The County of Lennox and Addington is the latest Ontario community to dip a toe into private health care by signing a deal with Medavie Health Services to run its paramedic service.
The three-year partnership began on Nov. 8 and the paramedics who make up the service are still county employees but managed by Medavie.
Brenda Orchard, the county's chief administrative officer, said she's excited by the change because it will add resources and expertise for the small service.
Others question what benefits the agreement will actually bring, as well as Medavie's motivation.
"The focus needs to be on patients, not profits," said Darryl Wilton, president of the Ontario Paramedic Association.
Wilton said injecting a private company into public health care doesn't work. He suggested this could be a way for Medavie to get a toe in the door so it can continue expanding its footprint across the province.
Darryl Wilton, president of the Ontario Paramedic Association, says issues with Medavie Health Services have been reported in other parts of the country. (Matthew Kupfer/CBC)
The company is based in Atlantic Canada, but operates in six provinces, including Ontario. In some places it controls all staff and assets, while in others, such as Lennox and Addington, it only employs management.
Medavie describes itself as a not-for-profit where the money goes toward a foundation that gives back to the community, or is reinvested in the organization, according to Matthew Crossman, the company's vice-president of operations.
"We're here to do what's best for the patient," he said. "It's not about profits."
2020 report found issues in N.B.
Ambulance New Brunswick, the Crown corporation that runs that province's paramedic service, has contracted management to Medavie since 2007.
But a 2020 report from New Brunswick's auditor general found Medavie lacked oversight and the contract allowed the company to conceal lower response times for rural communities that would, in some cases, have caused it to miss out on performance payments.
The contract also allowed for other "questionable payments," stated a news release accompanying the audit.
"Paramedic shortages created over $8 million in surplus payments to Medavie Health Services New Brunswick, providing a disincentive to address low staffing levels," said auditor general Kim Adair-MacPherson at the time.
Crossman, who also ran Ambulance New Brunswick for about five years, argued Medavie was hitting targets there but they were set up based on an urban response, instead of a rural one, which led to issues.
County excited about change
Orchard said Lennox and Addington's contract with Medavie doesn't include any set performance targets.
After being asked about specific concerns raised in New Brunswick, she reiterated council remains in control of the budget and governance of the service.
Orchard said the "magic" of Medavie is: it offers best practices from other provinces, data analytics, buying power and "bench strength," which can be called upon when issues arise.
"We're really quite excited because they're going to be able to help us implement programs that we can't develop ourselves," she explained.
Matthew Crossman, the vice-president of operations for Medavie Health Services, says the company offers expertise and data analysis that can help smaller paramedic services. (Kerry Campbell/CBC)
Crossman said Medavie brings resources, education and a digital dashboard that allows the service to monitor performance metrics.
Wilton remains skeptical of the company's "dazzling" sales pitch, calling it "lingo bingo."
He said Ontario paramedics are already recognized as experts in data collection and pointed to reports of Medavie's performance and payments as "money that the taxpayers should have held in trust for their medical care."
Company wants to keep growing
Wilton also pointed to the District of Muskoka, which previously partnered with Medavie before bringing its ambulance service back in house in 2016.
A staff report to that district's council showed an estimated $480,000 in savings if the district started delivering its own ambulance service.
Medavie also runs the paramedic service in Chatham-Kent, Ont., where there was a five-week strike this past summer.
Laurie Chapman, who manages hospitals with Service Employees International Union, worked with paramedics during the work stoppage and said she hasn't seen any of the improvements the company promises.
"There doesn't seem to be any special skill or strength that Medavie brings to the table," said Chapman, adding there's a sense among some paramedics in Ontario that the company is "slowly taking over the world."
Crossman said Medavie is "absolutely" open to growing its presence in the province if the move makes sense for the company and the community.
A Medavie spokesperson declined to provide details about plans for expansion, saying the information is confidential, but stated growth is a "key focus" for the company.