'We understand that air ambulance can be improved, should be improved': Osborne says medevac improvements for Labrador are coming

Health Minister Tom Osborne. -Joe Gibbons/SaltWire file photo

People in Labrador have had to wait days for a medevac.

Some have even been denied boarding a medevac flight when they needed it.

Residents have been forced to resort to flying commercial when medevacs weren’t available.

Over the past few weeks, SaltWire has documented the stories of several Labrador residents who say they were failed by the province’s medevac service.

N.L. Health Minister Tom Osborne recently addressed some concerns about the medevac service in an interview, and says he realizes there are some shortfalls with the system.

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“Right now, we have a very fragmented service," Osborne says.

"There are seven providers of air ambulance in the province today. It is fragmented in terms of the numbers of providers and the lack of central command for both road and air."

Osborne says he understands that residents in Labrador rely on air ambulance –– and he's promising that change is coming.

“We have an RFP that’s closing the April 1 that is intended to improve air ambulance services throughout the province,” adds Osborne.

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Osborne was quick to point out that previous recommendations for a third plane for Labrador are now irrelevant.

“What we’re doing (is) based on the Health Accord, which is the most recent recommendations, and two years old. Based on the advisors that looked at modern services today, and looked at the best services that we could base ours on," he says.

“The introduction of rotary wings will get to areas that have not been well served by fixed wings."

He says that the new service, under the RFP, will require medevacs to be ready within 30 minutes of being called out – half the current time of 60 minutes.

“There has to be an aircraft available at all times, ensuring that the availability of air ambulance," Osborne says.

"There’s a number of features built into the RFP that would ensure better service for the residents of Labrador."

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Osborne says the RFP will have added benefits –– key among them being a central command and a single service provider responsible for the entire operation.

“Somebody requiring a medevac, for example, the decision is made between the attending physician and the receiving physician. The ultimate decision for a medevac will be made by the emergency physician on duty at central command," Osborne says.

“Ultimately, when a decision is made, then the air services will be communicated to when the decision is made. Then they determine based on weather conditions whether it is safe to fly."

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Osborne points out that sometimes, medevacs are storm-bound when commercial flights are in flight.

“Medevac requires a different set of standards for flight than commercial airlines, based on turbulence, weather, time of day,” says Osborne.

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Osborne also addressed issues with the costs of returning home after a medevac.

“The responsibility of medevac is getting a patient who requires a higher level of care from one facility to another," he says.

“I think we’ve had some discussion with the provincial health authority in terms of protocol and how communication is provided to a patient upfront, so that patients understand, families understand exactly what’s involved.

“There should be a standard of communication so that that is clearly outlined and defined to a patient and/or a family.”

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Labrador residents have been concerned that they've needed to compete with each other to get ahead of the queue for a medevac.

"Somebody may be next in the queue, and based on another person requiring a medevac who may be more urgent, they may move up ahead of the person who’s next in the queue," Osborne says.

"But those decisions are not made by the department, they’re not made by the pilots that fly the planes.

“Those decisions are made between the attending and receiving physicians. They are medical decisions that are made by medical professionals and signed off by the emergency physician at the command centre. It’s medical triage, we don’t determine who’s next.”

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Recently, NDP MHA for Torngat Mountains Lela Evans claimed that the health authorities have lied to patients about the status of their medevac.

An official with the Department of Health and Community Services explained why sometimes, patients didn’t have information about the status of their medevac.

NDP MHA Lela Evans. - Juanita Mercer/The Telegram

“Patients’ condition is monitored by the attending physician and the online medical control. That situation can change in real time," the spokesperson explains.

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“With this patient, at this time, there might be six or seven patients at the same time. Their conditions are changing all the time. And the prioritization of the operations is quite fluid.

“The patient on the ground is not necessarily aware of that whole system view. That’s a situation where you get that different perspective.”

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Osborne says the availability of aircraft is another major issue with the current air ambulance service.

“There will always be aircraft available, and ready under the new contract," he adds.

"The provider has to ensure that they are accredited, which will also ensure that the services are reliable and efficient."

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Osborne says he has heard complaints from people.

“We understand that air ambulance can be improved, should be improved, and that is the whole reason for the RFP that’s been put out. We see that improvements are required, and there’s an RFP on the street,” says Osborne.

Health Minister Tom Osborne speaks with reporters at Confederation Building’s West Block. - Juanita Mercer/The Telegram

He says improvements are coming.

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“We can’t control weather. I’d like to have a direct line to the guy who does," he says.

"Weather aside, the RFP will ensure a more efficient, more reliable service for the people of the province. Medical triage is left to the medical professionals, and weather is left to a higher power."

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He admits that delays will still be possible, even multiple day-long delays, but says that will be limited to specific situations.

“Only based on weather or medical triage. In terms of flight availability and aircraft availability, we will have a better service," Osborne says.

“We will recruit the required staff. We’ve done very well in terms of recruitment in the province in all health disciplines. We will recruit to ensure that staff are available."

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PC leader of the opposition Tony Wakeham says the RFP is a great step, but he’s worried about some aspects.

“It’s one thing to have aircraft, but it’s another thing to have pilots," Wakeham says.

"That’s where the breakdowns have been. We do not have, in my opinion, enough qualified staff for our medevac program –– even pilots. They now say pilots have timed out.”

Progressive Conservative leader Tony Wakeham. - Keith Gosse/The Telegram

Wakeham says staffing concerns aside, there are other things his government will do differently.

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“In my government that I would lead, I would make sure that it included a routine air ambulance service everywhere in the province,” says Wakeham.

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Wakeham adds that an overhaul to the province’s MTAP program is also needed, which will include help to those needing to get back after a medevac flight.

“There’s a bunch of things that would have to happen in the whole medical transportation field. There’s a significant cost that is on people. I have said that when we form government, we’re going to reimburse people 100 per cent of that," Wakeham says.

“People should never have to worry if they have to travel for their specialist appointment, or some other medical procedure they need to get done."

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Sanuda Ranawake is a Local Journalism Initiative reporter covering Indigenous and rural issues.

Sanuda Ranawake, Local Journalism Initiative Reporter, The Telegram