Press Release: May 5, 2014 – BCEHS Political Agenda vs Anything Factual
(This Letter was submitted to the editor but size of article maybe too large for print, see below for full edition).
I have no desire to get into a lengthy letter writing campaign with BC Emergency Health Services (BCEHS) or anyone else for that matter. However, facts, not spin, must be considered when decisions are made that affect public safety. In response to Wynne Powell’s letter to this paper, I have read the report by Alan Craig, he references as BCEHS’s 3rd party expert. I don’t doubt the mandate of the BCEHS board is to ensure that the best interest of patients and the public is always a priority. My question remains, is his letter, fact or spin? There is a significant difference between Mr. Powell’s comments and fact, as provided in their own third party Alan Craig’s experts report.
Dr. William Dick, vice-president of medical programs at B.C. Emergency Health Services, said the changes flow from a rigorous two-year expert review that assessed outcomes for patients. BCEHS says, Craig’s analysis reported that changes were made based on industry best practices using a process that is superior to those used by most emergency medical service (EMS) systems. At page 21, Craig’s report actually contradicts those claims. Craig’s report speaks at length to the inaccuracy of any analysis due to the missing data. His lengthy report on that point is summed up with this quote “It is recommended that the BCEHS analytic metrics be amended as described to improve the precision and usefulness of the analysis”; quite different than BCEHS Medical director Dr. William Dick’s claim that the review was based on patient outcomes.
Wynne Powell states “….the RAP committee – comprised of physicians, paramedics, nurses and first responders – used evidence-based methodology to develop the updated ambulance and fire department response to medical calls.” Fact or spin? Again the Craig report contradicts BCEHS, when looking at page 4 and again at page 31, which is best summarized in this quote from Craig’s report “BCEHS RAP development was in essence an “expert opinion” process. In medical science, expert opinion is considered less powerful than decisions derived objectively from actual data”. Craig goes on to say “Transitioning future decision processes towards increased reliance on clinical data, and less upon expert opinion, would enhance the process.”
What Wynne Powell and Dr. William Dick are not saying, the Craig’s report does is “The BCEHS RAP process as it exists today is, at its heart, a consensus process, driven by individuals who play varying roles in the EMS system. Although informed by data, the process was not decided by the data, for a wide range of reasons.”
Any RAP review or analysis did not consider if there were any health interventions applied before the paramedics arrived on scene; where first responders can enhance patient care. For example a patient may have had high blood pressure, rapid respirations and a rapid heartbeat, but received oxygen treatment and all their vitals were normal when the paramedics arrived with a quick response time (lights and siren). If that same patient is left waiting for 30, 40 -60 minutes due to the routine response, critical vital signs may deteriorate.
As I stated in my first letter, if BCEHS, has no desire to enhance patient care with first responders, then there is only one alternative; there needs to be more ambulances in service. If the BCEHS mandate, as stated by Wynne Powell is to ensure that the best interest of patients and the public is always a priority, then it is time to stop the spin and face the facts. Trust is at the heart of the matter when their public statements contradict their expert opinion.
Regardless, it is troubling that BCEHS would be so intent on comparing itself to Ontario, which at best is a mediocre system. There are many far better systems and a world class system two hours down the road in King County. Our residents deserve the best possible system, they pay for it; when they call 911 they have a right to expect a timely response and not be told theirs in not a real emergency. BCEHS, Wynne Powell, Dr. William Dick and the Craig report have a convenient response to all concerns raised by all those interested. The Craig report both by its nature and context in the body of the report contradict the conclusion. Fact or spin; you decide. In the view of Surrey Fire Fighters, this debate and the Craig report is more about a BCEHS political agenda than anything factual.
President, Surrey Fire Fighters’ Association