Paramedics Leaving the Profession - Support is Required

CLAUDIA CHENDER « » : Thank you, Mr. Speaker. I am honoured to speak to this issue here on the floor of the Legislature. Over the last several months, I've had many conversations with paramedics across the province, and it has become impressed upon me that paramedics as a whole are at a breaking point. Our entire emergency medical system, as we have been discussing, and will continue to discuss, is in crisis. And the paramedics on the front lines are sadly, the best example of this.

Paramedics deserve to be acknowledged for the work they do - to be thanked, to be appreciated, and to be appropriately remunerated. And the government can do all of this. They can create safer workspaces, and they can give paramedics a permanent wage increase that will keep them in the province.

We are talking a lot about retention, and I want to tell the members of this Chamber, contrary to some assertions to the contrary, I am an optimist. I am a positive person. I am in this job because I want to make a difference in the lives of Nova Scotians. And I believe that everyone in this Chamber wants to do the same, and that is why issues like this are so important, because they fly under the radar.

We were told recently by a paramedic who was 15 years in that every paramedic she knows has an exit strategy, that there is not a single paramedic she has ever spoken to in the last several years who doesn't have a Plan B when it all blows up. We know that paramedics are leaving this province, or they are leaving the profession.

According to one Cape Breton paramedic, and I apologize, I don't have my tabling documents, but I will get them to you by the end of this speech, things are significantly worse for first responders than they were just a few years ago. This paramedic asked to remain anonymous but told us:

"It's harder and harder to do the job. I recently worked a day when there were only two rigs for the whole Island, and that meant my unit had to respond to a call two hours away" -

two ambulances for all of Cape Breton Island.

"Sometimes it means people just have to wait, and it can take hours. Situations like this are causing moral distress for paramedics because we can't help people the way we want to in the moment. I've seen lots of people leave the profession or leave the province and I can't blame them when you feel so unsupported, and you feel like you're filling the gaps of services that are falling apart."

I want to take a minute and just acknowledge this idea of moral distress. We hear it from paramedics. We have heard it in committee, in the Legislature. We have heard it in conversation. Imagine. Put yourself in the position: You get a call, and that call is a cardiac arrest or some other acute medical distress, and you know that it's going to take you an hour and a half to get there, and you know what that means. You know what you're going to find when you get there - imagine - and you have no control. All you can do is respond to that call and know what you're going to see when you get there. It's a terrible situation for people to be in, and it's why people are leaving.

Samantha Hamilton, another paramedic, told us:

"Paramedics are front-line health professionals who make life-and-death decisions in roadside ditches and in hospital hallways for the people they serve day in and day out. The paramedics who have remained in this mayhem have been hanging by a thread. No breaks, hours of forced overtime on top of 12-hour shifts, in a job well known for its challenges. Many are contemplating whether to stay or take other opportunities that other paramedics have left for. This government is not considering its actions and has ZERO respect for paramedics or our union. We are offered platitudes when it is convenient, but the failure of this government to step up to our issues speaks louder. It is time that we are taken seriously and time that our service is recognized, valued and appreciated."

Women in particular have reached out to us about working so much overtime that they don't see their families and can still barely afford to feed them, feeling like they need to be on stress leave but not being able to afford to. For those who are off, horror stories of fighting with Emergency Medical Care Inc. to retain basic benefits while trying to get back to work are awful. Let me remind everyone in this Chamber that EMCI is a private company. Our paramedics are contracted to a private company, and that private company treats them, by their admission, terribly. The CEO of that company has been all over the news lately advocating for an expansion of private health care across this country, and that should tell us everything we need to know about the priorities of EMCI. I'll give you a hint: it's not Nova Scotians, and it's not our paramedics. It's their bottom line.

Paramedics are the canary in the coal mine of our emergency system. The ERs in Nova Scotia - as we have discussed many times - are chronically overcrowded. Long waits and unscheduled closures are the norm. Lack of access to primary care and long wait-lists for long-term care are exacerbating factors. We all know this, but we need to also remember that all of this impacts the severity of calls to Emergency Health Services and the constraints on paramedics once they arrive. The average response time in the Central Zone for paramedics in 2016-17 was around seven or eight minutes. In 2022, it was closer to 26 or 27, and it can be much, much higher. There were more Code Criticals, when there are no available ambulances in a zone in Nova Scotia, in the first three months of 2022 than in all of 2021.

I remember a time not that long ago when we were talking about Code Critical in this Chamber, when it was a big deal when there was a Code Critical. Now when we talk to paramedics, they tell us, we don't even bother to talk about it because it's Code Critical all the time. That is the status quo right now. The response times right now by paramedics are far beyond safe, they are far beyond desirable, and they are beyond the targets in our contract with EMCI. The current contract, which was signed by the Liberal government, is worth $165 million a year to EMCI, and they have had to pay zero dollars in penalties despite consistently not meeting these targets. We are seriously concerned about the performance of EMCI and the government's ability to manage this contract. Why aren't they paying penalties? If we are going to contract a private company, presumably we think they can do it better. They are failing. Why aren't we holding them to account?

A recent FOIPOP reveals that multiple recommendations from the Fitch Report that looked at emergency services remain incomplete, including considering an annual independent performance review of contractor expenses and performance. There's a free tip for the government. Please do an independent review of EMCI. They are failing at their job. In 2022 there were more than 200 paramedics off work due to injury or illness. That is 20 per cent of the workforce. In the fourth quarter of 2022 there were 255 vacancies and Freedom of Information records also note that EMCI is now required to post those vacancies externally, as interest from candidates in full-time positions is decreasing. We don't have to wonder why that is. One hundred and thirty-three paramedics resigned in 2022; 133 in one year. That is the largest number in six years.

We cannot overstate the impact of this on our health system writ large. All of us are going to be in a situation where we have to call an ambulance and we'd better be ready when that ambulance doesn't show up if this government isn't going to do something about it. We know that Allison Holthoff's family decided not to call an ambulance. They decided to drive to the ER because they were concerned about how long it would take for an ambulance to get to them. We need to change that. This government says they want to change the narrative, so change the narrative. Do what it takes to retain these paramedics and make this a desirable profession again.

Paramedics are underpaid, poorly treated, and are leaving the profession in droves. The wages are too low and the working conditions are bad. This government needs to act now, sit down with paramedics and not wait until the Fall when the contract comes up. This government hands out money to various people like it is candy on Hallowe'en. Why not paramedics? Without the paramedics, the rest of our system collapses. Do what it takes to make sure that we can keep every single paramedic possible and retain and hire more.