> Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019.
> CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.
- Avg 90th Percentile response times have gone from 12 minutes in 2019 & 2020 to 14.5 mins in 2024 and almost 15 minutes as a 2025 target: (12.1, 12.1, 13.0, 14.2, 14.0, 14.5, 14.8)
- staffing is up more than 50% in that time, while number of patient transports is up just 10% during that same timeframe
- Page 4
- scary graphic - graph concerning Daily Hours with < 10% available ambulances
The snapshot, from Saturday, March 1 to Tuesday, March 4, shows paramedic response times in Toronto are wildly inconsistent even where people could be having heart attacks or strokes.
In those four days, the city’s ambulance service failed to respond to almost half of Delta calls within the standard response time of eight minutes and 59 seconds.
A Delta call is the fourth highest in severity in the service’s five level classification system — Echo patients are in the most life-threatening state while Alpha are in the least.
For all calls, paramedics try to be on scene in under nine minutes but on average that response time is met only 69% of the time.
Over the four-day period, Echo calls were responded to within the goal response time 100% of the time on only two days.
On March 1, several Echo calls — which could be for a child not breathing, for example — only hit the standard 66% of the time.
On March 4, Echo calls received in the afternoon were only responded to in less than nine minutes 33% of the time.
Worse, paramedics told the Sun, they routinely arrive at calls classified as less serious that turn into more serious calls.
Almost seven out of 10 people needing an ambulance for a Delta response, like chest pain, between 7 and 10 p.m. March 3 waited more than nine minutes.
Paramedic union chairman Glenn Fontaine says the documents are more evidence that residents are playing “Russian roulette” when they dial 911.
Fontaine said every time paramedics fail to get to a scene in less than nine minutes, lives are at risk.
“That’s the time you need medical intervention if you’re having a medical emergency,” Fontaine said. “These numbers should be 90% and years ago they were.”
“I hope this isn’t a trend we’re seeing but my fear is it is ... And this (March) is slow time, wait till we get into summer vacation.”
Healthcare funding is managed provincially and the Ontario government has been poorly managing the system, pretty consistently, for over a decade. Some would argue decades, but things do seem to be steadily declining post Covid, as they were pre-Covid. Over the last few years, several ERs have been experiencing intermittent closures, and at least one was closed permanently, due to staff shortage.
What's worse is that the closures are poorly communicated. I know of at least two people who, within the last couple of years, went to an ER only to find it closed.
With respect to Toronto, and more specifically ambulance services, they are jointly funded by the province and the city, but I understand that provincial funding is more significant.
All parties recognize things are not functioning well, and various attempts at increasing spending have been made, but any effort will take significant time before results are visible. I'm not particularly optimistic, and the current provincial government's track record here is dismal. Their policy is to be tight-fisted.
Toronto healthcare generally is quite below the bar. When I moved here 5 years ago, I was told that hospitals are short staffed, ambulances have significant delays, and when you do finally get care you are rushed through the system.
Fortunately I only had one encounter with a situation requiring ambulance (and subsequent hospital visit). Ambulance arrived in about 10 minutes, triaging before seeing a medical professional took hours. There were no rooms so I was kept in a hospital bed in the hallway along with other patients but with some monitoring.
Now to be fair - this was during Covid which understandably put pressure on medical resourcing.
The federal government shifts the responsibility to the provinces, the provinces in turn try to download as much as possible onto the cities. There's not enough money for everything on every level of the government.
This also reflects on 911/dispatch systems, where there indeed might not be easy visibility of when an ambulance might be available, and even then it could be preempted by a higher priority call -- although a heart attack has to be close to the top of the list.
There are also occasional weather events, like the storm two days ago, that cause a surge in demand (>300 crashes reported and many of them needed attending to).
> The federal government shifts the responsibility to the provinces
It's not a 'shift'. Healthcare has always largely been in the hands of the provinces.
The federal government funds research, distributes money from have regions to have not regions, and sets federal standards, but the actual spending of money and provision of services is in the hands of provincial authorities.
Healthcare is one of the exclusive powers of the provinces, as laid out in the constitution. There are things the federal government can do, such as provide money, but provincial leaders complaining about lack of federal involvement do so in bad faith; they would certainly complain louder if the federal government overstepped their bounds. It's worth pointing out that taxation and borrowing are also constitutionally protected powers of the province.
It is indeed a power of the province. I meant the shift in responsibility for funding the healthcare programs. The initial health transfers to the provinces in the 1970s covered approximately half the cost; now, the ratio is around 22% (and actually growing in recent years).
like in many places people live too scattered (higher density would provide more healthcare facilities closer to people), service costs are enormous, and productivity is abysmal
