Interagency transfers that privatize acute care

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The UCP government's latest plan to privatize parts of the health system faced strong opposition on Thursday.

Emergency medical services (EMS) interfacility transfer services in the trading block — transporting patients between hospitals and other locations providing specialized care or services.

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The change is part of a $35 million, three-year support package that will spend $25 million to replace aging EMS vehicles from a fleet of 578 ambulances and 82 support vehicles.

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Health Minister Adriana LaGrange said the move will reduce emergency wait times and help AHS focus on emergency medical care in Alberta's two largest cities, where government numbers from February showed 90% of all emergency calls were answered in urban areas. Within 13 minutes by EMS — down more than two minutes from February 2023.

According to Alberta Health numbers, there are about 174,000 non-emergency transfers each year, with 24,000 in Edmonton and about 20,000 in Calgary identified as “suitable for contracted service partners,” LaGrange said.

“This volume is not urgent, low-acuity transfers,” he said.

Guardian Ambulance Ltd. of Calgary for the plan. and Associated Ambulance and Services (Whitecourt) Ltd. of Edmonton.

La Grange said work is underway to expand inter-agency transfers to other areas of the province.

The rural medicine president of the Alberta Medical Association told Postmedia earlier this year that interfacility transfers to urban health services are sometimes delayed or denied.

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“In the wake of the pandemic, the demands to maintain an effective EMS fleet have increased dramatically,” said Marty Scott, executive director of Alberta Health Services' EMS provincial programs.

According to Scott, workers in the privatized system report to Alberta Health Services, use AHS protocols and must meet statutory AHS standards.

“Gambling under the Privatization Scheme”

Given the failure of DynaLife Labs, promises of cost savings and increased efficiency in corporate health care “are nothing short of a sham to destroy the public health system,” said Mike Parker, president of the Alberta Health Sciences Association.

Parker pointed to a report by the New Brunswick auditor general and the National Union of Other Public and General Employees that found serious problems with quality of care and fiscal management when Medavi took control of EMS in New Brunswick.

“New Brunswick's 2020 Auditor General's Report Highlights the Harmful Impact of Commercial EMS Delivery. This led to a shortage of paramedics and earned Medavi $8 million more in revenue than it needed. The contract with Medavi allowed for “excessive utilization” of employee exemptions, which led to “increased response time productivity,” Parker said.

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“I call on this government to put the health of Albertans before profits and fulfill its commitment to address the health care workforce crisis by making all EMS publicly funded and available to the public.”

Alberta NDP health critic Dr. Luann Metz said UCP is gambling on another privatization scheme with EMS in the midst of a health crisis.

The results of private delivery will no longer be easily monitored and it will be impossible to know how much public money is spent on private gain, he said.

“Frontline paramedics tell us that contracting out this service will make an already broken system worse, and they are concerned about the accounting of some of the companies that have been awarded the contracts,” Metz said.

Other personalization efforts (some of which followed a $2 million bill from an Ernst & Young contractor) under the UCP banner, including DynaLife, P3 at Red Deer Hospital, private surgical clinics, contract inpatient food and laundry, ophthalmology, physical therapy, and occupational therapy; includes home care. , and addiction recovery.

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In February 2020, the UCP government spent $400 million to outsource operations to the not-for-profit Alberta Surgery Initiative, which has been hailed as a game changer. According to a Postmedia commentator, after three years, the province's overall surgical activity has dropped to a level lower than in 2014-2015.

“After the failed $130 million privatization of medical labs and the costly failure of private surgical clinics to eliminate wait times, Albertans are angry that this government is pushing to privatize anything it can get its hands on. Health care is another big UCP gamble,” Metz said.

Privatization includes ensuring quality of care, LaGrange said.

“It's a transfer of people with low acuity who have to travel between health facilities. This will reduce pressure on the overall ambulance system so that higher acuity can be attended to by paramedics with higher life-saving potential,” he said.

“We do the same audit as emergency medical services,” LaGrange said.

“If people don't honor the contract or contracts, we will follow up on the contractual obligation very closely. I am confident that the winners of the contracts will be able to perform.”

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