EMSEDU

Tories' grand plan for health a little unsettling Don Braid, Calgary Herald Published: Tuesday, December 16, 2008 Health Minister Ron Liepert has said candidly he doesn't want to unveil his whole health care plan all at once, in case he "scares the hell out of people." Now we can see the whole plan, pretty much, in the McKinsey report that was slipped quietly onto a government website on Monday. This document sets goals that seem impossible to achieve. Yes, it's going to scare the hell out of people. In a fascinating section, the report says if all its reforms are implemented, the annual operating cost of health care will be reduced by $1.5 billion by 2020. The population will rise sharply, but somehow Alberta won't need as many health care professionals --5,000 fewer nurses, for example. This is either magic or a recipe for sharply declining health care. The cost projection is also at odds with the minister's own words. Liepert insists at one news conference after another that his measures so far "are not about cost-cutting." He says operating costs will rise next year, although at a slowing rate. Yet, the report shows cost-cutting --not relative, but absolute--is a major goal of the reforms. Liepert insists the goals are not unrealistic, though. "A lot of what they've uncovered is what's been wrong with the health-care system all along--it's incredibly inefficient," he says. He's undoubtedly right in theory, but in the real world it's hard to imagine a system that costs less providing better care for more people. There can be no doubt the role of rural hospitals is about to change radically. The future state of those hospitals, the report says, will be marked by investments in ambulatory care centres, tele-health, selected rural hospitals and EMS. Crack the code and the message is: Alberta will have fewer rural acute-care hospitals. Some will be converted into what those of us who don't write bureaucratic reports would call clinics. The system will rely on ambulances to get sick rural people to city hospitals. The trend that spread across Saskatchewan years ago is coming here. In fact, some patients in big cities are already being steered to smaller hospitals for elective surgeries. This may mean communities near Edmonton and Calgary will keep their full-service hospitals. What it means farther out is much less clear, although getting sick in High Prairie might not be a good idea. This rural reform could prove to be the toughest thing the Stelmach government ever does, because it will inflame passions in the Tories' rural heartland. If you've wondered why they moved with such blazing speed to uproot the old health regions, here's your answer. No rural regions exist to raise the alarm at hospital closures and conversions. Meanwhile, the report is full of doomsday predictions about what will happen if the system isn't changed. By 2020, Alberta will need 32 per cent more acute-care beds, 51 per cent more long-term beds, 39 per cent more doctors and 40 per cent more nurses. Acute-care beds in Calgary hospitals, 92 per cent full now, will run at 97 per cent occupancy. The dying David Thompson region (Red Deer area) will rise from 89 per cent to 110 per cent. Nobody wants the status quo in health care, but this utopian report tries to convince us the government can completely reverse these trends in a growing province with fewer staff and less money. Frankly, the grand plan sounds impossible-- and that's scary. Dbraid@theherald.canwest.com

Two quick thoughts - waiting until this situation is fait accompli is a dangerous plan. And I wouldn't count on an "uproar" from the public, especially a public who has no idea what the differences are or what it would mean to them. There is a reason why clear and decisive information is not being made available. Think about it.

According to this, when the city trimmed it's budget to reduce the tax increase they got rid of the EMS budget that Bronco originally allocated. I also doubt that the city would top up the budget, especially after the fiasco that was contract negotiations last spring. If the province says they can run it for less, the city would jump at the chance to move the funding elsewhere. But then, there is no funding anymore anyway. Calgary city council approved its first major cut to the controversial 2009-2011 budget Tuesday evening, as it continued to go through the document line by line looking for more places to trim. Aldermen approved Mayor Dave Bronconnier's suggestion to remove the operating costs for the city's Emergency Medical Services from the budget, after the province pledged to take over that responsibility effective April. By removing the $15.1 million in EMS expenses for next year from the budget, the council was able to bring down the proposed property tax increase for 2009 to 7.8 per cent, compared to the 9.6 per cent originally proposed. Council also managed to trim another $1.3 million in other expenses on Tuesday. That barely puts a dent in a proposed $2.5-billion operating budget for 2009, but council was only a quarter of the way through the budget documents by mid-afternoon. To make the cuts, council members have agreed to trim funding for consultants, cut four new jobs in park maintenance and delay hiring some staff in the asset-management department for six months. Council Trims Controversial Budget

No, you didn't imagine that, I read it as well, and in fact, mentioned this to my buddy, but he said that the city can do nothing to stop it even if they wanted to, which they don't. The province backed down 3 years ago but it won't happen this time: The province is hell-bent on going forward with this, even as members of their planning committee are admitting that the time allotted to plan this transition is ridiculous.

Recently was out for drinks with a very high-ranking City of Calgary employee whom I trust implicitly. He related to me a conversation that he had with a equally high-ranking member of Calgary EMS management. Apparently, during a recent meeting between members of the "planning committee" in charge of the transition of EMS to the Province and said member of management, it was indicated that the budget for Calgary and area (read: Southern Alberta) was significantly lower than the current budget for running Calgary EMS alone. When the "planning committee"member was asked how they planned on running Calgary plus surrounding areas on a budget that is more than 4 million dollars short of what it takes to run Calgary alone, the answer was "get rid of the Paramedics, go BLS except for a few speciality units, which would respond to ALS calls". Said "planning committee" member went on to defend this practice by claiming that with such a short planning/transition period, this was the ONLY possible solution and that the province was providing them with an impossible budget. I completely admit that I'm hearing this 3rd-hand, and the actual conversation may have been distorted by the time it reached me. However, if there is even a grain of truth to this, then my colleagues in Calgary and elsewhere need to be aware of the potential eradication of their jobs. I don't know about you, but I plan on being pretty damned persistent in trying to find some answers about this transition and ending the speculation. And as for a provincial union... hurry hurry hurry!

Word on the street today is this is the last straw for a LOT of people. It may sound nice on paper but unless they bring some people with actual field experience into the decision-making process, this may end up being a huge step backwards. I'm very interested to see how they plan on pulling this off.

Alberta Health & Safety Training has an ITLS Trauma course posted for June, last I checked there were 8 spots left.

All rightie then. You can just continue to call yourself a "paramedic" in Alberta and see how much respect you get from your EMT-P co-workers. Clearly, everyone involved in PAC/ACoP has no idea what they're talking about, no education to back up their decisions, no experience in this area. You, obviously, know more than they do and are in a better position to make decisions. Yes, it MUST be that I'm being "fed" from ACoP, couldn't have anything to do with working along side with PAC, CMA, etc etc. Couldn't be that I'm simply educated in the processes and history, must be that I just buy into whatever I'm told. Yeah. Sure. That must be it.

hahahahahahahahahahah oh that was good.

How helpful.

Ummm, no, actually GAP training had very little to do with the NOCP, it referred to changes in the AOCP. :cyclops:

"Did you read this whole thread?? First off I cannot obtain my EMT-P because that course is not offered in Canada anymore!" Uh... yeah, I don't know how you can justify that statement. EMT-P is, of course, offered in Alberta. And believe me, ACoP will not be changing the title anytime soon. Check your registration card, and tell me what it says. Even if all EMT-P courses in Alberta are recognized at the ACP level by CMA, they are still designated as EMT-P Programs. Ditto with EMT/PCP. Because if they weren't, they would not include the AOCP.

www.calgaryparamedics.com I'm pretty sure they are talking per day per Calgarian.

Worried about a half-baked, scab version of EMS? Don't be ... the walkout won't happen UPDATED: 2007-07-20 01:39:45 MST By RICK BELL Union votes to strike Strike but no strike. The moves on the chess board will be made but there is no reason for fear or loathing. Our ambulances will not disappear from Calgary streets. Citizens will not face some half-baked contingency plan where city staff with basic ambulance operation and first-aid training try to make Emergency Medical Services work. Such is the commitment of Iris (Not An Idiot) Evans, the province's minister responsible for labour, who is also a Calgary-trained nurse and former Alberta Health head honcho. Yes, our world-class paramedics voted 354 to 4 this week for a strike and their union execs discuss today when to serve a three-day notice of a walkout. Yes, the paramedics will give the 72-hour notice, probably sometime early next week. But the province, as the clock ticks down the 72 hours, is expected to declare an emergency exists and send the city and the paramedics to an arbitrator who will impose a deal binding on both sides. A strike will have been called and paramedics will come close to hitting the bricks but a strike will not actually occur. Paramedics will be sent back to work. Calgary EMS will be treated as an essential service without being an essential service written in law. "The bottom line now is we're not going to let Calgarians be put at risk. We can't have an interruption of service. We're going to effectively stop any public emergency," says Iris, who speaks similar sentiments when she meets with the Sun last week during a Stampede visit. "The process can be put in place and start right away." Mayor Bronco insists the city has the bases covered with a backup plan using EMS management in ambulances and other city workers as drivers. "It will not provide the service Calgarians have come to expect," admits Bronco. No kidding. The mayor even offers voluntary arbitration, a case of too little, too late. Iris says she remains "always hopeful" the city and paramedics can somehow come to an 11th-hour handshake, but she's a realist. And, also as a realist, Iris is almost certainly not going to use the provincial government's other option, to send the mess to a mediator who can stall the strike but only offer a suggested settlement either side can punt. In this dispute, the two sides are too far apart. Mediation is a waste of time. The city offers 12% over three years, paramedics want 18% plus an adjustment of the pay grid adding up to a total 30% hike over three years. Even the United Nations can't bridge that kind of gulf. Grumblers may not like these numbers, but EMS staff do a stand-up job, their skills are much in demand and there is already a shortage of trained people here. And, in case you didn't notice, the cost of living is booming and the tide of this boom isn't lifting all boats equally. The show-and-tell set can't mouth about how much money they're making and then expect those without a seat on the gravy train to not want a slurp of the sauce. Besides, the strike vote shows how united the paramedics are in their position. The membership is very unhappy, frustrated over their dough, especially when compared to some other city workers, and peeved about short staffing where some paramedics are on the job upwards to 60 hours a week. The move of Iris to grab the gong and end the show is not going to create too many sobs over at the paramedics union HQ. "They'll do what they do and we'll follow," says Bruce Robb, president of the paramedics union, a man who has been through over a year of back-and-forth blither and blather with the city and still has somehow managed to stay on an even keel. Bruce says they've tried everything to get a deal. Going to a third party for a binding agreement is a gamble but the odds at this table aren't bad. "Shouldn't they have been bargaining rather than building a contingency plan providing half the service or a quarter of the service?" asks Bruce. "We've tried. At some point the employer has to take responsibility. Every once in awhile you have to re-right the balance. This is the day." There is a day to vote for a strike, a day to notify the city and the public of a strike but not a day to go on strike. I guess our paramedics provide us too valuable of service to risk a game of chicken. Hope their value will now be acknowledged. - Calgary Sun.

This is on the Union website... take it as you will. I found it very interesting. BACKGROUNDER FACT SHEET • Calgary Paramedics received their last wage increase in late December 2004. • EMT-A employees are the Crew Members on an ambulance unit. These employees receive 1 ½ years of training with Basic Life Support. Their starting wage rate is $21.96/hour. After 23 years an EMT-A earns $26.70/hour. The annual start wage rate is $47,960. The annual wage rate after 23 years is $58,312. • EMT-P employees are trained in Advance Life Support. This certification requires 3 ½ years of training. The starting wage rate for an EMT-P is 23.74 for an annual wage of $51,848. After 23 years the wage rate for an EMT-P is $30.26 for an annual wage rate of $66,087. • Crew Chief is the employee in charge of the ambulance unit and they are required to be certified EMT-P. The starting wage rate for a Crew Chief is $30.26 per hour. The annual rate is $66,087. After 23 years a Crew Chief earns $33.53 per hour for an annual rate of $73,229. • EMS service in the City of Calgary costs Calgarians $1.81 per month. EMS represents 6% of what the Calgary taxpayer pays for Fire, Police and EMS service. Police service costs taxpayers $16.03 per month and Fire $10.03. • Calgary EMS receives 25% of 911 calls. In 2006 Calgary Police handled 107,152 emergency calls. Fire responded to 35,252 calls. Calgary EMS responded to 95,178 calls. • Calgary EMS has the fewest number of employees in Calgary’s emergency response system. Police handled 68.2 incidents per employee. Fire handled 33 calls per employee. Calgary EMS responded to 190 calls per employee. • A city employee who sends out the ambulance bills to users receives an hourly start rate of $22.05 and achieves their top wage rate of $29.49 after 4 years. • A city employee who cares for sick and injured animals earns $23.48 per hour as a start rate and $31.40 per hour after 4 years. • A city employee who test our drinking water quality is paid $25.01 per hour on hire and $33.44 after 4 years. • A city employee who answers and dispatches 911 emergency calls receives $23.98 as a start rate and $31.76 after 7 years.