Ontario’s firefighters say that since they’re often first on the scene, it only makes sense for them to be equipped to deliver more emergency medical care. While that sounds perfectly logical to some, many municipalities and paramedics are hopping mad. They call the proposal a brazen attempt to protect incredibly costly firefighter salaries at a time of dwindling fires.
Last year, the Ontario Professional Fire Fighter’s Association proposed that the province change the rules to let firefighters perform some of the duties of paramedics. Since then, the association has modified their plan, now saying that firefighters who are or were fully licensed paramedics should be allowed to use those skills if they’re the first to arrive on scene.
Association president Rob Hyndman says the idea is to better serve the public and save the province some money: The provincial government helps fund local emergency medical services along with municipal governments.
The auditor general has repeatedly found the cost of ambulance services in the province are increasing rapidly, Hyndman says. “We’ve got to be aware that not only is [firefighting] a better service delivery model but it’s more financially sustainable.”
The claim that allowing “fire medics” to provide emergency care when they’re first on scene will save money and provide better care is hotly contested by the Canadian Union of Public Employees, which represents the majority of paramedics in the province.
“The one common thread between last year’s proposal and the OPFFA’s newest one is that it will mean more work for members of their union,” says Corey Nageleisen, member of the CUPE Ambulance Committee of Ontario. “It doesn’t seem like a good use of taxpayer dollars.”
Nageleisen warns that given the long shifts firefighters work—24 hours, in contrast to the 12-hour shift Nageleisen had worked the day before speaking with TVO.org – public safety could actually be put at risk by overly-tired firefighters attempting to administer medical care.
“When crime goes up we pay more for police. When fire risk goes up we spend more on fire service. EMS calls are going up, so we pay more for firefighters? It doesn’t make sense.”
The argument between essentially two different organized labour unions would be just that except that the demand for emergency services in Ontario has changed dramatically over a generation and promises to keep changing.
While firehouses and pumper trucks were built throughout the 20th century to ensure the fastest possible response times, fires are on the decline and make up a shrinking share of actual fire service calls. A 2013 City of Toronto report found that actual structural fires made up about one fifth of total calls. Meanwhile, an aging population means a growing share of calls are being made for emergency medical services. In other words, firefighters and police are increasingly being called to provide services that paramedics normally would.
Paramedics argue they are better trained to handle medical emergencies than other first responders, and that it is much more cost effective to send a two-person ambulance than a four-person fire truck to help someone in distress.
Historically, paramedics have not received the same level of funding as fire and police services. For Nageleisen, that makes any proposal to let firefighters do the work of paramedics tantamount to an insult.
“When crime goes up we pay more for police. When fire risk goes up we spend more on fire service. EMS calls are going up, so we pay more for firefighters? It doesn’t make sense,” he says.
The provincial government said it will spend a year consulting on the idea, and Minister of Health and Long-Term Care Eric Hoskins says the government’s primary focus will be on public safety.
That’s disconcerting to some municipalities who fear “public safety” will be an excuse for a cash-strapped provincial government to saddle them with new costs: the province pays grants to cover some of the price of paramedic response, but cities carry the burden of fire service. Shifting EMS work from paramedics to firefighters would, absent any other changes, end up shifting some of the cost of health care from the province to cities.
At this year’s annual meeting of the Association of Municipalities of Ontario, outgoing president Gary McNamara warned that police and fire service payrolls are already straining municipal budgets, and adding paramedic services to the fire payroll would make matters worse.
“Police and firefighters are the most highly-paid employees we have, and they should be. But we can’t pay them increases at the expense of other services that keep our communities safe and healthy,” McNamara said.
Of particular concern is that, if the province allows the hypothetical use of firefighters as paramedics, municipalities could be forced into it by the binding arbitration that governs police and fire labour negotiations.
Hoskins has said, both at this year’s AMO meeting and when speaking with TVO.org, that isn’t the government’s intent.
“We have suggested that, if this is considered, it would be opt-in by municipalities,” Hoskins says. “This isn’t something we would want to impose.”
Update: An earlier version of this article gave the impression Rob Hyndman of the firefighters' association cited the auditor general's findings that ambulance services in Ontario were not always meeting their response time targets. Hyndman was actually referring to the auditor general's findings that the cost of ambulance service was increasing rapidly. TVO.org regrets the error.
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