Province nixes Ottawa paramedic plan to use taxis for some calls

Ottawa paramedics will not be calling on taxis to help transport some non-urgent patients, as the service had initially planned.

Paramedic Chief Pierre Poirier said in a memo Monday afternoon that the Ontario Ministry of Health did not approve a pilot project that would see some low acuity patients put in taxis to take them to alternate destinations that are "best suited for meeting their immediate and individual health-care needs."

The pilot project was originally slated to begin Nov. 1, 2023, but Poirier said the proposal to the ministry was not approved in time to meet that launch date. Now, he says, the plan has been rejected completely.

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"The Ottawa Paramedic Service has now received confirmation that the Ministry of Health has denied the request to permit a paramedic to offer a taxi service to a patient," Poirier wrote. "Specifically, they did not approve the use of 9-1-1 paramedics to coordinate alternate transportation options to the emergency department/hospital, including taxi services."

The goal of the project was to mitigate the effects of offload delay on paramedics and reduce the occurrence of level zero events – where there is no ambulance available to take an immediate call, something that has been happening hundreds of times every year.

Poirier said despite the setback, the use of taxis is still on the table.

"I can confirm that staff continue to explore other options, including the use of community paramedics, to provide care and appropriate transportation (including the use of a taxi) of patients to the hospital," his memo said.

A letter from Assistant Deputy Minister Susan Picarello to Poirier said the ministry would continue to work with the Ottawa Paramedic Service on developing a new patient care model and requested Poirier collaborate with both the Ottawa Central Ambulance Communication Centre and the Central East Field Office.

"Ottawa Paramedic Service should continue to work with the Regional Paramedic Program for Eastern Ontario and all other relevant partners in the development and implementation of this model, including any necessary medical directives and protocols related to the patient care model," the letter said, before stating the ministry does not approve the use of 9-1-1 paramedics to coordinate alternate transportation options to the emergency department or hospital, including the use of taxi services.

"The ministry will continue to work with your service during the implementation and monitor the project through your report backs as indicated in the Patient Care Model Evaluation Framework," the letter said.

'Not giving up': Paramedic Chief

Poirier said he was disappointed when the province did not approve the plan, but told Newstalk 580 CFRA's Ottawa at Work with Patricia Boal that the service is still trying to find a way to make it work.

"We haven't given up. There are opportunities. The ministry of health said specifically we can't use a 9-1-1 paramedic, and some of the options we're looking at is the use of community paramedics. We're looking at how we can make use of their service to provide that safe, alternate transportation to the hospital," he said.

Poirier said the Ottawa Paramedic Service has about three dozen community paramedics who could be part of a future plan that incorporates taxis as an alternate form of transportation.

"It isn't the solution to all the problems in health care, but we have to do every little thing we can to improve the situation," Poirier said. "The offload delays at hospitals have not gone away and it truly is impacting our service to the community."

He described a scenario in which a 9-1-1 paramedic at the scene of a low acuity call consults with a physician, determines the issue is not life-threatening, and then consults with a community paramedic who can then set up a taxi or another form of transport for the patient.

"That's what we're working on today. I won't say we have that in place, but we're looking at how we can do that," he said. 

Health coalition applauds ministry's move

Kevin Skerrett with the Ottawa health Coalition says the use of taxis as alternative transportation does not address the root cause of problems in the health care system.

"This is a Band-Aid," he said. "Rather than addressing these problems and making our ER system and our hospitals work the way they're intended to, they're coming up with this as an alternative in the paramedic situation."

Skerrett says the coalition had serious concerns about the pilot project and the news it was rejected is important and positive.

"We certainly raised serious concerns and I think others have as well about, having a paramedic service that is partly handed over to private taxi drivers that are not equipped to be dealing with patients with injuries and illness urgently," he said. "We were very concerned about this proposal and I think it's very good that the province has made this decision to not support the pilot."

But Skerrett called the province's decision a "half-victory." There is still work to be done.

"There are serious problems in the hospital system at the ER for paramedic services, which need to be addressed through funding and staffing and, there's very serious problems that this decision doesn't address," he said.

-- With files from CTV News Ottawa's Leah Larocque