Letter: Hand over responsibility for ambulances to the municipal level

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Re: “A critical need for better ambulance service” (Editorial, July 16)

This is an excellent editorial about the substandard level of the pre-hospital emergency medical care across Quebec. Sadly, there have been many excellent editorials over the decades just like this one.

Many of us have been advocating for the recognition of Advanced Care (Advanced Life Support) Paramedics for 30 years as Quebec lags woefully behind its neighbours. While “Paramedic” is now emblazoned across our ambulances, the term gives a false expectation to the public.

We continue to lose our most skilled ambulance technicians to other jurisdictions. Quebecers need not suffer, or die, before getting to the hospital when there are so many eager ambulance technicians available and willing to be trained to perform at a much higher level.

The lack of transparency, lengthy response times and fleet availability in the regional ambulance service cited by the editorial is fixable. Hand over the service to the municipal level. Fire and police services for the Montreal Island are not run by the province, nor should they be. The same stands true for ambulance services. The level closest to the citizen will result in better care and a higher quality of services.

Glenn J. Nashen

City Councillor


© Copyright (c) The Montreal Gazette


Editorial: A crucial need for better ambulance service

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Gazette Editorial, July 16, 2014

Not that long ago, calling an ambulance in Montreal often meant summoning a vehicle from a funeral home. True, the optics weren’t good, but emergency response in those days was a private business — and a competitive one. Funeral home station wagons could carry stretchers, so they took calls.

Emergency services have come a long way since then. They are now highly professionalized and centrally coordinated. Montreal police took over ambulance service starting in 1958, and Urgences-Santé was established in 1989 to cover Montreal Island and Laval, although Côte-St-Luc maintains its own supplementary first-responder service. But the reality is the greater Montreal region today lags behind almost every other jurisdiction in Canada and the U.S. in pre-hospital emergency care. And now our shortcomings have been highlighted once again as the union representing almost 1,000 Urgences-Santé employees threatens pressure tactics as they negotiate a new contract.

Quebec may call those first responders ambulance paramedics, but the vast majority are not trained — and not permitted — to provide the same level of emergency care that is allowed in other jurisdictions. For years, the Collège des Médecins, and the professional order of nurses, have jealously guarded the right to perform “medical acts.”

When Premier Philippe Couillard was health minister a decade ago, a pilot project created 18 new “advanced care paramedics” — trained in Ontario for work in Quebec. But until two years ago, they still couldn’t use their new skills unless a physician was on board. Today, only 12 of those original 18 are still left; the others have left to work in cities where they have more freedom to practise independently at advanced levels.

Now the union for first responders wants to see 150 or more advanced-care paramedics in their ranks. This is a long-overdue reform. Empowered paramedics have proven to be a valuable asset outside of Quebec, not a public-health liability.

A broader challenge for Urgences-Santé, however, lies in improving its basic response times. The ambulance operator claims its average response time, for the highest priority calls in Montreal and Laval, is 7.04 minutes. But anecdotal evidence, from both patients and first responders, casts doubt on this. There are times when there are no ambulances in Laval, and vehicles are directed there from as far away as LaSalle. Urgences-Santé has denied a Gazette access-to-information request to open its books, so there is no way to tell how response time is being calculated.

The lack of transparency is troubling, but there’s reason to suspect that there simply aren’t enough ambulances and paramedics. In fact, the union is asking for 20 more ambulances and 40 more paramedics as part of its contract talks. The government, as overseer of health care in Quebec, should take this bargaining period as an opportunity to review the entire structure of Urgences-Santé. In Toronto and Ottawa, ambulance services are run by a body accountable to the cities, rather than the provincial government. At the same time, user fees should be reviewed, and brought into line to support higher standards of service, especially as the population ages.

Ambulance services aren’t entirely unwritten by the public purse. People pay out of their own pocket; a ride to the hospital costs a basic $125 and $1.75 per kilometre. There are exceptions — those on welfare, those over 65, anyone involved in a car crash or a workplace accident. But the rates haven’t changed since 1997; meanwhile, services still trail other jurisdictions.

None of these issues are new — but they are still issues of life and death, and they deserve closer public attention than they are getting.

A healthy ambulance service needs advanced care paramedics

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The decision last month by paramedics in Montreal and Laval to invoke pressure tactics against Urgences Santé to protest against the lack of ambulance resources is just one part of a larger problem with ambulance services in this province.

I have worked as a primary care paramedic with Urgences Santé for the past six years, and every year seems to be worse than the last.

Our response times have been unacceptable for quite some time now, and no one seems to be noticing.

However, there is a bigger problem here in Quebec, and it’s what we are doing once we arrive on the scene of an emergency.

Quebec is the only place in North America (aside from New Brunswick) where advanced care paramedics are not part of the operational routine. The rest of Canada has three levels of paramedics: primary, advanced and critical. Advanced care paramedics have more training than primary care paramedics and are able to bring the hospital emergency room, so to speak, out onto the road with them.

I completed my advanced care course in Ontario, a program that is accredited in all of Canada but not in Quebec, where it has been stuck at the pilot-project stage since 2001. Urgences Santé and the Quebec government fail to recognize my training, and keep me at the level of primary care paramedic.

For the last year, I have had to sit on my hands and watch as patients had seizures while being transported to the hospital, because I am not allowed to administer medication.

If you fall and fracture your hip in another province, the treatment you will get includes use of a scoop (a device that goes underneath you to lift you off of the floor), an IV, morphine for the pain and anti-nausea medication if you need it.

In Quebec, by contrast, you will be put in a vacuum mattress (a device that becomes rigid and acts as a full body cast), which requires a paramedic to turn you on your side, which is extremely painful if you have a hip fracture.

Why is it that we are the highest taxed citizens in North America, yet we are the only ones that don’t have access to advanced pre-hospital care?

It’s time we stand up and start demanding that we get treated just as well as our neighbours in the rest of Canada. As for me, I’ve been forced to move, to work in a province that recognizes my training and that will allow me to properly treat my patients.

Phil McHugh is moving July 7 from Montreal to Calgary, to take a job as an advanced care paramedic. He has worked the last six years with Urgences Santé.

Outstanding Cote Saint-Lucer wins prestigious award

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Congratulations to Dr. Marc Afilalo, winner of the Jewish General Hospital 2013 Award for Excellence in Physician Management. Dr. Afilalo is Chief of Emergency Medicine at the JGH and one of the leading emergentologists in Quebec and has served as advisor to several Ministers of Health and Social Services.

Dr. Afilalo is also an outstanding Cote Saint-Lucer and has been a strong supporter of CSL’s campaign to recognize Paramedics in Quebec since the 1980′s. During the municipal merger era (2002-2005) faced with the prospect of losing the CSL Emergency Medical Services Dr. Afilalo organized a letter of support signed by nearly every emergency medicine physician at the JGH. This crucial support, coupled with D’Arcy McGee MNA Lawrence Bergman’s push in the National Assembly and strong community support from Anthony Housefather, Ruth Kovac and myself, ensured the continuation of EMS on CSL territory.

Dr. Marc Afilalo

Dr. Marc Afilalo

Dr. Afilalo was also the recipient, earlier this year of the Queen Elizabeth II Jubilee Medal which was presented to him at a public ceremony at City Hall.

Congratulations, yet again, to a truly remarkable Cote Saint-Lucer and an extraordinary leader on this well deserved honour.


Outstanding CSLer awarded Queen’s Jubilee Medal


Félicitations au Dr Marc Afilalo , recipiendaire du Prix d’excellence en gestion médicale de l’Hôpital général juif. Le Dr Afilalo est le chef de la médecine d’urgence à l’HGJ et l’un des principaux urgentologues du Québec et a siégé comme conseiller de plusieurs ministres de la Santé et des Services sociaux .

Le Dr Afilalo est également un remarquable Côte Saint- Lucois et a été un fervent partisan de la campagne de CSL à reconnaître les paramédics au Québec depuis les années 1980. Pendant l’ère de la fusion municipale (2002-2005) face à la perspective de perdre les Services médicaux d’urgence CSL le Dr Afilalo a organisé une lettre de soutien signée par presque tous les médecins de la médecine d’urgence à l’HGJ. Ce soutien crucial , couplé avec le support du député Lawrence Bergman à l’Assemblée nationale et un appui solide de la communauté par Anthony Housefather, Ruth Kovac et moi-même , a assuré la poursuite de SMU sur le territoire de CSL.

Le Dr Afilalo a également reçu, plus tôt cette année, le Médaille du jubilé de la reine Elizabeth II qui lui a été remis lors d’une cérémonie publique à la mairie.

Félicitations , encore une fois , à un remarquable Cote Saint- Lucois et un leader extraordinaire pour cet honneur bien mérité.

En savoir plus:

Outstanding CSLer awarded Queen’s Jubilee Medal

24h Montréal – Actualités – Des évacuations médicales aériennes partout au Québec

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English: University of Utah AirMed medical eva...

English: University of Utah AirMed medical evacuation helicopter. (Photo credit: Wikipedia)



Terrific news for the safety of all Quebecers – well at least those that can afford it, privately.


AirMedic will begin offering medical evacuation by Air Ambulance helicopters in all regions of Quebec by the end of June, according to its president, Christian Trudeau.


AirMedic will operate out of four bases in Quebec and have a plane and “several helicopters.”


“What we offer is comprehensive coverage throughout the province. If you are injured, you call us and we will pick you up,” said Trudeau.


Areas inaccessible or difficult to access by land or sea, as the mining camps that spring forth with various projects related to Northern Plan, the company very interested.


The company plans to offer medevac two types of subscriptions. The first, for individuals, would be around $ 120 per year for hunters and outdoor enthusiasts for example. To obtain service, however should a GPS phone outside cellular coverage areas.


The second type of subscription, “corporate”, propose to outfitters or administrators controlled zones to register for their members. The mining would also be very interested, according to Mr. Trudeau. “We have vendors that deal specifically with that,” he said.


“We propose to mine site employees of 500 or 600 packages per person. That’s how we approach them, “he added saying that the field of medical evacuation is” really in development “with the construction of new roads in remote areas.


This is the businessman Stephan Huot, well known in the Quebec region and chairman of the holding company Capital HELiPRO, AirMedic shareholder, who is behind the project.


24h Montréal – Actualités – Des évacuations médicales aériennes partout au Québec.


Reminder to avoid accidental dialling 9-1-1

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On EP week, thank an emergency responder

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Cote Saint-Luc’s finest in orange: volunteer Citizens on Patrol

As Emergency Preparedness Week winds down across Canada I believe it’s important for everyone to take a moment to thank someone involved in emergency services and emergency preparedness, especially those who volunteer their time.  It is because of these fine individuals and their sense of dedication that all of us are safer where we live, play and work each day.

Kudos to Cote Saint-Luc's long-serving medics

Cote Saint-Luc’s long-serving EMS volunteers being congratulated by City Council

I salute everyone involved in Cote Saint-Luc’s Public Safety Department starting with our volunteers.  These folks who give so much of themselves within EMS and vCOP are terrific in so many ways.  Without salary, they show up for their shifts, rain or shine, heat wave or deep freeze.  They do continuous training and provide extra coverage at special events, all to ensure our safety.  They respond when called upon and are always at the ready.  Thanks so much to all of you.

CSL launches eco-friendly COP Scooter Patrol

CSL launches eco-friendly COP Scooter Patrol

Our CSL Public Security agents patrol our streets 24/7.  They are friendly and helpful professionals here to maintain order within our city, to educate our residents and visitors and to help when help is needed. They enforce our bylaws to ensure our neighbourhoods are clean and orderly.  Merci a tous l’équipe pour vos efforts remarcable.

Cote Saint-Luc volunteer Emergency Medical Services honour guard

Cote Saint-Luc volunteer Emergency Medical Services honour guard

Our emergency communications staff, also known as dispatchers, must answer all the phone calls and send the right resources, quickly and professionally.  They juggle phones, Urgences Santé and EMS radio systems, computer-aided dispatch screens and more. Thanks to them for keeping calm under pressure and for their polite and helpful interactions with residents.

Public Safety Director Jordy Reichson

Public Safety Director Jordy Reichson

Public Safety Chief Jerome Pontbriand

Public Safety Chief Jerome Pontbriand


Our team is headed by Director Jordy Reichson and Chief Jerome Pontbriand.  Jordy oversees the entire operation of 150 volunteers and some 20 staff members.  He also plans for wide scale emergencies. Jordy deals with residents and partner agencies and plans strategically to keep our city safe.

Jerome works directly with our volunteers in vCOP and EMS.  He helps to bring them ongoing training and improvement to help them meet the challenges of servicing our city. Jerome is a seasoned paramedic who makes sure you get a first responder fast when you need one.

Both Jordy and Jerome are committed emergency professionals, dedicated to the safety and security of all Cote Saint-Lucers as well as those working and visiting here. YOu may even bump into one of them on a 911 call.

EMS Chief Sheldon "Shloime" Goldberg and his team of skilled and dedicated medics are always close at hand, ready to spring into action

EMS Chief Sheldon “Shloime” Goldberg and his team of skilled and dedicated medics are always close at hand, ready to spring into action

So please be sure to salute our emergency responders that are in and around Cote Saint-Luc (and all across our country). In addition to those solely in our city I mentioned above, there are also Montreal police officers and firefighters and CP Rail police.  You’ll occasionally see the RCMP here as well.  And of course there are the paramedics of Urgences Santé, responding to all of our medical 911 calls.  Please thanks them for all they do to keep us safe and secure, for answering our calls, for being ready when we need them most.

Cote Saint-Luc Public Security officer Jean-Noel Champagne

Cote Saint-Luc Public Security officer Jean-Noel Champagne


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