On Jan. 8 at 6:38 PM, Toronto’s paramedics union tweeted out a Code Red: there were no ambulances available in the city to respond to emergency calls. Anyone who called 911 with a medical emergency would’ve had to wait for an unknown amount of time for an ambulance to reach them, or somehow get themselves to a hospital. In a major city such as Toronto, this seems almost unimaginable—how can it be that such a crucial and life-saving service could be unavailable to those who need it? Unfortunately, this Code Red is yet another example of the failure of the capitalist politicians to manage the COVID-19 crisis; and, as with every other element of the crisis, they have no idea how to fix it.
Confirming the Code Red, Mike Merriman, the paramedic unit chair of CUPE Local 416, stressed that incidents such as the one on Saturday are more common than most people realize. With the recent surge in COVID infections caused by the Omicron variant, more and more medical staff have been unable to come to work. Not only are there fewer paramedics available to respond to calls, but there are fewer nurses available to staff the emergency rooms. This has led to a situation where ambulances are left tied up for hours at hospitals, waiting for patients to be admitted.
These staffing shortages are not just caused by active COVID infections amongst hospital workers. After two years of chaos and COVID surges, burnout amongst paramedics and nurses has skyrocketed. Merriman cited burnout when explaining that fewer paramedics are volunteering for overtime; but the problem goes far beyond overtime. Healthcare staff are leaving the field because they are emotionally and physically exhausted from long hours of underpaid work, the lack of support or resources from senior management and the Ontario government, and growing abuse from right-wing anti-vaxxers. Ontario currently has over 8,000 unfilled nursing jobs, which demonstrates the severity of the problem across the whole sector.
With this level of staff shortage, Merriman said that EMS services in Toronto are “on the verge of collapse”. However, while it’s obvious that this problem has been exacerbated by the pandemic, it would be wrong to say that the pandemic is the cause.
Even before COVID-19 hit Canada, Ontario hospitals were underfunded and understaffed. Healthcare workers and their unions have been sounding the alarm for years, warning that the system has no surge capacity. In 2019, before the pandemic, the CBC reported that Ontario hospitals were routinely over capacity and that hospital beds were being placed in hallways and conference rooms on a day-to-day basis, not just during peak times such as flu season. If the government had acted with urgency then, perhaps the system would not be in a state of near-collapse now. Instead, Ford and the Conservative government passed Bill 124—an appalling piece of legislation which caps pay increases for healthcare workers, including paramedics, at 1% per year, well below the 2.2 per cent rate of inflation. The government also pushed through massive funding cuts in the healthcare sector in 2019. It’s therefore no surprise that we are in this mess—the COVID-19 healthcare crisis was entirely predictable!
The pandemic has thoroughly exposed the cracks in our healthcare system, but those cracks were created by decades of austerity and attacks on healthcare workers such as Bill 124. Now, after two years of watching the system teeter on the brink of collapse, what solutions have we been offered?
Responding to Saturday’s Code Red, a spokesperson for the City of Toronto offered reassurance—that this happens all the time! The spokesperson stated to CTV that “at any moment” all ambulances may be tied up on calls, and that a lack of available ambulances “is not an uncommon occurrence”, blaming COVID-related absences for “delays” in responding to “low-priority” calls. That we are constantly at or near ambulance capacity is hardly reassuring!
Toronto Paramedic Services Chief, Paul Raftis, denied the claims by the paramedic’s union that the system is near-collapse, pointing to the use of overtime (though not responding to the issue of reduced overtime due to burnout) and reliance on firefighters to fill gaps caused by COVID-related absences. He blamed the Code Red on paramedic teams getting tied up at hospitals, therefore proposing that ER staff simply need to prioritize EMS patients. However, the crisis in the ERs—itself a crisis of underfunding and understaffing—cannot be solved through simple reorganization.
Mike Merriman proposed to CTV that paramedics who are currently in managerial positions should instead be deployed into the field. While his sentiment that “we don’t need management pushing pencils in ivory towers right now, we need paramedics on the road” is certainly understandable, this would be a temporary band-aid solution for a long-standing, system-wide crisis. In addition, this wouldn’t solve the issue of staffing shortages in ERs.
At the provincial level, Ford and the Conservatives have stayed mum about Code Reds across Ontario—which is unsurprising, as they clearly have no solutions and care far more about money than they do about healthcare workers and other working-class Ontarians. The Ontario NDP, on the other hand, have spoken out against paramedic shortages in other regions and have repeatedly called for the repeal of Bill 124 and for pandemic pay for healthcare workers. However, they have failed to organize anything meaningful on this front.
Pandemic pay and the repeal of Bill 124 are certainly part of the solution, but neither action would go far enough to resolving the crisis in the healthcare system. Bill 124 should unquestionably be scrapped, but the government shouldn’t stop at removing the cap on wage increases—they should immediately give all nurses, paramedics, and other criminally underpaid frontline workers a permanent raise, in addition to pandemic pay! The government has called these workers heroes for two years but has refused to put their money where their mouth is. Healthcare workers, and all frontline workers, deserve better!
On top of pay increases, we need immediate measures to create permanent surge capacity in the system, to ensure this state of near-collapse doesn’t continue indefinitely. Mass training and hiring of new, permanent paramedics and nurses should be undertaken immediately, and new funding poured into the whole system in order to undo some of the damages caused by decades of austerity. The capitalist government has created this crisis, and healthcare workers should not be the ones paying for it.
Repeal Bill 124 and immediately raise wages!
Mass hiring of paramedics! Create surge capacity!
Stop the criminal underfunding of Ontario’s healthcare system!