Helicopter described as 'Achilles heel' could respond to only 1 in 5 medevac calls
Chopper also not permitted to land at major hospital in St. John's
The helicopter contracted to handle provincial medevac services in Newfoundland and Labrador was assessed to have a "maximum reliability" of 20 per cent because it can't fly at night or in bad weather.
That's according to internal Eastern Health emails from more than a year ago obtained by CBC News through access to information.
Not only that, the Bell 407 can't actually land at the Health Sciences Centre in St. John's, due to Transport Canada restrictions.
For every one helicopter flight we conduct, we are requested four additional times that we can't respond.- Corey Banks, in 2016 Eastern Health memo
That issue was flagged in a 2015 review of the province's overall ambulance system. But nothing seems to have changed since.
A CBC News investigation Wednesday revealed that military search and rescue helicopters were called in to handle more than half of all provincial helicopter medevacs in 2016.
The province asked for help because those calls couldn't be handled by the fleet contracted for medevac services.
- CBC INVESTIGATES | Repeated N.L. calls for military help with medevacs sparked search and rescue concerns
Operational concerns about those helicopters are not new, according to records obtained by CBC News through access to information.
"The major Achilles heel in air ambulance (rotor-wing) service is the aircraft itself: single engine/single pilot/VFR (visual flight rules)," Corey Banks, then-director and chief of paramedicine and medical transport with Eastern Health, wrote in an Oct. 14, 2016 email.
"So the call volume is low as many calls we get we can't respond due to darkness or the poor weather. FYI: recent stats show that for every one helicopter flight we conduct, we are requested four additional times that we can't respond."
Those helicopters are also used by other government departments.
Banks noted that there are long launch times waiting for them to return to base and reconfigure for patient transport.
He also pointed to a previous analysis of the contracted choppers' availability for medevac flight service.
"Considering a full 24-hour day as 100 per cent, then accounting for darkness and predicted weather patterns, the maximum reliability of the contracted helicopters was 20 per cent," Banks noted in that email.
Can't land at Health Sciences Centre helipad
In late 2015, the province released a review of the overall paramedicine and medical transport system.
That report, by Pomax Consulting, flagged another issue with those choppers.
It noted that "a concern exists among hospital and paramedics that helicopters cannot land adjacent to hospitals," and added that the St. John's hospital helipad is not able to accommodate single-engine aircraft flying under visual flight rules.
"While a lack of approved helipads is the most important barrier to expanding helicopter paramedic operations in Newfoundland and Labrador, aircraft range, flying at night, and the small size of the helicopters are also impediments to paramedic air operations," the report advised.
There has been no apparent action taken since to address that issue.
Eastern Health and the Department of Health declined interview requests and steered inquiries to the Department of Transportation and Works.
No one was available to speak there either.
But in a statement, a spokesman noted that "landing at nearby helipads is a common practice at other hospitals in the country due to nearby terrain, buildings, obstacles, and safe operation of the aircraft in and out of the area."
Different province, different response
Another Atlantic province recently faced a similar dilemma.
A couple of years ago, after Transport Canada tightened up regulations, medevac helicopters were prohibited from landing at hospitals in Halifax.
So the Nova Scotia government decided to pay for new ones that could.
- New LifeFlight helicopters ready for takeoff after delays
- Province inks $105M deal for 2 air ambulance helicopters
- EHS LifeFlight helicopter grounded at Halifax and Digby hospitals
"The ability to land directly at the rooftop and directly at that specialty service will mean multiple minutes in savings of time and of course minutes count when you're talking about the sickest of patients," Colin Flynn, program manager for EHS LifeFlight, said at the official launch of the new choppers in December.
Those Sikorsky S-76C+ Nova Scotia medevac helicopters have more powerful engines, a cockpit that works with night vision goggles, and backup life-saving equipment.
'Should be a rare event'
Back in Newfoundland and Labrador, internal Eastern Health emails from late 2016 and early 2017 showed continued concern about this province's medevac fleet.
Calling in the military for help "should be a rare event and is performed under auspices of 'humanitarian support' as SAR (search and rescue) assets have a federal legislated mandate for air and nautical search and rescue — not land-based SAR or provincial air ambulance," Banks wrote in a Feb. 20, 2017 email.
If this was the way to operate, then all the other provinces would be doing the same.- Corey Banks, in 2016 internal Eastern Health email
"So each time we utilize SAR we risk actual SAR response to offshore incidents, and we have had incidents where SAR has not been available due to ongoing offshore SAR events."
The "last resort" for provincial medevacs after calling the military would be trying to request Cougar choppers at $13,000 per hour, internal Eastern Health documents advised.
A few months earlier, in October 2016, another Banks email noted concerns being expressed by the military: "We had to launch JRCC again this weekend and we keep getting pressure from DND on this reliance."
Banks, who has since departed Newfoundland for a job in the United States, called for a fundamental re-think of the system.
"If we keep doing what we have been doing for the last 20-30+ years we are not providing the true level of service needed … especially with the centralization of health care and aging rural population," he wrote on Oct. 14, 2016.
"If this was the way to operate, then all the other provinces would be doing the same."