Alberta has lots of paramedics but a 'toxic work environment,' narrow view on health: report

There are more than twice as many paramedics per capita in Alberta than Quebec and Ontario so staffing is not what's causing a "crisis" in the system, according to a new report by the Parkland Institute.

Lights and Sirens: The Critical Condition of EMS in Alberta was released Tuesday morning by author and medical sociologist Michael K. Corman.

The report states that while most paramedics surveyed believe the system needs more staff and ambulances, federal data disputes that.

In 2020, Alberta had 201 paramedic providers per 100,000 people. Quebec had 66.5, Ontario had 64.3 and B.C. had 100.7, according to the Canadian Institute for Health Information.

"Will more doctors, nurses and paramedics solve the problem? Absolutely not," Corman said.

"We must address the fundamental causes of why people are falling into the health-care system in the first place. And that requires a look at broader forces outside of healthcare, like the social determinants of health and addressing the root of the issues that lead to illness in our society."

Corman concluded that the system has many issues including an "erosion of key work processes" on top of a "lowering of standards and a toxic work environment that made providing good care nearly impossible."

He issued 15 recommendations including a higher focus on the mental and physical health of paramedics, exploring a 30-hour work week, improved education and retraining.

Corman also suggested educating the public on the "appropriate use of EMS resources" and said Alberta should spend more on public health efforts to keep people out of hospitals in the first place.

“The current crisis was not simply the result of increased call volumes due to the pandemic,” Corman said.

“The pandemic just exposed the weak foundation of a system that has been teetering on the edge for some time.”

'A BROKEN SYSTEM THAT WILL ONLY BREAK MORE PEOPLE'

The Health Sciences Association of Alberta, a union that represents 30,000 health professionals in the province, agreed with Corman that a more holistic view of the system is needed.

“Investing money in EMS for new equipment won’t solve this crisis,” said Mike Parker.

“Government needs to consult with us to create working conditions that are both physically and psychologically safe for all health-care professionals. More staff helps, but without improved working conditions all we are doing is throwing more professionals into a broken system that will only break more people.”

Corman said in 2022, more than 22,000 12-hour paramedic shifts were lost due to sick days and "burnout."

His report also found "an alarming increase in disabling injuries among paramedics in the province."

Alberta needs a "retention plan" that includes officials listening to workers on the streets, Corman said.

"We can have 20 more ambulances and staff them but what's the point if we don't keep our workers happy and healthy?" Corman asked.

"We are going to be in the same crisis, time and time again."

'WE KNOW THAT THERE'S A CHALLENGE WITH EMS'

Health Minister Jason Copping said he briefly scanned the report Tuesday and feels some of the recommendations align with what the government is working on.

"I've already asked my staff to take a look at this [report] and see where it lines up because we know that there's a challenge with EMS," he said.

Alberta already has 90 recommendations, including improving mental health support for paramedics, Copping stated.

He added his UCP government recently invested $200 million to expand and improve EMS services.

On Monday, a leaked email from a unit manager at a hospital in Calgary raised alarm about a plan to have paramedics drop off patients and return to the road in 45 minutes.

NDP Leader Rachel Notley said "paramedics are being directed to dump critically ill patients off at the ER, even if there's nobody there ready to care for them."

Premier Danielle Smith said Notley was spewing "information that is unverified, untrue and irresponsible" while insisting the 45 minutes is simply a "target" that is used Canada-wide.

Smith said 114 full-time nurses are being hired to form "offload teams" to accept patients and free up paramedics for 911 calls.

Parker said it would be "fantastic" if paramedics could meet that 45-minute target but he believes patient care will suffer if EMS are encouraged to offload patients "to a waiting room chair."

With files from CTV News Edmonton's Amanda Anderson