The union representing paramedics says Manitoba is not getting good value on the dollar when it comes to its contract with the STARS air ambulance service.

Michelle Gawronsky, president of the Manitoba Government Employees Union (MGEU), says the $12 million the Province of Manitoba provides to STARS would have much more impact if it were spent on paramedics on the ground. 

Air Ambulance

A STARS air ambulance lands on the Trans-Canada Highway near Portage la Prairie in August 2013 to transport an injured man to hospital. (Courtesy STARS)

Gawronsky said rural Manitoba is short 80 paramedics, and that filling those positions and training more specialized paramedics in rural areas would save more lives, she said.

"If you took that $12 million and you dropped that into … rural EMS, that would revolutionize the [rural] service," she said, adding that a specially-trained rural paramedic treating someone at their doorstep for a heart attack is more likely to save someone's life than waiting for a helicopter to air lift that person to Winnipeg.

Manitoba's contract with Alberta-based Shock Trauma Air Rescue Society (STARS) came under fire on Wednesday by provincial Auditor General Carol Bellringer, who said the province did not follow proper tendering procedures when it signed the $159-million, 10-year service agreement in 2011.

The audit also found Manitoba Health was aware that it would likely be paying much more for each STARS mission than what other provinces pay for similar services.

STARS officials argue that comparing its costs per mission in Manitoba to Ontario's air ambulance service is not fair.

However, the costs per mission in Manitoba are still higher than what they are for missions in other Prairie provinces, according to 2013 figures provided by STARS:

  • Alberta: 1,688 missions for $31.5 million = $18,661 per mission
  • Saskatchewan: 821 missions for $20.5 million = $24,969 per mission
  • Manitoba: 177 missions for $10 million = $56,497 per mission

STARS did note that as with Manitoba, neither Alberta nor Saskatchewan tendered its air ambulance contracts.

Earlier this month, while the STARS service was still grounded pending a review, dozens of Manitoba fire chiefs signed and sent a letter to Health Minister Erin Selby demanding the return of the air service.

"The suspension of STARS creates a serious void in our emergency medical response system," the letter stated.

The service was grounded in December after a number of critical incidents, including one where one patient died, and another was left brain damaged.

The government allowed STARS to resume flights earlier this month.

On Thursday, Manitoba Health insisted that it is not changing, re-negotiating or terminating its contract with STARS. 

'Shocked' at STARS contract

CBC News has connected with five air ambulance helicopter services across Canada, and three of them — the Manitoba Aviation Council, Canadian Helicopters Ltd. and HeliJet — said they would have been interested in bidding on the Manitoba contract if it had been tendered.

Rob Blakely, vice-president of EMS operations with Canadian Helicopters, said he can't believe Manitoba didn't tender the air ambulance contract, as he would have jumped at the chance to bid on it.

"We're also dealing with patient lives, so nothing could be more important. I think government has a duty to ensure the best — the absolute best service possible — at a reasonable cost," he said.

The province says before it signed the agreement with STARS, it connected with two companies, Ornge and HeliJet, but determined that neither could do the work.

Rob Blakely

Rob Blakely said it's 'shocking' the Manitoba government would award such a large contract without first tendering it to get competing bids. (Courtesy Rob Blakely)

Canadian Helicopters, which has been around since 1947 and offering EMS services since 1977, has 130 helicopters in its fleet. It transported 150,000 patients for the Ontario government between 1977 and 2012, according to Blakely.

Blakely said a contract is usually for a base fee plus incidentals such as fuel. As more flights are done, the price per flight drops.

"So for any government to award a contract of this magnitude and importance without going through a competitive bid process is shocking," he said.

Manitoba shouldn't have rushed into its deal without first doing some research into the other air ambulance services out there, Blakely said.

"I imagine Manitoba has been running without a helicopter ambulance program for years, so to do it right takes time. And I think you have to take the time to do it right," he said.

Problem is 'fixable'

But he thinks the province could still do the right thing.

"Bottom line, I think in Manitoba it's fixable. One recommendation could be that STARS continues [on a shortened contract while] the province puts together a request for proposal, goes out to the industry and allows everyone to bid on it," Blakely said.

"I think that would be fair for everyone."

But Health Minister Erin Selby said the government did not want to put the contract out for bids because it did not want a gap in service before or after the tendering process while a company sets up.

"We wanted to continue that service. We didn't want to go 18 to 24 months without being able to provide that really vital service in the cases where we have no other option," she said.

Blakely said during a tendering process, it's often the case that the front-runner — in this case, STARS — would operate on an interim basis while the process was underway.

"If it you want to do it right, you have to take the time. And yes, companies like Canadian Helicopters, we can provide interim aircraft," he said.

Even STARS says it might have covered a gap in service.

"We would certainly consider it, depending on what the volunteer board of directors decides," the society told CBC News in an email late Thursday.

Safety always a top concern, says premier

Shortly after the report was released on Wednesday, the Manitoba Progressive Conservatives accused Greg Selinger's government of pushing through the contract to get positive headlines in the months before the 2011 provincial election.

Selinger responded on Thursday, saying safety was always the top concern.

"The election was always in the background," Selinger said. "But the number one priority was saving lives and making sure Manitobans were safe. That's why we brought them [STARS] in for the flood of '09. That's why why we brought them for the flood in '11. And that's why we kept the service going."  

The Manitoba Aviation Council (MAC) also said there are Manitoba aviation companies that would have bid on the air ambulance contract had they been given the chance.

"MAC is not concerned about who wins a bid for services as long as it is awarded in an open and fair process subject to public scrutiny," the council stated in a press release issued Thursday morning.

Statement from Manitoba Aviation Council

The Manitoba Aviation Council (MAC) is pleased that the Auditor General has completed their investigation into the STARS Air Ambulance Contract.  MAC has always been critical of how the contract for Rotary Wing Air Ambulance Services was given to STARS without following the Government’s Policies and Procedures for a contract of this size and duration.

By sole sourcing this contract with no discussions with the Aviation Industry all Manitoba Aviation Companies were precluded from bidding and possibly providing these services.  Had Manitoba Aviation Companies been given the opportunity they would have bid on this contract.  This sole sourcing with no input from Manitoba Aviation service providers has always been the concern of MAC.

MAC has always maintained that a fair and open bid process with clear criteria and expectations is required to ensure that the Province of Manitoba receives the best service for the best price.

A key component to a good request for services begins with an open dialogue with Manitoba Aviation companies to ensure that the applicable criteria for operating in Manitoba is documented and part of the bid. This did not appear to happen with the sole sourcing of the STARS contract.

MAC is not concerned about who wins a bid for services as long as it is awarded in an open and fair process subject to public scrutiny.

The Province is now reviewing the delivery of Fixed Wing Air Ambulance services.  The Provincial Government has committed to working with Manitoba carriers to discuss what is needed and what is available.  MAC supports an open and transparent process where Manitoba businesses have the opportunity to serve Manitobans.