Feature Article February 12, 2004
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Kingston Health officials raise flap over ambulance changes
Officials from Kingston General Hospital and the South-eastern Ontario Health Care Network have raised concerns about the Minimum Emergency Coverage (MEC) system that is being implemented by the Land Ambulance Service of the County of Frontenac.
As of February 1st, from Saturdays through Tuesdays, the ambulance service provides non-emergency transfers of patients when doing so will not bring the number of ambulances available to cover the emergency needs of the City of Kingston and Frontenac County below a minimum level. When ambulances are not available, the non-emergency transfers will have to wait until an ambulance can be spared. In the past, transfers were done on demand. Hospitals are complaining that they are being left with patients waiting for transfer home or to other centres, and this is an expensive and inefficient use of their budgets.
The Minimum Emergency Coverage (MEC) System has been in effect on weekends for several months and is slated to go into effect seven days a week by April 1.
While other ambulance services throughout Ontario have been looking into the MEC system in order to improve their emergency service, which is their prime mandate from the province, the County of Frontenac is the first to implement the MEC system.
When contacted, Tom Bedford, Land Ambulances Services co-ordinator for Lennox & Addington County, said that while Lennox & Addington have not yet implemented a minimum emergency coverage plan, they have been apprised of what is being done in Frontenac County, and we are looking at starting down the same path.
Bedford pointed out that in Napanee there is only one ambulance available after 5:00 pm, and when that ambulance is sent on a non-emergency transfer, Napanee is without coverage. An ambulance from Belleville is stationed closer to Napanee in those cases, but there is a detrimental effect on response times.
Its an even bigger issue for Frontenac County, Bedford said, because Kingston General Hospital is the regional hub of the health care system, so the demands for transfers are greater.
The decision by the County of Frontenac to implement the system comes after a year of discussion with the southeastern Ontario District Health Council and the Kingston hospitals, which have repeatedly asked for delays in order to put together a replacement scheme. In early January the Health Council wrote to the County asking for a further delay.
When the matter was considered by County council in mid-January, a report by ambulance services co-ordinator Shawn Carby indicated weekend implementation of the plan had improved emergency response times, and decreased the need to call in outside ambulance services when County ambulances were not available. Since the County ambulance service has been struggling to reduce response times in order to conform to provincially mandated standards, the Council took the staffs advice and began implementation of the MEC system during the week. Implementation was staggered over the winter in what County Chief Administrative Officer Elizabeth Fulton called a final olive branch to the hospitals.
While officials in Kingston are reluctant to blame the County for the move, they are exhorting the province to take back control over the ambulance system, or at least provide more funding.
In the end it would cost the hospitals more money to provide faster non-emergency patient transfers themselves, and they are looking to the province for funding.
In an interview with the Whig Standard, MPP Leona Dombrowsky said the County had looked for a loophole. Its not acceptable to suggest you put these people in a car and drive them over to the hospital, also saying If transfers can happen in other places, I dont know why they cant happen with Frontenac.
When questioned about these comments, a spokesman for Dombrowsky said that the MPP feels this is a municipal matter and the County run Ambulance service should be able to provide emergency coverage and also do the transfers for hospitals as part of its ambulance service.
Central Frontenac Mayor Bill MacDonald, who is also deputy warden of Frontenac County, thinks Dombrowsky must be misinformed. He says the process by which the current system was developed is over a year old, and all the parties, from the Ministry of Health to the Hospitals and the Southeastern Ontario District Health Council have been informed of our plans all along the way. The plan was approved by the Ministry of Health.
The County delayed their plans several times at the request of the Health Council, but each time a plan was expected, none was presented. Eventually we decided to go ahead with the plan. We had to do something to help us decrease response times in emergency situations.
MacDonald also said the Ministry of Health did a study on how to set up a non-emergency transfer system, but that study has never been released.
At this point, the County plans to continue implementing the Minimum Emergency Coverage Plan unless directed differently by the Ministry of Health.
