Shortage of ambulances in Toronto means city not prepared for major disaster, paramedic union says

Toronto is not prepared for a major disaster involving mass casualties because the city has a shortage of ambulances available to respond, warns a spokesperson for the union that represents the city's paramedics.

Mike Merriman, paramedic services unit services chair for CUPE Local 416, said the city doesn't have enough ambulances to cope with normal call volumes, let alone a disaster, and blamed the shortage on chronic underfunding and understaffing. The union local represents about 1,400 paramedics in Toronto.

"If there's ever a huge disaster, I don't know how they're going to handle it. I have no idea. When they have to call in surrounding services to handle what's considered our normal call volume ... then what are they going to do when there's a major event?" Merriman said on Wednesday.

"These other surrounding ambulance services are not in the greatest position to be sending their troops into Toronto as well."

A shortage of available ambulances in Toronto prompted the union to declare a code red on Monday. The designation means there are no ambulances available in the city to respond to a 911 call. It can also mean a backlog of calls in the queue.

Service has reached 'tipping point': union

Merriman said Toronto Paramedic Services had to request help on Monday from paramedic services in municipalities that border the city.

"It's bad out there on a daily basis," he said.

"The other day wasn't really an anomaly except for the fact that the service has never gotten to the point where they've had to basically beg their neighbours for help and put out a call to the surrounding municipalities to help clear up probably at least 50 calls that were sitting in a queue."

Merriman said the service has reached a "tipping point" and members of the public as well as their elected representatives need to know what is happening.

He said the calls on Monday were not life-threatening but individuals on the other end of the line were left waiting. 

"The one that comes to mind, what I heard about from one of our crews, is a woman in her 80s who fell and looks like fractured her arm and she was waiting on the ground for hours before a unit could get there. It's not acceptable," he said.

Merriman said there should have been enough paramedics in Toronto to respond.

He said part of the problem is a growth in management ranks at the expense of frontline staff. For example, management has recently taken about 25 paramedics off the road and made them acting supervisors. He said the result is some paramedics are burning out while others are leaving the job.

'No borders for ambulances,' city says

Dineen Robinson, spokesperson for the city, confirmed that Toronto Paramedic Services experienced higher than normal emergency call volumes on Monday.

Robinson said the city does not track code red data and that there are situations when ambulance availability is low.

"During busier periods like Monday, paramedics are routinely diverted from lower priority calls to higher priority calls. Higher priority calls will always be responded to first," she said.

"In order to help ensure the most effective response to high priority patients, there are no borders for ambulances. The closest ambulance is always chosen to respond to high priority calls, regardless of location," said Robinson.

Robinson went on to add that paramedics in neighbouring jurisdictions respond to a small number of emergency calls in Toronto daily and that Toronto paramedics do the same outside their borders.

Robinson said paramedics face "significant hospital pressures" when offloading patients and that emergency call volumes have returned to pre-pandemic levels. She attributed that to an "aging, growing and increasingly vulnerable population."

She said members of the public can help to ensure that paramedics are available for the most seriously ill and injured patients by considering alternatives when faced with minor medical issues. These options include going to a walk-in clinic, talking to a pharmacist or accessing Health811 by calling 811.