Remarks to the Standing Committee on General Government regarding Bill 160, Strengthening Quality and Accountability for Patients Act, 2017

Good morning and thank you for allowing me to present to you this morning.

My name is Kelly McDermott, and I am the Senior Solicitor for Labour Relations at the Region of Durham and I am here on behalf of Norm Gale, President of ESSC, who could not be here today.

The Emergency Services Steering Committee (ESSC) is a working group of senior staff from municipalities that provide some combination of fire, police and paramedic services.  Our membership includes multiple employer stakeholders involved in emergency services.

I want to start by saying we support many of the amendments to the Ambulance Act under Bill 160. In particular, we support the legislative framework that will give paramedic services alternative options for on-scene medical treatment – that is to treat and release and treat and refer as well as more flexibility in determining where a patient is taken to receive care at an “alternative destination,” a health facility other than an emergency room at a hospital.

We understand our friends at Association of Municipalities of Ontario will be appearing before committee later this morning and speaking to proposed amendments to the Ambulance Act to augment this operational directive.

What concerns us is the fact that Bill 160 will enable fire-fighters, certified as primary care paramedics, to treat low acuity conditions as part of a fire service.

We foresee several adverse consequences arising from the introduction of this model and we stand firmly beside the Association of Municipalities of Ontario, Large Urban Mayors Caucus of Ontario (LUMCO), Mayors and Regional Chairs of Ontario (MARCO) and the Ontario Association of Paramedic Chiefs in opposition to it.

First, there is simply no objective data to demonstrate this model will improve patient outcome or response time. Further, this parallel service will not free up ambulance resources. Ambulances will still have to attend scenes to assess and transport patients. This is simply a duplication of resources.

Secondly, this model is bound to create disputes, litigation and increase costs for all stakeholders. The legislative and labour relations structures in the fire and ambulance sectors are very different and we fear that duplicating this service in the fire sector will lead to labour disputes and litigation.

Further, in order to blend these two regimes, we foresee a number of additional costs to municipalities, base hospitals and the province in order to maintain the standard of paramedic care in the province.

Finally, this model cannot remain voluntary in the current interest arbitration system. There is no better example than the 24-hour shift in the fire sector, which started as a voluntary model and was subsequently imposed on municipalities through Interest Arbitration awards.

For this reason, safeguards need to be built into Bill 160 to preserve the rights of municipalities to determine how emergency services will be provided in their communities.

AMO will be speaking to proposed amendments to the Ambulance Services Collective Bargaining Act and Fire Protection and Preventions Act to preclude interest arbitrators from expanding the scope of work for paramedics and fire-fighters respectively.

We worked with AMO to develop this language, which notably mirrors existing language in the Police Services Act.

While we understand the Committee can only examine the legislation before it, we respectfully request that these revisions be considered during the clause by clause review of this proposed legislation.

In conclusion, while support many of the changes contained within Bill 160, we ask the government:1) abandon its proposal regarding the use of firefighter PCPS or 2) wholly adopt the revisions AMO will be tabling to prevent this voluntary model from being involuntary imposed on municipalities.

We appreciate the opportunity to provide you with this input during the Committee’s deliberations on Bill 160.  We would be pleased to provide any clarification on the issues we have raised.