Alex Forrest’s Response to Free Press Article and Letter to the Winnipeg Free Press Editor from the Chiefs and the Medical Director
March 18, 2015
Editor
Winnipeg Free Press
We, the leadership of the Winnipeg Fire Paramedic Service (WFPS), express our profound dismay with
Mary Agnes Welch’s column of March 11, 2015 (“Firefighters skilled at manipulating the political system”). Ms. Welch had an opportunity to research and report facts as a service to your readers; instead, the article used only select facts that do not paint an accurate picture.
In this limited space, it is difficult to fully describe the tremendously successful integrated EMS-Fire model of the WFPS. Perhaps we can interest the Winnipeg Free Press in publishing a series of articles to fulfill that task. For now, we are hopeful the following facts will be published to assist readers in seeing beyond the limits of the article:
The majority of paramedics who work on Winnipeg’s ambulances are primary care paramedics (PCPs). They hold the same emergency medical education, qualification, and licence as those who work on Winnipeg’s fire trucks. In fact, the vast majority of paramedics in Manitoba are PCPs. Ms.
Welch’s characterization of “hand-holding” is as wrong as it is offensive. Regardless of the uniform they wear, PCPs are the foundation of Manitoba’s EMS system. PCPs are proud of the emergency medical care they provide, as are we.
A community’s fire service is part of its infrastructure which attracts investment of business, industry, and residents. Proper fire resourcing reduces the insurance premiums of homeowners and business owners, on the order of $2 in savings for every $1 of taxation to support fire service.
Fortunately, fires don’t occur continually, resulting in an inherent response capacity in the fire protection service.
Placement and staffing of fire resources is solely determined by response time to all parts of the City for fire-related calls. The National Fire Protection Association (NFPA) guideline 1710 describes the response time standards to which urban fire services are held.
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Integrated fire & EMS departments provide service to almost 60% of Manitoba residents, as this model is also used in Brandon, Thompson, and Shilo. Integrated service has existed in these communities for many years. As well, a number of other Canadian communities employ this model, and it is very common in US centres.
Winnipeg’s integrated model arose in the late 1990s and early 2000s due to the lack of capacity of the existing, standalone EMS service. Using the inherent response capacity in the fire service avoided significant duplication of resources. The integrated model framework was recommended by several independent consultants, was created in the mid 2000’s, and culminated in 2007 with negotiated work sharing agreements. These agreements remain in our practice today.
The popular myth that fire departments bolster their call volumes with medical calls to preserve their staffing is categorically false. In fact, if Winnipeg’s fire service ceased medical response, our staffing and resources would not change at all, and our net cost would increase significantly with the loss of several million dollars of funding we receive for our fire service’s contribution to the EMS system.
Equally false is the notion that sending a fire apparatus to a medical call is a waste of tax dollars. As noted above, that crew and apparatus would be on duty and paid regardless of their involvement in medical response. Indeed, not responding with that crew would truly be a waste of tax dollars.
In 2014, our integrated system provided average travel times to the highest priority calls of 3.72 minutes. Had we relied only on our ambulance resources, the average travel time would have been 6.73 minutes. Welch’s statement that “speed doesn’t matter” on these calls demonstrates a lack of understanding of medical and traumatic emergencies. We are confident that anyone who has called 911 for themselves or a loved one in medical distress would agree that having a skilled paramedic arrive almost 50% faster is critical, regardless of the vehicle in which they arrive.
In 2014, fire-based PCPs responded alone to 11,192 calls. Almost 90% of these were “person down,” “falls,” or “assist police.” This represents the call volume of approximately three, 24-hour ambulances. Without fire involvement, these three ambulances would have been unavailable for calls more likely to require advanced care and/or transport to hospital. The addition of three ambulances would further add to the tax burden.
Fire crews DO NOT respond to every medical call. We have used our many years of experience to hone the system responses to send the most appropriate resources to different types of calls.
Of 63,000 calls for emergency medical service in 2014, fire resources attended just over 31,000, less than half. We send resources according to the initial information in the call, then scale up or down as the situation presents.
·The efficiency of our system is demonstrated by impartial comparison to other cities. Winnipeg participates in the Ontario Municipal Benchmarking Initiative (OMBI), which involves many facets of municipal services. The 2013 data shows Winnipeg as providing among the highest number of ambulance service hours servicing the most calls at the lowest cost per hour among 13 cities. Winnipeg was among the busiest fire services, with the second lowest unit staffing costs among nine cities.
All of these bona fide facts were available to Ms. Welch for the asking. We publicly presented the OMBI data during our budget presentation on March 9, 2015. Regrettably, the only fact that Welch chose to verify with the City was the percentage of female firefighters in the WFPS. Her insertion of this figure to insinuate a gender issue borders on salaciousness.
While the focus of the article was clearly limited to observations on a political landscape, the selectiveness of factual reporting has led to an imbalance that not only slights the paramedics who serve our city, but also does a disservice to your readers by not accurately representing the integrated model citizens are served by. The March 16 column by Dan Lett (“Firefighter-paramedic rift harmful”) exacerbates the misunderstanding of the integrated model and its benefits to our citizens. We respectfully urge the Free Press to address this imbalance.
John A. Lane, BSC Tom Wallace
Chief Deputy Chief
Winnipeg Fire & Paramedic Service Winnipeg Fire & Paramedic Service
Rob Grierson, MD Joe Seewald
Medical Director Deputy Chief
Winnipeg Fire & Paramedic Service Winnipeg Fire & Paramedic Service
Christian Schmidt
Deputy Chief
Winnipeg Fire & Paramedic Service
Response to an article by Mary Agnes Welch
“Firefighters Skilled at Manipulating Political System”
By
Alex Forrest, President UFFW
I.A.F.F. Canadian Trustee
Lieutenant, Winnipeg Fire Department
This letter is on behalf of firefighters and fire-paramedics across Manitoba who were disappointed and in disbelief regarding an article by Ms. Welch which was biased, un-researched, inaccurate and insulting to all firefighters in Manitoba who risk their lives daily for the citizens they serve.
This tabloid style of reporting was not up to the Free Press’s usual standard and has likely severed ties between Ms. Welch and fire services in Manitoba, as she is now impossible to deal with after showing such bias against firefighters.
The research that Ms. Welch did for this article was one call to the Winnipeg Fire Paramedic Service where she asked one question, “How many women do you have in the Department?”
Firefighters make no apologies for being successfully involved in politics. We have to be involved in politics in order to advocate for public safety. Political decisions decide how successful we are in saving lives. Our involvement in politics affects everything from the resources we need to do our job to issues such as the safety of our clothing and equipment to a proper level of support for firefighters who are hurt or killed doing their job. We are successful because we do not simply support one party; we support those who support public safety and firefighter safety. In past municipal elections we have supported councillors from across the political spectrum. We have a respect and trust in the community that is always at the top in polls in Canada. We have a 96% rate of customer satisfaction in the City of Winnipeg.
In Winnipeg we fight fires on a level that is unequalled anywhere in Canada in spite of having one of the harshest climates in the world with wind-chills as low as -50 and humidex levels that can reach 45 degrees. As well as responding to fire calls we have voluntarily taken on the role of paramedic response and we now have 400 paramedics who ride on 40 fire trucks and have the same license as the paramedics who are on ambulances. Also, the highest ALS Providers are assisted by our system so that they are available when needed. We are proud to assist them. We respond to 40,000 medical calls every year, twice as many as the Toronto Fire Department that serves over three million people and they have 3000 firefighters to our 950.
Winnipeg’s system of firefighting and EMS response is one of the most cost-effective systems with the best patient outcomes of any major city in Canada, largely due to our response times. We save lives like no one else, a fact that is supported by statistics and can be confirmed by Winnipeg’s Medical Director and Fire Paramedic Chief.
At the NDP convention, we made the difference for Premier Selinger as we have with so many other politicians. We do not always win but we work hard to make a difference. There were no deals; we supported Premier Selinger because he has supported public safety and firefighter safety for decades. The accusations are nothing but part of the internal politics of the NDP.
Paramedic Self-regulation will be decided on its merits. Our members respond to 80% of the paramedic response calls in Manitoba but we were shut out of the application process. This application was not supported by the WRHA, the City of Winnipeg or the Fire Paramedic Chief. It was also not supported by a single paramedic in either Thompson or Brandon. This was never an issue of firefighters vs. paramedics but an issue of what is best for the people of Manitoba. Paramedic Self-regulation will place an unnecessary financial burden on paramedics and will just add another level of bureaucracy. It was an idea put forward by rural paramedics to try to fix the issue of paramedic response in rural Manitoba. Even MGEU Past President Lois Wales, in a memo dated June 18, 2012, declared a clear, concerned opposition to Paramedic Self-regulation. This is not a new issue in Canada as the Province of Ontario recently turned down the application for Paramedic Self-regulation for the same reasons we have put forward. Interesting enough MGEU’s provincial union counterpart also spoke against Paramedic Self-regulation.
http://www.hprac.org/en/resources/HPRAC_Paramedic_Report_Volume_1.pdf
Ms. Welch’s description of firefighters as bullies is ridiculous, especially considering that the Paramedic Association is backed by MGEU, the largest union in Manitoba. How ironic that the MGEU President sent a letter to Premier Selinger regarding Paramedic Self-regulation that seems to try to bully him into accepting something that has failed based on its merits.
We have great respect for our brothers and sisters who are ambulance paramedics. We have supported them in the past and we will continue to support them whenever we can. We are all part of a team that is making a difference and saving lives.