Toronto

City's own figures show 'public safety is at risk' due to paramedic shortage, union warns

A shortage of paramedics and ambulances is likely compromising public safety, according to statistics obtained by the union representing Toronto's frontline paramedics and shared with CBC News.

Canada's largest city only has about 35 available ambulances most of the time, statistics show

Paramedic shortages are putting residents and visitors at risk, according to statistics obtained by CUPE Local 416 - the union representing Toronto's paramedics. (David Donnelly/CBC)

A shortage of paramedics and ambulances is likely compromising public safety, according to statistics the union representing Toronto's frontline paramedics has shared with CBC News. 

The figures, obtained from the city through Freedom of Information requests by CUPE Local 416, suggest the number of ambulances available to help Torontonians is dropping to the point where some patients are waiting hours for assistance.

Meantime, city budget reports indicate demand for paramedic services is up because of a growing and aging population.

And the union says response times to emergency calls are hovering at about 40 per cent higher than provincial guidelines.

"Public safety is at risk," said Mike Merriman, the paramedic and EMS unit chair for CUPE Local 416.

"The system is on the verge of collapse," he added.

All this is happening as Mayor John Tory is asking most departments and city agencies to freeze spending this year in an effort to keep property tax increases at or below inflation.

However, in an email to CBC News, Tory's spokesperson says the city has been hiring many paramedics .

"The City hired more than 200 new paramedics in the last five years as part of a hiring strategy. This year's budget continues our investments in paramedics and includes the hiring of more paramedics for the community paramedicine program," Don Peat wrote.

But Merriman says those 200 hires replaced paramedics who quit or retired. He notes actual staffing levels haven't increased since 2016, despite an approximate 15 per cent increase in the number of emergency calls paramedics are dispatched to.

According to the city's budget documents, paramedics are expected to respond to a record 337,265 medical emergencies in 2019 —or almost 1,000 a day.

Mike Merriman, unit chair for paramedic and EMS services with CUPE Local 416, says the system is on the verge of collapse. (CBC)

But at times, the number of paramedics available to handle those emergencies has plummeted to critically low levels, according to the union.

"There have been times — and we have the statistics to prove it — that there hasn't been a single ambulance available in the system to service residents of Toronto," said Merriman.

On numerous other occasions in the past year, the number of ambulances available in Toronto to service almost three million residents dropped to less than 10, according to the statistics.

Overall, during the first 11 months of 2018, the picture wasn't much brighter.

There were only 35 ambulances available to serve the entire city about 67 per cent of the time, according to the data obtained by the union.

Meanwhile, average response times for emergency calls have risen since 2016  to about 11.8 minutes. Provincial guidelines suggest they should be around 8.7 minutes.

Kim McKinnon, a spokesperson for Toronto Paramedic Services, maintains there is no reason for public concern.

"Toronto Paramedic Services has a dynamic system that is designed to maintain continuous ambulance coverage to respond to all 911 medical emergency calls. Public safety is not at risk." she wrote in an email to CBC News.

911 calls getting 'stacked'

But CUPE Local 416 disagrees with the city's assessment.

When the number of available paramedics drops, calls for service get "stacked," meaning responses to lower priority emergencies get delayed.

Merriman says paramedics have told him about numerous situations where elderly people have slipped on ice and possibly fractured bones, yet they've waited hours for help.

"That's happening, and this is wrong," said Merriman. "That could be your mother; that could be my mother."

The volume of calls is also leading to burnout and injuries, the union warns, with the number of paramedics off on operational stress leave up almost fivefold since 2016.

System 'just 1 disaster away' from collapse, paramedic says

One veteran frontline paramedic, who spoke with CBC News despite not being authorized to do so, says the chronic shortages mean Toronto is increasingly relying on paramedics from neighbouring jurisdictions, such as Peel, Durham and York regions, to make up the shortfall.

CBC News has agreed not to identify the paramedic.

"You see it all the time" he said. "Toronto is sucking in units from other municipalities to come help pick up our workload."

This shot of a computer screen at a Toronto hospital in November, 2018, suggests only 14 ambulances were available to service the city's 2.8 million residents.

While Toronto paramedics also cross into neighbouring municipalities to help, the paramedic says Toronto is taking more emergency services than it gives.

"We are always just one disaster away from the system completely collapsing," he said.

He also said paramedics don't always get the required 20 minutes to fully disinfect ambulance stretchers before they are put back into service.

Until recently, paramedics could see how many ambulances are available city-wide on computer terminals posted in hospitals. Recently, though, that information was pulled..

In an email, Toronto Paramedic Services spokesperson Kim McKinnon told CBC News the information was no longer deemed relevant.

"The data ... was removed several months ago as the information was not accurate and, if taken out of context, could be misleading. This information is dynamic and does not reflect overall system performance," she wrote.

Toronto Paramedics to outline new hiring strategy

Toronto Paramedic Services has asked the city for an additional 12 frontline paramedics. That would translate into an additional six available ambulances city-wide.

That's still not nearly enough, according to Merriman.

City council will vote on the 2019 budget next month, but there does not appear to be money for more frontline paramedics assigned to ambulances — at least not until 2020.

"The Mayor has spoken to Toronto Paramedic Services Chief McEachen and many frontline paramedics about staffing and patient volumes," wrote Don Peat, Tory's spokesperson.

"The Chief has assured the Mayor that he will be coming forward with a plan later this year for hiring new paramedics. The Mayor looks forward to receiving the new hiring strategy." 

About the Author

John Lancaster

Senior Reporter, CBC Toronto

John Lancaster is a senior reporter with CBC News focusing on investigative and enterprise journalism. His stories have taken him across Canada, the US and the Caribbean. His reports have appeared on CBC Toronto, The National, CBC's Marketplace, The Fifth Estate-and of course CBC online and radio. Drop him a line anytime at john.lancaster@cbc.ca.