Beginning in March, emergency patients being transferred by fixed-wing air ambulance from northern Alberta to Edmonton will be rerouted to the International Airport instead of landing at Edmonton's City Centre Airport.
The move has been in the works for some time with the City of Edmonton moving forward on its plan to close the City Centre Airport and open the area up for residential and commercial development. The plan hasn't been without controversy and with the changeover now imminent, it's difficult to find a municipal politician in northern Alberta that doesn't have reservations about the change and what it will mean for emergency care for northern Albertan residents.
But Bonnyville-Cold Lake PC MLA Genia Leskiw said that as far as she is concerned the issue “hasn't come across my desk,” in recent months. “I have so many other issues that I haven't really looked into it.”
She said while she has received emails and letters on the issue, they have come from individuals and groups outside of her constituency. Asked specifically if local municipalities have raised the issue with her, Leskiw indicated nothing had been brought to her attention recently, adding it was a “done deal.”
“Patient welfare is the number one priority in what is being done,” Leskiw said. “I have to believe that, I want to believe that.”
While it may in fact be a done deal, the lobby to pressure the provincial government to step in and somehow force the hand of the City of Edmonton to keep the City Centre Airport open is far from done.
Save Our medevac Service (SOS), a group of medical doctors, medevac pilots and rural Alberta advocates, is charging that it is the Alberta Government's duty as guardians of the provincial health care system to ensure air ambulance continues to land at the City Centre Airport until such time as an alternative which provides the same level of tertiary care that is available today is found. SOS does not support Health Minister Fred Horne's assertion that the International Airport plan is going to achieve that.
“We have a saying in medicine: time is tissue. The longer tissue isn't getting blood, the faster it dies. I can push a gurney down (the road from City Centre Airport to the Royal Alex Hospital) faster than an ambulance can get from Edmonton International Airport to either the University of Alberta or the Royal Alex Hospital,” Dr. Kerry Pawluski, an Edmonton doctor and president of SOS, told a recent meeting in Lac La Biche.
It is the additional time involved in getting an emergency patient from northern Alberta into an Edmonton emergency room for specialized treatment that is at the forefront of concerns over the switch to the International Airport.
Pawluski issued a call to action in a letter to northern municipal councils in October, asking them to contact the Premier and MLAs and voice their opposition to proposed changes. “Acting now to keep Edmonton's tertiary care hospitals accessible to timely medevac air ambulances will help avoid preventable deaths and impaired health outcomes,” Pawluski wrote.
Pawluski cited an independent study by the Health Quality Council of Alberta that found in 2010 that the “close proximity of the Edmonton City Centre Airport to two primary tertiary care hospitals has resulted in Edmonton providing the best medevac delivery time in Canada.” However, “the long distance for ground ambulances to travel through traffic from the international airport to the tertiary care hospitals will result in more than a 35 minute delay in patients receiving care even under ideal traffic conditions … the move away from the City Centre Airport will cause us to have the worst medevac transport time in Canada.”
In response to Pawluski's letter, Bonnyville town council sent a letter to the Premier and all Alberta MLAs, including Leskiw, in November expressing that the government should ensure medevac flights continue to land at City Centre Airport “until proper arrangements are in place to continue the high standard of medevac services for our community and other communities in northern Alberta.”
This wasn't the first time the town had expressed concern about the closure of City Centre Airport. Mayor Ernie Isley has long been a proponent of keeping the City Centre Airport open, not only to receive medevac flights but also for commuter air traffic to and from the north so that Edmonton might in fact live up to its billing as the Gateway to the North. Bonnyville stepped up in 2010 to provide funding support to the Envision Edmonton campaign, a lobby group working to keep the City Centre Airport open.
Isley is deeply concerned about the airport closure but worries that people are coming to the discussion too late to make a difference. He said a local doctor raised the issue with him recently.
“He said, ‘People are going to die' and I said ‘We are a little late doc, I've been arguing that for seven years now'.”
Alberta Health's plan is to have a six-bed patient care area staffed by EMS staff at the International Airport. The most urgent patients will be transferred from the fixed-wing aircraft at the International Airport to Edmonton hospitals by STARS helicopters, while those patients in less critical condition would be transferred by ground ambulance.
STARS will continue in its role as a rotary medevac responder to northern Alberta emergencies bringing patients directly to tertiary care hospitals in Edmonton. However, STARS helicopters are unable to fly in bad weather and face range and speed limitations that are not a factor for fixed-wing medevacs.
“Minister Horne is either deliberately misleading northern Albertans on this or has no clue about what is actually happening to emergency medical services,” MLA Shayne Saskiw said of the government plan. “You don't need a triage unit at the International Airport. There's not going to be a heart specialist sitting at the International Airport. The transportation is going to obviously add time to the emergency.”
While Saskiw is quick to sing the praises of STARS, he said the “workhorse” of emergency medical services has and always should be the fixed-wing planes.
“Every single doctor that I've talked to has said the closure of the City Centre Airport will detrimentally affect patient outcomes. So I will take the word of prestigious doctors over the health minister on this one.”
County of St. Paul Reeve Steve Upham said he is troubled by the rerouting of medevac service to outside of the city centre and believes it's not a stretch to believe emergency response will be compromised due to increased transfer times.
“Municipalities have been networking back and forth to try and advocate for the service. There's definitely some concern with the air ambulance service going to the International and the potential for extended transfer time between there and the hospitals,” Upham said.
“The powers that be would say that with the triage that is going to be available at the International, that it's probably taken care of. I don't have the expertise in it but I would challenge that.”
“As far as the community of St. Paul, of course the decision impacts our community as far as access to health care in an emergency, I can't deny that,” St. Paul Mayor Glenn Andersen said.
“Obviously, if someone is going by air, time is of the essence or it would be ground.”