Long-delayed reports reviewing N.S. ambulance system, anaesthetists could come soon

Ten months after it was originally due, Health Minister Randy Delorey says a review of Nova Scotia's ambulance system is imminent.

Health Department officials hired U.S.-based consultants Fitch and Associates last year to carry out the review as the system faced increased strain due to rising demand and delays handing patients over to emergency department staff. In response, paramedics staged a public campaign drawing attention to burnout and problems with service availability.

The report was due last December, but the deadline was then pushed to the spring. More recently, Delorey said he expected the review by the end of September.

"My update today is that the report details have been finalized and I should be receiving it imminently," the minister said in an interview at Province House on Tuesday.

Paramedics still expressing concern

Delorey could not say why the report has taken so long, although he noted the system is complex to evaluate because it does much more than just provide emergency services.

"It integrates and touches multiple parts of our health-care system," said Delorey.

"There are also community-based programs as well that the [Emergency Health Services] is part of supporting."

Tory health critic Karla MacFarlane said she's frustrated by the report's delays, particularly because she continues to hear from paramedics voicing their concerns with the system.

"They feel that there has been no improvements made, regardless of what the minister has indicated. They're still working long shifts with no breaks."

She's hoping the report provides a template, or even direct solutions, on how to improve the system and working conditions for paramedics.

Delorey said he hasn't waited for the report to make changes to the system. He referred to a recent directive aimed at decreasing ambulance offload times at five of the busiest emergency departments in the province — a move that is showing positive initial results.

The Health Department is also looking at ways to expand the use of paramedics and their role in the community, said Delorey.

It remains to be seen whether the report will be made public when it's finally delivered. Delorey said there could be proprietary information in the document, and he noted there is a process that can be followed using the freedom-of-information system for people to get government documents.

But NDP health critic Tammy Martin said that's not what it should take for the public to see the report.

"We're talking about public health. We're talking about people and lives. We shouldn't have to investigate and file reports in order to find out what's in this report."

Martin said it's disturbing how long the report has been delayed.

Other delayed information

The ambulance review is not the only overdue report Delorey has been waiting on. 

Recommendations from the Nova Scotia Health Authority's perioperative group regarding the use of family practice anaesthetists in the province were also due by now.

Delorey had initially asked last autumn for information on the role, which can be used to augment anesthesiology services in the face of a national shortage.

While the process appears to have dragged on, potentially costing the province training opportunities, the perioperative group was scheduled to make a presentation to the health authority's medical leadership in late September. A spokesperson for the health authority said on Tuesday that officials would be meeting with the deputy health minister in mid-October.

Although the role, which is filled by a family doctor with additional training in anesthesiology, is widely used in Ontario and western Canada, Delorey said he's still waiting on information and advice "as to whether this clinical practice is appropriate in a Nova Scotia environment."

"When I see the report and I'll see the nature of the information that's been assessed and the recommendations that come forward and I'll draw a conclusion from that at that point."

Medical leadership in New Glasgow and Antigonish have called for family practice anaesthetists to be used to help address service shortages, which have also plagued hospitals in Yarmouth and Amherst.