Wait times for an ambulance in Quebec 'unacceptable,' says health minister

Quebec's Health Minister Christian Dube says wait times for ambulances in the province are "unacceptable" and an action plan is coming to improve access in the coming days.

Dube was responding to an investigation in le Journal de Montreal that found nearly 85 per cent of municipalities in Quebec are unable to provide an ambulance in the required time to an urgent 911 call.

"We cannot compromise on patient safety," Dube wrote on X. "Ambulance coverage must be adapted to the reality of each territory. Each establishment must assess its needs and let us know so that we can make the necessary adjustments."

Hal Newman runs The Last Ambulance, a website that monitors and reports on the emergency hospital care system. He said the numbers were unsurprising and have been a fact in the industry for years.

He said for a priority three urgent condition call (chest pain, serious bleeding, broken hip, etc.) in Montreal on Saturday, the wait time is 96 minutes.

"Of course, when we say someone's a lower priority, that's in theory, right," Newman told CTV News, noting that there were 12 calls waiting during the interview. "So as a paramedic, you may arrive and someone who's [had a] possible hip fracture, they may have underlying reasons as to why they fell. They might be having a diabetic emergency, they might have had a stroke, and just lying on the floor for 90 minutes."

For a priority four, less urgent condition call (sprain, urinary infection etc.), the wait time is over 13 hours.

The federation of Quebec paramedics (FCPQ) said in a news release on Saturday that "response times are putting a great deal of pressure on ambulance cooperatives and their paramedics, who are already fully dedicated, through their profession, to responding adequately to urgent requests."

The FCPQ represents 1,500 paramedics and auxiliary workers and is responsible for 37 per cent of pre-hospital transports in Quebec.

The federation said that paramedic cooperatives respond to calls based on a deployment plan drawn up by regional and provincial authorities. The plan, the federation said, estimates demand and sets strict guidelines, including the number of ambulances on the road and wait times for them.

"Even though many of the factors causing response times are a direct result of the deployment plan, we make it a point of honour to be in solutions mode to improve the situation in the regions where we operate," said FCPQ president Philip Girouard.

Work-life balance crisis

Girouard said the federation has already presented proposals to public authorities to improve response times. A major issue, he said, is erratic and demanding schedules that are unsustainable.

"We are calling for the stabilization of additions of hours that recur on a recurring basis in a territory in order to meet the needs of the population, the introduction of rapid response vehicles, the promotion of advanced care, the practice of community paramedicine, and many other cooperative initiatives that stem from our partnership with the Health and Social Services ministry," said Girouard.

The federation wants to limit "one-off additions that occur on a regular basis" and improve paramedics' work-life balance.

Newman said work-life balance is a primary grievance of the hundreds of paramedics he's spoken to.

"It's the schedules," said the retired paramedic. "We're investing three years in training paramedics, then we want to keep them for as long as we can, but if we give them zero work-life balance, how are they supposed to? How are we supposed to have young families?"

The FCPQ would also like rapid intervention vehicles added that would only work on the most urgent cases.

"Our paramedics are the essential raw material for providing citizens with quality care and responding to public demands," said Girouard. "If there's one message we can pass on to the public today, it's that they can rest assured that we are working proactively to develop solutions and are doing everything in our power to provide an irreproachable response to every call we receive."

Action plan coming

Dube said that the government will present an action plan on pre-hospital services in the coming days.

"It includes concrete actions to continue to improve access to ambulance services for the population, in conjunction with the establishments," he wrote.

Dube added that the CAQ government invested $32 million in 2022 to improve coverage in regions and concluded a new agreement with ambulance companies to improve ambulance services' transparency, performance and accountability.

Newman is skeptical that any action plan will solve the problem.

"So much as I love that the Minister of Health woke up yesterday, saw the headlines and suddenly acknowledged that there's a crisis in emergency prehospital care, and that he's going to give us a plan in a couple of days that will resolve all of it, it's it's not that easy," said Newman. "In terms of in terms of real-world solutions, it'll probably take about five to seven years to sort this all out. The biggest problem is we don't validate paramedics and this is, you know, right across our health care system."