Alberta takes a step forward.

[rock_shoes]

Thanks Squint. That needed an informed response and I'm just coming off a 3 week stretch in the patch so I really didn't feel like hammering one out. ACoP can't even get its own house in order. Why the hell should they be trusted to set standards for everyone?

[Siffaliss]

ACoP can't even get its own house in order. Why the hell should they be trusted to set standards for everyone?

Sure, however more so from the government.

Should we take a poll on how long it takes for the provincial government to get their hands into regulating as ACP does, providing nobody in EMS here votes in the next election and the current party stays in power?

Edited February 22, 2010 by Siffaliss

[Jamie Hersey]

Tniuqs,

No, I am not living in Saskatchewan, rater I am keeping a close eye on what is happening in Alberta.

I get the feeling that somehow you feel that progression is a bad thing; The sky is falling. I also feel that regardless of how this plays out - good or bad - you view towards management, government, foreign trained doctors, ACoP, or whoever comes along will be the same.

What I press to you is to see the bigger picture. EMS needs to progress does it not? How does this happen? I will give you a hint: You get a national voice, and you support your members. Instead of worrying about all those 'FT MDs' steeling all the jobs, or someone from a Province over, heaven forbid, moving here. You are fighting over what exactly? To keep EMS in Alberta as is? Or to keep people out?

"So I pose a question just how will reciprocity improve Paramedic Standards or Level Care to taxpayers ?"

Simple. People can move where they want and seek work that they want. People will vote with their feet. If you don't like where you are, well then move to someplace else. Take a look at nursing for example. An individual can work across Canada, the US, or abroad, yet you still see RNs working in small towns, or wherever. Did the law of supply and demand suddenly pop up and mess things up? No, now employers have to offer and compete for employees. Call it economics 101. If I get the gist of your posting what you are advocating for is security and barriers. What you are actually getting is a monopoly or creating a small market - the EMS employees of Alberta - within a larger market (Canada). I hope you see my point. An open market gives the freedom to the individual and the closed market doesn't.

My previous example of the northern ambulance service demonstrates this perfectly. Why changes as next month there will be a new batch of EMTs with nowhere else to go. Who has the power in that situation, and how would perpetuating such a system improve EMS? That is what I am after here.

If medics are quitting in droves, like you say, then we will soon find out as then employers will have to make additional offers to 'attract' employees. See my point? If they can't seek employment elsewhere then what?

[tniuqs]

='Jamie Hersey' date='22 February 2010 - 11:36 AM' timestamp='1266863799' post='236629']

Tniuqs,

Then just where do you reside and provide services ?

Firstly this is NOT progression in the slightest, in the way they are proposing.

I suspect you are not aware of that EMS is quite litreally under siege in BC and AB, with AHS takeover (cost control only) Dictation to EMS providers by government as to what union is to represent them (divide and concur technique)and now entities in Federal levels that have no true interest in our profession in the slightest an feel to fund where "they" feel fit and really have no understanding of what Paramedics actually do, simply stated any MD and just dropping into a slot on car from wherever is not doing anything positive for our profession. This when needs assessment has not been considered (things have changed in the last year) As I have quite clearly stated before that having ACoP "selected" without due process is shameful and closed door politics. Knowing full well the history of this the old boys/girls club and the lack of any forward thinking or proven experience to advance our profession (ps their present exam question banks are not based on evidence based medicine and need a huge overhaul before even considering that they should regulate or examine on a National level) This when their are bona fide experts in these areas that are NOT going to be included in this process ... good lord can you not see that this is being thrust upon the Profession and fast tracked ... my suggestion is whoa nelly lets put a bridle on the horse before we open the chute.

What I suggest is you do some serious Canadian EMS history homework look to the names of the real leaders that initially developed the NOCP and oddly enough they vast majority of these leaders do NOT work or reside in Alberta. I believe that your sir are not seeing the long term ramifications or bigger picture as your being duped. ACoP stands to increase its funding to develop exams and then as a "product" market this ...if you can't see this your blind ... its about the money only.

I am ALL for a national voice I have been screaming about this for YEARS ! Maybe 200 posts on this topic alone, but a tempered, experienced, educated, voices directed by those with the proven history to be an advocate for the profession, not just regulate ...sheesh ! ACoP has not yet made any attempt to clearly identify or even define the CCP level to start with and exactly what huge steps to advance EMS in Alberta has ACoP done in say the last 7 years (well besides council establishing clearly they can overthrow any voted mandate ... because the Lawyer said they can!)

"So I pose a question just how will reciprocity improve Paramedic Standards or Level Care to taxpayers ?"

Nonsense its not that simplistic and you did not answer the question in the first place,people in Canada are free to move anywhere they want too ... working to specific standards and qualifying is the real question !

The AIT agreement was a legislated and signed document by the provinces to decrease trade barriers, best read the entire document first and foremost please. This is not clearly a one way street the destination being the very lucrative Oil-Patch industry in Northern BC and Alberta. So tell me it is't so and I have 30 'medics' and names doing just that, this very minute. Those that have actually gone through the process of reciprocity and we are richer for this in some ways, but damn near none are working on the Streets of Alberta PERIOD! but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?

Are we talking whats best for the profession of Paramedicine or a market place, Health Care in Canada is NOT a marketplace we as Canadians are recognized because of high standards in Health Care it is part and parcel of our world wide identity.

Better yet drop the market crap (is getting saturated already) and the gist of my post is assuring standards, not drop them to suit a market place. I am fighting for improving standards(as this is what it will amount too) and believe it or not this IS the real agenda.

With an economic melt down, your wrong people are voting with their pocketbook's the vast majority do not want to leave their home and family (thats human nature in fact)its quite sad in fact, that many believing the propaganda that the grass is greener or move to a land of milk and honey to find out that the grass is NOT greener and the honey is all gone. Then to go home with even more empty pocketbooks.

To be so naive to believe that there is no protection in place in any industry is absurdity try getting reciprocity as an ACP in BC and THEN get hired .... Bhwaa haa ha your kidding right ?

I AM advocating that this reciprocity deal is extremely complex and should not be fast tracked it is a very poor idea to try to do a quick fix, especially when the entire profession is at stake GO SLOWLY. Just what is the rush really ? Other than watch the governments cave into multinational corporate whims this intuitive is NOT about advancing our profession in the slightest, what amazes me is you can not see this.

RN reciprocity ... again best look again Health Standards are different in every province your not informed at all.

My previous example of the northern ambulance service demonstrates this perfectly. Why changes as next month there will be a new batch of EMTs with nowhere else to go. Who has the power in that situation, and how would perpetuating such a system improve EMS? That is what I am after here.

Or the next bunch of Grad EMT, so just how does this example equate somehow to national standards this is part of the "turd" way that AHS is perpetuating. This is the reality in AB presently this is where one gets a start (do I like it NO) but just how reciprocity will assist to solve this problem beyond me.

If medics are quitting in droves, like you say, then we will soon find out as then employers will have to make additional offers to 'attract' employees. See my point? If they can't seek employment elsewhere then what?

I did not say droves I said they were QUITING with this new delivery (to hell with the staff) because this is a better way ... meh. Those individuals (this is really a different topic) are leaving the new improved ABS EMS and orcastrated by "transition" and trial and error tactics ... who looses here really ?

Edited February 23, 2010 by tniuqs

[DartmouthDave]

Hello,

"The AIT agreement was a legislated and signed document by the provinces to decrease trade barriers, best read the entire document first and foremost please. This is not clearly a one way street the destination being the very lucrative Oil-Patch industry in Northern BC and Alberta. So tell me it is't so and I have 30 'medics' and names doing just that, this very minute. Those that have actually gone through the process of reciprocity and we are richer for this in some ways, but damn near none are working on the Streets of Alberta PERIOD! but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?"

Who cares if Paramedics come from outside of Alberta to work in the oil patch? If they do not want to work in the 'streets' and go for the easy cash of sitting on an oil lease....so be it. That is their choice. They are professionals with needed skills. Therefore, the can work with whomeven they want. IMHO.

The same goes for schools. If a student wants to go to SAIT as opposed to SIAST....again who cares. If they are accepted by the school and meet the schools standards I do not see the issue.

As for EMS in Alberta and BC being under siege. I can not comment on Alberta at the moment. But, BC I agree in many ways. Labour issues. Part of the transfer budget has been given to the health authority. Rumbling about moving EMS and transfer services to health authorities as well.

I guess....time will tell how things play out.

Tniups. It is obvious that you are passionate about this issue and have strong ideas. This is a good thing. Have you consider trying to develop a political solution? Work with a union? Develop a group to promote EMS in your area? Get your views in the press?

So, get involved in this process of change. Look at the good example of EMS in Canada (EHS NS...Provinical System) and ones that becoming somethings better (Eastern Health...ACP for St John's and new flight service...a Health Authority System).

Cheers

[tniuqs]

Hello,

I will not get into depth, but the field of remote medical care IS indeed a very specialized area and an intimate knowledge of the local health care systems is mandatory to provide optimal care. Just throwing buddy in an MTC, off a plane that was just practicing in a urban area only, is asking for problems, I have witnessed this numerous times.

Dave have you ever heard of DIPROM the University of Edinburgh the Diploma of Remote and Offshore Medicine ? This is specialized field and I know ACoP nor any present regulatory body has no idea nor in fact have any standards or been even considered, tell me I am wrong please as this area of Paramedicine we are so so far behind in Canada.

For consideration to open some eyes ... using a slit lamp the use of Tetracaine, temporary tooth fillings, delivering IV antibiotics for a celulitis (or do you call in a helo ?) or use oral antibiotics for a suspected strep throat ... do you take buddy off work or send him back with an ear infection .... I will stop just so many areas that most ACP have no background or education at all.

Here is why it matters, the most its the present taxation laws, so buddy from wherever commutes and when he files his taxes (in his/her province of residence) the income tax earned then goes into THAT provinces coffer's even though the income is not earned there. But herein lies the problem, that individual is using the infrastructure of hospital, the roads and the like, not contributing to the very province that is providing employment. Its not a matter who or where they are from ... but the tax money goes someplace else --> hence the reason why with the massive amount of transient workers (in this example) Alberta has lost out and now has become a have not province.

The NWT on the other hand mandates that a 2% additional employment tax stays and support that territory. Bottom line transient employees do not financial contribute to that community, yet Alberta is financially retarded !

Another point in the EMS industrial aspect is this is 'considered' private health care AND there is a continual revolving door with staff, absolutely no job security when multinationals companies can hire at a lower wage, and very dependent on boom or bust, this is not an answer in the slightest to promote Paramedicine. Besides just complain once to an Industrial (purely for profit margin) Employer that you are missing this or that vital piece of gear and your replaced in a new york heartbeat, so typically the "new guy" keeps his mouth shut or in fact lives in fear of getting "skidded" so in the end this undercutting ends up with poor standards and crap for gear. Yea Industrial Paramedicine !

A most excellent point and glad you brought it up, so if a CMA approved program has the same criteria and in education stanards and teaches the same scope of practice. So why then if that student graduates do we even need to do more "exam testing" why does a regulatory body need to do this (don't answer its a cash grab)besides does provincial licencing really assure anything except the academic portion ? Now throw in very ancient ACoP exam banks and you may see why I am so concerned for the future.

I propose to you that employers from wherever would hire a grad from one school or another, so then the "product student" of that school in either success or failure with that employer. This would in itself eliminate the less than stellar programs this would be an most excellent way to police the institutes. But wait a minute just where are the experienced educators in this master plan of reciprocity nationally ... I would think they should be a HUGE player in this goal.

Under siege to the point where many AB new Grads are looking to relocate to areas of less bull shit and more far more security ... oh be very careful the rest of Canada as AB medics may be looking to take others jobs away too ... just saying Alberta punches out with the private schools far more grads a year than any other province. Now add in the non CMA approved Bresdin Institute curiously funded by the very same Government ministry that is funding a Reciprocity Agreement ... How many times do I have to say this ... there's something damn phishy here !

I for one will not take the apathetic approach of watch and wait I am way too old and a personal sebatical from involvement of ACoP set me reeling when I did open my eyes .... So I dare to challenge the current status quo of mediocrity that I presently observe.

OK te he he ... if one believes I sit back and just write on EMS forums ... Bhawaa haa ha on you !

But Union NO way this polarizes in public perception alone with the goal of promoting standards and the advancing the profession but yes one can associate and include, but serious error put just one hat on, hey just look at BC. There is a group already established (to ADVANCE the Profession, lobby government federally and have been the most successful group in our very short PmHx) but because of a most serious lack of inclusion by Immigration Economic Development Canada of that group and then deciding arbitrarily on ACoP ... again there is something damn phishy ... Dave YOU should be asking questions yourself and if YOU believe ACoP will be of any assistance for your area ... the Yukon ... do you have any representation going to the first talks in Montreal ?

BTW do you remember where you met me ... LOL.

In any democratic culture a strong opposition is essential to keep governments honest. Assuming anything on the internet is folly, the pen is truly mightier than any sword, but timed political strategy moves are essential to accomplish any goal, as always stay tuned to this channel.

Cheers

[Jamie Hersey]

"Nonsense its not that simplistic and you did not answer the question in the first place,people in Canada are free to move anywhere they want too ... working to specific standards and qualifying is the real question !"

Yes, it is that simplistic, and I do believe I answered the question, but just for clarification here it is again: If you can work in Canada, then you have the right to work wherever you want, in whatever setting you want. If that ability to work is based on a national standard even better.

Right now we are just on the cusp of realizing this vision. The AIT is the first step in this. After all, how can we be considered a profession if we cannot define what that is beyond demographic boundaries?

The next step beyond that, and perhaps it should be left to a future discussion, is getting EMS integrated with the healthcare system. Patient care is not just one episode. I see alignment with the healthcare system as key to this. Alignment with health authorities will aid in this, but let's stay with the issues at hand, and the discussion here before introducing this.

"The AIT agreement was a legislated and signed document by the provinces to decrease trade barriers, best read the entire document first and foremost please. This is not clearly a one way street the destination being the very lucrative Oil-Patch industry in Northern BC and Alberta. So tell me it is't so and I have 30 'medics' and names doing just that, this very minute. Those that have actually gone through the process of reciprocity and we are richer for this in some ways, but damn near none are working on the Streets of Alberta PERIOD! but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?"

Thank you for making my point again. I am familiar with the document. Yes, that is the exact purpose to the AIT, and if people are doing just that, then fine. They are members of our profession and they can work wherever they want doing whatever they want. That is the very purpose of the AIT. People in a profession can work in a variety of setting - it is their choice - and as professionals it is not our place to judge some else's practice.

As for your comment at the end. I am not sure if I follow. Could you please clarify? If I remember correctly you seem upset at the prospect of foreign trained MDs getting re-trained as paramedics citing the cost to tax payers, but here you seem to be suggesting that if an individual wants to work in a province they are to train and only work in that province? That seems wasteful doesn't it?

"Are we talking whats best for the profession of Paramedicine or a market place, Health Care in Canada is NOT a marketplace we as Canadians are recognized because of high standards in Health Care it is part and parcel of our world wide identity."

"Better yet drop the market crap (is getting saturated already) and the gist of my post is assuring standards, not drop them to suit a market place. I am fighting for improving standards(as this is what it will amount too) and believe it or not this IS the real agenda." <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

Ok, so let me get this straight: you are arguing that healthcare is not a marketplace, yet you counter that the market is saturated. To me it sounds like you are worried that the supply is up without a commensurate increase in demand. If I may speculate, and read between the lines, you are saying that because of this you are worried that income will drop. No wait, I forgot economics doesn't apply to healthcare... For the record I was talking about the economics of healthcare - someone has to pay for it do they not? As for fighting to improve standards wouldn't a national standard do that?

"but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?"

"..I am fighting for improving standards(as this is what it will amount too) and believe it or not this IS the real agenda..."

To me it still sounds like you are saying let's elevate things unless it impacts on me. Correct me if I am wrong.

"Here is why it matters, the most its the present taxation laws, so buddy from wherever commutes and when he files his taxes (in his/her province of residence) the income tax earned then goes into THAT provinces coffer's even though the income is not earned there. But herein lies the problem, that individual is using the infrastructure of hospital, the roads and the like, not contributing to the very province that is providing employment. Its not a matter who or where they are from ... but the tax money goes someplace else --> hence the reason why with the massive amount of transient workers (in this example) Alberta has lost out and now has become a have not province."

No, that is incorrect. Income tax goes to the federal government, then they use something called transfer payments to send the money back to the provinces. To be specific to healthcare this is regulated by the Hearth Care Act which provides all provinces with money to run their healthcare system. The province can also charge residents additional fees if they wish.

As for out of province residents who visit a hospital they get a bill sent to their provincial healthcare authority. Federal employees have their own plan (DND & RCMP for example). The territories are handled directly by the federal government. So typically everything is covered except ambulance trips to the hospital, sometimes inter-facility and air ambulance is covered, but for most it is not.

As for provincial taxation of income, you are correct that does go back to the host province.

Sales tax goes to the province. GST to the feds.

But enough on tax regulations.

I see your point though. Who likes a boom town? I think living in a dying town because the pulp mill closed would be much better, or perhaps a east cost fishing village. That's right look at that nice stable tax base. None of that mad money boom town crap...

"With an economic melt down, your wrong people are voting with their pocketbook's the vast majority do not want to leave their home and family (thats human nature in fact)its quite sad in fact, that many believing the propaganda that the grass is greener or move to a land of milk and honey to find out that the grass is NOT greener and the honey is all gone. Then to go home with even more empty pocketbooks."

"Under siege to the point where many AB new Grads are looking to relocate to areas of less bull shit and more far more security ... oh be very careful the rest of Canada as AB medics may be looking to take others jobs away too ... just saying Alberta punches out with the private schools far more grads a year than any other province. Now add in the non CMA approved Bresdin Institute curiously funded by the very same Government ministry that is funding a Reciprocity Agreement ... How many times do I have to say this ... there's something damn phishy here !"

How can that be? Don't you know 30 medic who came to work in the patch? Ok, I get it now, it is just those poor hold outs suffering on the homestead. You missed my point about the grass being greener. What I was saying is if you 'field' is big then overgrazing is not an issue. Does that analogy work? Small fields - or individual provinces - are subject to variability and the potential for sudden change (microeconomics - as proven by your worries regarding all these medics 'flooding' the market) vs. a large 'field' being a country (Canada) can promote stability (macroeconomics) by responding to gradual trends.

"To be so naive to believe that there is no protection in place in any industry is absurdity try getting reciprocity as an ACP in BC and THEN get hired .... Bhwaa haa ha your kidding right ?"

Oh good, then we agree protectionism is an issue. Can we also agree it is bad even if it is not in your favor? By the way, BCAS is hiring ACPs from outside BC. I know of four. Considering how small ALS is in BC that is a significant number.

"I AM advocating that this reciprocity deal is extremely complex and should not be fast tracked it is a very poor idea to try to do a quick fix, especially when the entire profession is at stake GO SLOWLY. Just what is the rush really ? Other than watch the governments cave into multinational corporate whims this intuitive is NOT about advancing our profession in the slightest, what amazes me is you can not see this."

Multinational corporate whims. Really? Don't worry healthcare is not a business. Ok, ok I couldn't resist that one. No, what is at stake is the status quos. Getting EMS to one standard is not some epic all we need to do is take the first step. EMS work is, for the most part, homogenous is it not? An ambulance is set to Hastings & Main, and the patient is taken to SPH; An ambulance is set to Portland St., and a patient is taken to the Dartmouth General; or an ambulance is sent to Whyte Ave & 106st in Edmonton, and the patient is taken to UofA. What is vastly different about those calls, and if so, where lays in the complexity?

"RN reciprocity ... again best look again Health Standards are different in every province your not informed at all."

Yes, it is that easy. Perhaps I could get my friend to answer that one... Hmmm, where is she now? Was it the Yukon? Nope she gave up their job and moved to Vancouver. No, that was two years ago, and now she is in Calgary, via Australia and NZ. Imagine not just being able to move between provincial boundaries, but international ones also?

"Or the next bunch of Grad EMT, so just how does this example equate somehow to national standards this is part of the "turd" way that AHS is perpetuating. This is the reality in AB presently this is where one gets a start (do I like it NO) but just how reciprocity will assist to solve this problem beyond me. "

Yep, you got me on that one. The AIT can't get new medics experience. Perhaps work experience and mentorship could help? Just an idea.

"...have you ever heard of DIPROM the University of Edinburgh the Diploma of Remote and Offshore Medicine ? This is specialized field and I know ACoP nor any present regulatory body has no idea nor in fact have any standards or been even considered, tell me I am wrong please as this area of Paramedicine we are so so far behind in Canada."

It is a great program. Are you going for the full diploma or just the certificate? What did you pick as your electives? Great, extended education is something a profession needs, but let's try to sort out the basics first shall we.

[tniuqs]

I should state before I continue in this debate that I did hit send before pre-reading and the comments were a rough draught and this rather large oilfield bed truck was bearing down on me, so apology for lack of clarity. SEND became a safety issue. I will proceed and continue to debate just why IMHO it is folly to proceed with a few provincial regulatory body's to head up and set standards for the entire country.

More preamble: I should mention that EMT City is not only a great way to communicate but a most excellent means of blowing off steam ... as the membership clearly understands this from more than 1800 posts I have made that my on screen persona, as my personal opinion changes substantially when I have positive input as a professional I try educate myself to current dynamic situations, some professionals forward good tangible information and others prefer to use a rolled up newspaper on a puppy ... that does not result in myself cowering in a corner like a beaten dog (just saying) many times the concept of literary licence is implemented to bring attention topics dear to myself and are generally intended to stimulate an active constructive dialog. But some readers / voyeurs are challenged by the concepts of figurative vs literal, I applaud RUFFUMS to recognize that I was yanking his chain to get a response ... as I do respect his onion being a turnip.

I must bring to the readers attention the term POSTAL that I had used prior ... being a true pacifist and a member of Amnesty International this a very successful modus operandi/tool and implemented for great success in other unrelated to EMS letter writing campaigns. enough said back to the thread at hand.

Jamie Hersey' date='25 February 2010 - 12:55 PM' timestamp='1267124102' post='236876']

"Nonsense its not that simplistic and you did not answer the question in the first place,people in Canada are free to move anywhere they want too ... working to specific standards and qualifying is the real question.

Yes, it is that simplistic, and I do believe I answered the question, but just for clarification here it is again: If you can work in Canada, then you have the right to work wherever you want, in whatever setting you want. If that ability to work is based on a national standard even better.

There is nothing simplistic other than the concept of labour mobility, the most serious question remains is the Profession of Paramedicine actually labour or a true Profession and once again as we all know that HEALTH is a Provincial mandate under the Canada Health Act "guidelines" then interpreted by the Provinces. So taking that one baby step further look at the huge level in delivery of Pre Hospital Care standards as some provinces have very high standards and others do not. If we look to a bell curve do you honestly believe that most provinces/ territories will come up in higher educational standards or that the math/ economics of the situation will dictate a lower level of qualification ... if one would believe that standards will rise ... IMHO I know this will not be the case.

That said ACoP is really an unofficial arm of the AB government and must follow the regulations set forth under legislation, legislation changes almost overnight here proof in point: http://www.health.alberta.ca/services/EHS-legislation.html

Now that is IF the current conservative government in AB survives the next election, their is much malcontent and it appears that the topic of Health is top of the political heap of problems right now. Following my fuzzy logic does one wish for what we have right now in EMS in AB under the direction of AHS like for the rest of Canada ?

Right now we are just on the cusp of realizing this vision. The AIT is the first step in this. After all, how can we be considered a profession if we cannot define what that is beyond demographic boundaries?

I would disagree its not a cusp its now a back molar with the compliant regulatory body's provincially ... I personally have observed that their IS a process to gain licensure BUT employment is very dubious based on the multiple entities .. and just today this announcement by the BC government. http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=4900475d-7b4b-4f49-9927-e18632fdf1e2&k=37713

It appears that Comrade Campbell is now following the AB lead ... possibly introducing even more opportunities to promote a "EMS private delivery service model".

The next step beyond that, and perhaps it should be left to a future discussion, is getting EMS integrated with the healthcare system. Patient care is not just one episode. I see alignment with the healthcare system as key to this. Alignment with health authorities will aid in this, but let's stay with the issues at hand, and the discussion here before introducing this.

Oh I do agree, but another question in these harsh economic times, is restructuring during economic downturn is cost cutting or very expensive (check out AB Health Care budget)and could this just (as we have seen in AB) a means to Union Busting ?

http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=4900475d-7b4b-4f49-9927-e18632fdf1e2&k=37713

"The AIT agreement was a legislated and signed document by the provinces to decrease trade barriers, best read the entire document first and foremost please. This is not clearly a one way street the destination being the very lucrative Oil-Patch industry in Northern BC and Alberta. So tell me it is't so and I have 30 'medics' and names doing just that, this very minute. Those that have actually gone through the process of reciprocity and we are richer for this in some ways, but damn near none are working on the Streets of Alberta PERIOD! but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?"

Thank you for making my point again. I am familiar with the document. Yes, that is the exact purpose to the AIT, and if people are doing just that, then fine. They are members of our profession and they can work wherever they want doing whatever they want. That is the very purpose of the AIT. People in a profession can work in a variety of setting - it is their choice - and as professionals it is not our place to judge some else's practice.

Is it fine well then perhaps I should do the same, live in AB and work in BC or SK the present AB conservative is quite concerned in residency now, and I do have responses in hand from AB Labour Minister in that regard.

The Back Door approach:

Just a recent observation, BC will now accept the US REMT-P registry and grant licensure. Now with AIT agreement then allow's that individual to challenge the AB exams ... taking 3 writes to eventually pass and then go on to work in Oil Patch. To then reside in lands far away with (and admitted by that individual to never to work in the public system) It appears this back door approach is very effective means of just working the system, with absolutely no intent of contributing to Canadian society ... Is this the professionalism you are referring too ?

As for your comment at the end. I am not sure if I follow. Could you please clarify? If I remember correctly you seem upset at the prospect of foreign trained MDs getting re-trained as paramedics citing the cost to tax payers, but here you seem to be suggesting that if an individual wants to work in a province they are to train and only work in that province? That seems wasteful doesn't it?

Two questions there:

COPR

The funding targets three prinicpal areas:

the creation of common scopes of practice (national)

the creation of a national examination, and

the creation of a process to evaluate foreign Paramedic graduates.

"Are we talking whats best for the profession of Paramedicine or a market place, Health Care in Canada is NOT a marketplace we as Canadians are recognized because of high standards in Health Care it is part and parcel of our world wide identity."

A better question is should Standards be sacrificed based on the "marketplace" ?

May I dare say I am favor of the first 2 objectives but the stakeholders are not JUST the regulatory Body's as they most obvious now biased because of Government involvement and at the mercy of the government whim of the day to further that parties objectives ie retaining political power.

The best thing for the Profession is the participation of each and every member, and not just my tiny voice in the wilderness as the Profession is currently under siege in standards as the term "barriers" are not artificial they are realistic tangible STANDARDS.

Ok, so let me get this straight: you are arguing that healthcare is not a marketplace, yet you counter that the market is saturated. To me it sounds like you are worried that the supply is up without a commensurate increase in demand. If I may speculate, and read between the lines, you are saying that because of this you are worried that income will drop. No wait, I forgot economics doesn't apply to healthcare... For the record I was talking about the economics of healthcare - someone has to pay for it do they not? As for fighting to improve standards wouldn't a national standard do that?

Are there any assurances that the highest common denominator will win out ? ACoP approve no AHC approved increase in scope and other members of this board will agree with the least amount of Education .. could this be the way that we will follow in the future more toys in the kit ? To that end I will prove there are no artificial barriers, coming from a CMA approved program.

"..I am fighting for improving standards(as this is what it will amount too) and believe it or not this IS the real agenda..."

To me it still sounds like you are saying let's elevate things unless it impacts on me. Correct me if I am wrong.

Firstly this does directly impact on my life.

Correction from poorly written above statement: I am fighting for improving standards, inclusive of 3 areas yet to be addressed and I believe the future of Paramedicine:

Critical Care Paramedic the definition and scope of Practice.

Remote Practice and Clinic Paramedic the definition and scope of Practice.

Wilderness EMT/PCP endorsements(ie Ski Patrollers, Mtn Guides, and remote and austere settings)

Lets get these clearly identified before we proceed shall we ?

Perhaps this Economic Development grant would better be served by funding Education for present and future Paramedics to improve levels of care to the community, instead of supporting other programs that favor those that have yet to become citizens of Canada, you know like helping Canadians better themselves before importing workers for big industry and then exploit them ?

Harsh economic times should have some influence or would some believe to foster the economic myth that Canada is a bottomless pit of support to the rest of the World ?

ie Charity begins at Home or so the saying goes ... the USA does not hand out "Green Cards" willy nilly so why should Canada ?

"Here is why it matters, the most its the present taxation laws, so buddy from wherever commutes and when he files his taxes (in his/her province of residence) the income tax earned then goes into THAT provinces coffer's even though the income is not earned there. But herein lies the problem, that individual is using the infrastructure of hospital, the roads and the like, not contributing to the very province that is providing employment. Its not a matter who or where they are from ... but the tax money goes someplace else --> hence the reason why with the massive amount of transient workers (in this example) Alberta has lost out and now has become a have not province."

No, that is incorrect. Income tax goes to the federal government, then they use something called transfer payments to send the money back to the provinces. To be specific to healthcare this is regulated by the Hearth Care Act which provides all provinces with money to run their healthcare system. The province can also charge residents additional fees if they wish.

Your understanding of taxation laws is delinquent, and you have complicated with provincial agreements in reguards to health. So perhaps go to the local post office and take another look at the General Form, and look to the very major recent controversy about transfer payments to AB. In the past economic history ALBERTA has paid far more than there fair share and has supported CANADA ... when the shoe changed feet ... well best do your homework is all I will say at this juncture .

cheers and to be continued

Edited March 15, 2010 by tniuqs

[rock_shoes]

I should state before I continue in this debate that I did hit send before pre-reading and the comments were a rough draught and this rather large oilfield bed truck was bearing down on me, so apology for lack of clarity. SEND became a safety issue. I will proceed and continue to debate just why IMHO it is folly to proceed with a few provincial regulatory body's to head up and set standards for the entire country.

You weren’t typing and driving were you ? Crashing an ambulance is way too much paperwork for my liking.

There is nothing simplistic other than the concept of labour mobility, the most serious question remains is the Profession of Paramedicine actually labour or a true Profession and once again as we all know that HEALTH is a Provincial mandate under the Canada Health Act "guidelines" then interpreted by the Provinces. So taking that one baby step further look at the huge level in delivery of Pre Hospital Care standards as some provinces have very high standards and others do not. If we look to a bell curve do you honestly believe that most provinces/ territories will come up in higher educational standards or that the math/ economics of the situation will dictate a lower level of qualification ... if one would believe that standards will rise ... IMHO I know this will not be the case.

In most ways being a paramedic has traditionally been a labour job. As we “grow-up” amongst the better established professions we are experiencing some serious growing pains. Not the least of which is carving out what exactly our role is within the healthcare system. It’s kind of like the three ghosts visiting old Ebenezer Scrooge in the Charles Dickens novel “A Christmas Carol”. What was, what is, and what will be, must all be addressed in their own due course. We cannot change what has already come to pass, but we can learn from it and adjust what we do now accordingly. If we don’t none of us are going to like the future result. Everyone must ask themselves the question. Do you want to direct the course of your profession as others have done or are you content with the status quo? Personally I’m not even remotely happy with the status quo. A responsible profession directs the course of its own development. Because ACoP hasn’t the mandate to represent paramedics nationally, and because ACoP has failed to implement true self regulation even within the borders of its own jurisdiction, I cannot in good conscience support their move to set national standards.

That said ACoP is really an unofficial arm of the AB government and must follow the regulations set forth under legislation, legislation changes almost overnight here proof in point: http://www.health.alberta.ca/services/EHS-legislation.html

This is one of the greatest problems arising from ACoP’s apparent appointment. Since when is it even remotely acceptable for a single provincial government to potentially dictate what’s done nationwide? I think I can hear the yelling and screaming out of Ontario and the Maritimes from here.

I would disagree its not a cusp its now a back molar with the compliant regulatory body's provincially ... I personally have observed that their IS a process to gain licensure BUT employment is very dubious based on the multiple entities .. and just today this announcement by the BC government. http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=4900475d-7b4b-4f49-9927-e18632fdf1e2&k=37713

Honestly Squint, everyone is still scratching their heads trying to figure out what all of the implications are. I don’t think Campbell even knows what they all are. Sometimes I think Campbell’s plan is to throw everything into such turmoil we’ll still be sorting things out when the next election arrives.

It appears that Comrade Campbell is now following the AB lead ... possibly introducing even more opportunities to promote a "EMS private delivery service model".

That was his plan from the beginning. Moving BCAS into the Provincial Health Services Authority allows him to do it without getting his hands dirty. Within the PHSA BCAS is one step further from the government allowing all of the blame for privatisation to be placed on the PHSA instead of directly on the government where it belongs. It’s all been a giant ploy to distract the public from the truth.

"The AIT agreement was a legislated and signed document by the provinces to decrease trade barriers, best read the entire document first and foremost please. This is not clearly a one way street the destination being the very lucrative Oil-Patch industry in Northern BC and Alberta. So tell me it is't so and I have 30 'medics' and names doing just that, this very minute. Those that have actually gone through the process of reciprocity and we are richer for this in some ways, but damn near none are working on the Streets of Alberta PERIOD! but yet again your duped into believing there is not already avenues open ... say like taking a program in that province ?"

Holy western alienation batman! I can’t really say anything more about it other than yep!

The Back Door approach:

Just a recent observation, BC will now accept the US REMT-P registry and grant licensure. Now with AIT agreement then allow's that individual to challenge the AB exams ... taking 3 writes to eventually pass and then go on to work in Oil Patch. To then reside in lands far away with (and admitted by that individual to never to work in the public system) It appears this back door approach is very effective means of just working the system, with absolutely no intent of contributing to Canadian society ... Is this the professionalism you are referring too ?

All I can say is this never would have happened prior to AIT. In the past BC EMA licensing has been the strictest, least forgiving governing body in Canadian EMS. AIT has turned out to be a true “Cart before the horse” disaster in some instances. Shouldn’t everyone be held to a national standard prior to shipping them across the nation?

the creation of common scopes of practice (national)

Trying to think of who might have already done all the ground work for this several years ago. Oh yah that would be the PAC. You know the group of paramedics from across Canada that set forth the standards to which all CMA accredited programs are held. Squint and I keep saying this over and over again. When are people going to wake up!

the creation of a national examination, and

I don’t think the creation of a national exam is anywhere near the top of the priority list. If a student passes a program held to national educational standards, successful completion of that program should actually be sufficient demonstration of that student’s competency. If successful completion of a program of study is not sufficient that program of study has failed to meet the standard which is a direct indication that program oversight has failed in its mandate. To me requiring a separate national examination would be a demonstration that we have failed to hold educators to the set standard. That would be a critical failure. The only reason for a national exam in the short term is to level the playing field for those of us in practise prior to national standardisation.

the creation of a process to evaluate foreign Paramedic graduates.

I know you agree with me Squint in saying we should look to our own first. If we are expecting a shortage within a particular group of skilled workers we should be taking steps to ensure enough Canadian citizens are educated in that field. Coming up with creative ways to plunder skilled workers from other countries is not in our best interest. All of us know such an evaluation would be a lowest common denominator process resulting in the acceptance of out of country “Medic Mill” ALS attendants. We don’t have that now so why the hell should we move to that? To the person who came up with this idea I must say. Don’t piss in the wind and tell me it’s raining!

Edited March 16, 2010 by rock_shoes

[rock_shoes]

A better question is should Standards be sacrificed based on the "marketplace" ?

Hell no. Paramedicine is a profession in which standards should dictate the marketplace. Not vice versa.

The best thing for the Profession is the participation of each and every member, and not just my tiny voice in the wilderness as the Profession is currently under siege in standards as the term "barriers" are not artificial they are realistic tangible STANDARDS.

Exactly.

Are there any assurances that the highest common denominator will win out ?

Not with ACoP or any of the current regulatory bodies at the helm. There are far too many interests other than those of paramedics at play within the current regulatory bodies. Just one of many reasons the PAC has my vote.

Firstly this does directly impact on my life.

Correction from poorly written above statement: I am fighting for improving standards, inclusive of 3 areas yet to be addressed and I believe the future of Paramedicine:

Critical Care Paramedic the definition and scope of Practice.

Remote Practice and Clinic Paramedic the definition and scope of Practice.

Wilderness EMT/PCP endorsements(ie Ski Patrollers, Mtn Guides, and remote and austere settings)

Lets get these clearly identified before we proceed shall we ?

Agreed. I think perhaps we should leave discussion of these definitions to another thread. This post is already becoming quite lengthy and I know both of us have much to say on the topic of these definitions in particular.