FORT FRANCES – After announcing the planned restructuring of the Rainy River District ambulance service, the president of the local emergency medical technicians union said it is the latest result of a long-standing, complex problem with no easy solution in sight.

Malcolm Daley is a professional emergency medical technician and president of CUPE Local 4807, the union representing emergency medical technicians in the Rainy River District.

The Fort Frances Times reached out to him for comment after it was announced last week that the District of Rainy River Services Board (DRRSB, formerly RRDSSAB) plans to temporarily relocate ambulance services in the area, moving Emo’s emergency services to Rainy River and Fort Frances and bringing the Community Paramedicine program to the station instead.

The DRRSB statement said the decision was made due to “ongoing and significant staffing shortages” and that implementation is planned for a later date, although no specific date was given.

Daley said what is happening in the district is nothing new and is not unique to our area.

“It’s a long story,” he said.

“We have been in a situation for a number of years, not just locally but across the province, where there is a lack of replacement due to various factors, such as expansion within careers. If you create more jobs that you don’t have people for, you now have too few.

“Retirements, the traditional reasons for leaving the profession like injuries, stress at work (which) are unfortunately over-represented in our profession. When people leave the profession for whatever reason, we simply don’t replace them at the rate we used to in order to maintain the demand, which is constantly increasing.”

Daley pointed out that this loss of staff did not happen all at once, but rather that the number of paramedics locally has been declining over a longer period of time. In the past, the lack of jobs meant that people had to move far away to pursue careers. Today, the same people who would have previously moved here can stay closer to home and still get a job.

Likewise, those who moved away for their paramedical job are now likely to be able to get the same job closer to home. Both of these points mean that it has become even more difficult to attract new paramedics to the region and keep them here.

“If you compare our numbers to 2019 … even through 2020, the end of 2021, we were still fully staffed,” Daley said.

“We are almost 40 percent below that number. We just feel it a little bit more in the north, like with everything. We are isolated here. We are our own animal. We suffer from the fact that we seem to be able to access services more often, or that it seems more severe. And paramedics are no exception, we are in the same boat.”

The decision to withdraw emergency services from Emo means that the communities served by these ambulances will soon have to travel further afield to reach the ambulances in the event of an emergency, a fact that Daley said should attract the attention of everyone in the district.

“This leaves Emo more than 30 minutes away from an ambulance,” he said.

“This results in Northwest Bay being even further away from an ambulance, New Gold Mine being even further away from an ambulance, Barwick, Chapple and Rainy River First Nations. These are all communities served by Emo that don’t even have an emergency room.

“Our members are citizens of these communities, just like everyone else. We should all be outraged that we find ourselves in this situation where we are suffering a serious loss of performance due to geography and lack of foresight and incentives.”

However, the staff shortage has wider implications than just the restructuring of services.

Daley noted that the district’s paramedics do their best to maintain as consistent a quality of service as possible, sometimes working double or more hours than required to avoid staffing shortages when a base does not have enough paramedics to respond to ambulance calls.

“We sometimes do as much overtime in a month as we have all year so far,” Daley said.

“We have paramedics who work tirelessly and just go to work to make sure an ambulance is on the way. Many of our members, when they hear there is no ambulance in a particular community, go to work whether they want to work that day or not, just to make sure someone is there.”

The problem with this, says Daley, is that this is simply not sustainable as it could lead to even more paramedics suffering significant stress or becoming injured. The official union position is that the service at the Emo station should be maintained as best as possible, but there is no denying that something needs to be done about the paramedic shortage in the district to avoid further disruption in the future.

“We need to do something to attract more people here,” Daley said.

“We need to get more paramedics here, otherwise this is just the first step. I don’t want to say there is a simple solution, because the problem is complex. We need to get as many people in as possible, we need to get more people in. These are possibilities that need to be thoroughly investigated. First of all, why are we not attracting as many people as we used to? And secondly, why are we losing people that we have?”

The most realistic option, Daley said, is to attract more people already in the district to the paramedical profession. Efforts are being made to encourage locals to become paramedics, with programs like the provincially funded Stay and Learn scholarships offered through organizations like the Seven Generations Education Institute. But it’s still a relatively lengthy process that won’t solve the problem overnight.

Daley said more needs to be done at all levels to encourage more people from other parts of Ontario to choose to work in the Rainy River District rather than others.

“There was a point in time when the province had too many paramedics compared to the number of available positions,” he said.

“And now we are significantly underproducing paramedics, and that is simply due to a more or less standard labor model that is currently occurring in many industries. We are not the only ones with the paramedic shortage, and we are not the only ones with the labor shortage. Everyone is under-supplied. I am just trying to draw attention to our particular area here.

“If we want people to leave an area where they have a life and a family, where they were educated or maybe worked, to come to Northwestern Ontario, they need an incentive. Because the only incentive they used to need was ‘there’s work,’ and that’s just not enough anymore.”

Efforts are underway within CUPE and local paramedic associations in the province to lobby the government for new and different incentives to bring more people into health care in the north of the province, Daley said. In addition, pressure is being put on ambulance service operators to promote their areas with further incentives to recruit and retain paramedics in the north.

To address the problem, discussions must take place at all levels, and all levels must contribute to the solution, whatever that may take.

“As CUPE 4807, as a local chapter, we are trying to bring attention to the problem because that is how change happens at the grassroots level, through conversations in the public space, through bringing attention to the problem, bringing it to the attention of stakeholders and elected officials at all levels,” he said.

“Whether it’s a provincial representative, federal representative, municipal representative or the DRRSB itself. The goal here is not to blame anyone, because how can we blame one person, one organization? There are certain details that are questionable and we would like to see more attention to Northwestern Ontario and health care in general, we all agree on that, but we have to focus on the fact that if we stay this course, we are talking about long-term, life-changing losses of what we already have.”

“We as paramedics, as voters of these areas, these communities and as taxpayers there, as citizens of this area, we also have family members here and we want to make sure that ambulances are available,” Daley continued.

“We want to make sure they are taken by ambulance to a fully staffed emergency department and that they have access to a GP, and that applies across the whole system. The initiative to discuss the paramedic shortage in particular is so that we learn how much that particular area is suffering at the moment. Let’s take a closer look at that.

“We need to start looking at this seriously and finding active solutions as to how we can maintain this service for future generations and how we can support and more or less reward the people who are currently doing this job tirelessly.”

Fort Frances Times / Initiative for Local Journalism