The Hamilton Paramedic Response Time Dashboard as presented to Hamilton City Councillors in January 2019 Credit: Joey Coleman / The Public Record

Ontario’s Paramedic Chiefs are holding an “emergency meeting” in response to news that the Progressive Conservative provincial government is planning to merge local paramedic services together to create 10 paramedic services across Ontario.
The following email has been circulated among paramedics during the past 12 hours, it was posted publicly for a brief period of time on the website of the Ontario Association of Paramedic Chiefs.

URGENT – Municipal Land Ambulance Services to be Restructured Municipal CAOs and Chiefs of Paramedic Services:
Today, we were told that it was MOHLTC’s [Ministry of Health and Long-Term Care] intent to move 52 ambulance services to 10 through restructuring. This is apparently what the phrase “by integrating emergency health services into Ontario’s health care system” means in the budget document.
AMO [Association of Municipalities of Ontario] is shocked with today’s news and deeply concerned. There is no ready information on the government’s plan to do this restructuring, how it was determined, let alone what happens to cost sharing and say for pay among other governance and funding matters. Municipal governments contribute about $720 million and the province about $580 million to what has been a cost-shared service, although not at a true 50-50 one.
Previous news that the province was improving dispatch and improving hospital capacity to receive patients was welcomed as both are the main contributors to ambulance service challenges. MOHLTC is contacting various stakeholder groups with an interest and we have advised MOHLTC that letters to each of the 52 service managers must go out urgently.
You will no doubt have many questions – as does AMO. We will work to get additional information from the ministry on its decision and approach and what our own next steps might be. Please have a bit of patience as we pursue this with the province.
For some, you already know the provincial budget was very clear on their intent to restructure public health – to move from 32 service managers to 10 by 2020/21 and that it will also phase-in an adjustment to the provincial-municipal cost-sharing arrangement for public health. This and some other matters will impact municipal governments in a substantive manner. More in the coming days.
Pat Vanini
Executive Director [Association of Municipalities of Ontario]

The provincial government stated in the 2019 Ontario Budget that it would merge public health units into 10 agencies from the present 35. The Ontario Association of Paramedic Chiefs state there are presently 52 paramedic services in Ontario.
The 52 paramedic services are provincially regulated, and have cooperative dispatch agreements. As an example, the Hamilton Paramedic Service is responsible for responding to calls within the boundaries of the City of Hamilton. Many calls are dispatched to the neighbouring paramedic services when those services have the closest ambulance to a medical call.
Niagara Region paramedics regularly respond to calls in east Stoney Creek. During Hamilton’s Code Zero events, when the Hamilton Paramedic Service has no available ambulances, Niagara paramedics have positioned response units in Hamilton. Similarly, Hamilton paramedics are dispatched to major highway collisions in Niagara. For Hamiltonians who live near Cambridge, Waterloo Region paramedics are often the first responders.
Hamilton’s paramedics are dispatched by a provincial dispatch centre. The Hamilton Paramedic Service is presently studying local control of dispatch. Niagara Region controls its paramedic dispatch, and recently implemented a new triage system with an Emergency Communication Nurse who will provide medical advice and support over the phone for 911 calls which do not require an urgent paramedic response. Hamilton’s Paramedic Chief is watching this program.
It is not known what would become of these type of local programs within the new model of 10 services across the province.

Production Details
v. 1.2.0
Last edited: April 18, 2019
Author: Joey Coleman
Edit Record
v. 1.0.0 original version
v. 1.1.0 added "AMO Email" to front of headline to clarify source of report for those who only catch the headline.
v. 1.1.1 added hyperlink in first paragraph of quoted AMO email to Chapter 1, Section C of the Ontario Budget document.
v. 1.1.2 added link to Mike Crawley tweet.
v. 1.2.0 CORRECTION - There are 52 paramedic services in Ontario. This article, for two days, incorrectly stated 22. I apologize for the error.