The Paramedic Deal to End Amalgamation Woes

As PNN subscribers clearly know, the paramedics in Winnipeg have been going through trying times for the past decade.

The planned integration of paramedic and fire services has been proposed in other jurisdictions (most notably Edmonton – where it failed) and has actually been attempted in Winnipeg before. In the 1980’s, the planned merger was to streamline care and save money however it was scrapped within a couple of years by city council. In 1997, the idea was resurrected by a new city council and led to 10 years of distrust, frustration, and conflict.

On May 11 & 12 2007, the membership of the Professional Paramedic Association of Winnipeg (PPAW) met to consider a Memorandum of Settlement reached by PPAW and the City of Winnipeg after negotiations that culminated with 2 days of mediation by a provincial conciliator. This deal was to avoid the continuation of a Manitoba Labour Board application by the City of Winnipeg to merge the firefighters and paramedics bargaining units into one and to stop the jurisdictional process through grievances that PPAW had initiated. PPAW executive considered parts of the deal “visionary”, requiring faith and trust in the City of Winnipeg’s willingness and ability to live up to the deal. This was not an easy thing for our membership as PPAW feels that past deals/commitments were not honoured by the City of Winnipeg.

The Memorandum of Settlement includes the following:

* All 24 hour ambulances are staffed by an ACP and PCP within 4 years (Winnipeg currently has 13 24 hour ambulances) and all peak ambulances are staffed by an ICP* and PCP within 4 years (Winnipeg currently has 5 peak hour ambulances). The current response model in Winnipeg has some ACP’s on some ambulances but nearly 50% of the fleet is PCP staffed ambulances. This commitment by the City of Winnipeg to an all ALS system would increase our membership’s training opportunities. The City of Winnipeg clearly identified needing 72 ACP’s and 25 ICP’s to achieve the staffing levels identified. There currently are approximately 35 ACP’s and 13 ICP’s.

* PPAW would allow firefighters to practice at a PCP scope of practice (symptom relief meds are Nitro, ASA, Ventolin, and Epinephrine for anaphylaxis). This issue was hotly contested and the reason for PPAW’s grievances. With concerns about future encroachments into PPAW’s work, the deal clearly limits firefighters to a PCP scope of practice and no firefighter is to perform from or operate an ambulance. Any higher scopes of practice are clearly limited to PPAW exclusively.

* PPAW gave some vacation concessions to achieve the training required in the next 4 years. Our vacation scheduling has changed from a maximum of 20% of staff at any one time to 17% (resulting in a reduction of the maximum by one person). Also, as our training is seniority based, a maximum of 3 ACP’s can be off at any one time in order to maintain an ALS system. All of these concessions are to be reviewed in 4 years. When considering attrition due to retirement and the increase number of providers required, it is obvious that the City of Winnipeg will have to be training considerable amounts of its personnel over the next 4 years. All ICP and ACP training is provided “in-house” by the City of Winnipeg.

* ACP premium rates would increase from 8.7% to 12% and a new premium of 4% for ICP was created.

* The Winnipeg Fire Paramedic Service (WFPS) is recognized as the management body of 2 divisions – Winnipeg Fire Department for firefighters and Winnipeg Emergency Medical Services for paramedics.

After considering the pros and cons of the deal and refusing the deal, the membership voted 75% in favour of accepting the deal. This “leap of faith” by the membership is reflective of the changes in practice by the City of Winnipeg since last December. PPAW feels that the management style has changed and that there is a commitment by our new Chief to keep his word and make this work. The original plan of a fully cross trained service has not been realized; instead the legacy of this deal is an unprecedented level of paramedic care for the citizens of Winnipeg while protecting the role of the singly trained paramedic in Winnipeg.

** ICP (Intermediate Care Paramedic) – WFPS provides ACP training from PCP level over 2 years. After the first year of training, personnel are classified as ICP and have a limited ALS scope of practice.

Marc Savard, ICP
Vice-President, PPAW