC Ambulance to talk about how far fire fighters could go in their response at medical calls.
When he brought it up about five years ago, he said city staff didn’t seem to want to “rock the boat” at that time, but now might be better timing.
“It warrants another look, it warrants investigation,” McNulty said. “And if I’m proven wrong, I’ll be the first to admit I’m wrong.”
