Facing enormous pressure, New Brunswick's ambulance service is under scrutiny for its inability to meet the needs of the province's burgeoning and aging population. Craig Dalton, CEO of Extra-Mural/Ambulance New Brunswick (EM/ANB), attended the legislature's public accounts committee Wednesday, where he candidly discussed the systemic issues plaguing the service. “We fundamentally need to think differently about how we provide (ambulance) service,” Dalton stated. “We can’t do it the way we were doing it in 2016 because the world has changed.”
Dalton's remarks reflect consensus among officials and the public alike about the urgent need for reform. The current model of dynamic deployment, which repositions ambulance crews as needed to fill gaps, has come under fire for its failure to serve rural residents effectively. Critics argue this system often results in longer wait times for these communities as local ambulances shift to urban areas.
Evidence of the service's struggles was highlighted by Medavie Health Services New Brunswick, which operates the provincial ambulance service under contract and is entitled to performance bonuses tied to response times. To qualify for these bonuses, the company must respond to 90% of calls within nine minutes in urban settings and within 22 minutes for rural areas. A 2019 report from the auditor general revealed significant inequalities, noting, “The performance payment system results in a bias toward achieving high performance in areas of greater population density, to the detriment of rural or remote communities where 911 calls occur less frequently.” Unfortunately, even these targets were not consistently being met across the province.
Dalton noted the service is “well beyond the point” where it can reasonably expect to meet the 90% response time standard. He suggested there ought to be “a broader set” of performance measures, which would assess not just response times but also the quality of care and patient outcomes. This proposal addresses growing concerns about the accountability of the ambulance service and its ability to meet the specific needs of varying communities.
The conversation surrounding the effectiveness of the current contract with Medavie has intensified. Last September, Dalton emphasized to the committee how public perception around response time bonuses was partly motivating the EM/ANB board to explore revising its contract before its expiration date in 2027. Despite administrative changes at the provincial level, talks with Medavie about the contract are anticipated to commence by the end of the year.
During the hearing, Liberal MLA Éric Mallet raised concerns about whether early renegotiation of the contract was necessary, advocating for reassessment of the whole system. He stated, “Given all the service problems identified across the province, it maybe should be.”
Green Party leader David Coon did not hold back on his criticisms, describing the current contract as “terrible.” He emphasized the necessity for systemic restructuring, calling for the ambulance system to become more community-oriented: “We need a restructuring of the ambulance system so it’s community-based and communities are served wherever they are and not this dynamic deployment disaster.”
Additional pressure for change is coming from local leaders, particularly mayors from rural regions who have become increasingly concerned about inadequate response times. Progressive Conservative MLA Margaret Johnson stressed this point, noting, “We’ve got ambulances being called to Campbellton through this dynamic deployment schedule” which leaves smaller communities without immediate assistance.
Fire chiefs across the province, having faced heightened medical response calls, also called for reforms. Scott Poupart, president of the New Brunswick Association of Fire Chiefs, remarked, “Our members are feeling the pressure from increased medical response calls...” Statistics reveal the gravity of this situation: since 2010, New Brunswick fire departments have received over 157,000 medical assist response calls.
For Chris Hood, executive director of the Paramedic Association of New Brunswick, the committee meeting was mixed. “It’s bittersweet,” he reflected, indicating he was pleased to see acknowledgment of the deployment model issues, yet frustrated it had taken this long. “We weren’t lying when we said the problem is in the system,” he asserted.
These mounting problems signal the urgent necessity for not just minor tweaks but substantial reform of the ambulance system. Stakeholders are eagerly awaiting the outcomes of the discussions surrounding the contract with Medavie and exploring how best to address the growing demand for reliable emergency healthcare services. With the province's population dynamics shifting rapidly, now is not the time for complacency. How New Brunswick responds could well determine the efficacy and sustainability of its emergency medical services for years to come.