Municipal leaders in eastern Ontario are nervously watching for what the PC government's plan to merge paramedic services will mean for their communities.
As CBC News has previously reported, the provincial government is planning to merge 59 municipal and local paramedic services into 10 regional providers.
Details remain scarce on how ambulance services will be amalgamated.
Michel Chrétien, director of emergency services in Prescott-Russell, east of Ottawa, said he's disappointed the ministry did not consult more with paramedics and municipalities.
"We're totally surprised," he said.
Chrétien said he's concerned it would worsen the persistent problem of ambulances from rural municipalities surrounding Ottawa getting tied up on calls in the city.
"That really scares me, where the rural communities will be less well served than the urban communities," he said.
He said a regional dispatcher could decide to move ambulances that are currently stationed in Prescott-Russell to Ottawa.
"We move one or two of those [and] people are going to wait longer [here] and, I don't want to say this, but people may suffer because of that."
Chrétien said he's skeptical reorganizing dispatch would save the province money.
He would rather see the province change the rules that force paramedics to wait for long periods to discharge patients once they're at hospital.
"The cost of sitting ambulance services in waiting rooms must be unbelievable across the province," he said.
Chrétien said he's also worried the province could dictate the cost to municipalities without giving them a say in the expense or how their community is served, which has been an issue with the Ontario Provincial Police.
Damper on innovation
Peter Emon, reeve of the Town of Renfrew, said he's also worried amalgamation could make the resource issue worse.
Renfrew County has also been struggling with paramedics tied up on Ottawa calls.
But the service has also invested in innovative techniques, such as community paramedicine, which has paramedics check in on isolated patients in the community to try and avoid hospital visits.
Emon is worried if Renfrew becomes one vote on a larger board it be bad "for innovation, for research, for individualized delivery."
"We're not sure at this time, nor in the future can we be sure, that any potential partners who sit on a board governing the actions of the paramedic service would share those values," Emon said.
Emon said he's encouraging constituents to write their MPPs to get details about the Doug Ford government's plans for emergency medical services.
Back east in Russell, Mayor Pierre Leroux said he's waiting for details of the province's plans and wants to make sure his residents will still be able to get help in French, as local paramedics are bilingual.
"In an emergency situation, you want to be able to speak in your maternal tongue," he said.
"If there are changes that affect that ability, you could be putting people's lives at risk."
Myles Cassidy, chief of Ottawa Paramedic Services, was not available for comment.
Jason Fraser, a paramedic in Peterborough, Ont., and chair of the CUPE Ambulance Committee of Ontario, said he's worried the restructuring could further reduce the ability to respond to increasing call volumes.
"Call volumes are escalating now at a greater rate than the staff for the ambulances are [increasing]. So with the restructuring, is there a potential there for that to get worse?" he asked.
Fraser said he's also worried that costs could be downloaded onto municipalities.
"If it is, all of our current problems will probably get worse. We'll probably see more of a lack of available resources to respond to the individual municipalities," he said.
"We have not seen a plan, so it's really hard to tell what's going to happen."
In a statement, the Ministry of Health and Long-Term Care said it is "reinvesting back-office, administrative efficiencies right into improving frontline care."
The statement also said no paramedic would lose their job and the ministry looks forward to working with front-line staff and municipalities on modernization.