Why is government sitting on patient transfer recommendations?


The provincial Ombudsman has followed up on his damning report on the privatized, non-ambulance patient transfer industry.  

The Mike Harris Progressive Conservative government privatized the patient transfer industry at the turn of the century, moving the work over from Emergency Medical Services (ambulance services).   

Two years ago, however, the Ombudsman and the CBC reported major problems in this newly privatized industry, including threats to patient safety and working conditions.  

Ontario residents would be better off taking a taxi to a hospital than one of the privately owned vehicles used to transfer hundreds of thousands of non-critical patients each year, provincial Ombudsman Andre Marin concluded.

On July 16, 2013, the Ombudsman followed up on his earlier report, stating that “Two years after promising to regulate the non-emergency medical transfer industry to protect the hundreds of thousands of patients transported annually in these ambulance-like vehicles, it (the provincial government) has yet to do so.”

In a special section on patient transfer the Ombudsman noted:

"In 2011,the Ombudsman completed an investigation into whether the Ministry of Transportation and the Ministry of Health and Long-Term Care were adequately protecting the public who use non-emergency medical transportation....The investigation found significant problems, including poorly trained staff, inadequate equipment and lack of infection control. The Ombudsman shared a working draft of his findings with the two ministries in May 2011. In June 2011, the then Ministers of Transportation and Health and Long-Term Care jointly announced that legislation would be introduced to regulate the industry.  Unfortunately, there has been considerable delay in introducing legislation, in part due to the calling of a provincial election just prior to the ministers’ announcement in June 2011, and the prorogation of the subsequent session of the Legislature in 2012.  The Ombudsman pursued this issue with the Ministry of Health and Long-Term Care, which was to lead the process of regulating the industry. The Ministry began consultations with stakeholders, with a commitment from the Minister that regulation would follow. In late 2012, the Minister received a report and recommendations arising from consultation. That report remains under review by the Minister. SORT (Special Ombudsman Response Team) continues to monitor this issue and pursues regular updates from the Ministry. The Ombudsman also discussed it with the present Minister of Transportation in May 2013." (My emphasis.)

It remains unclear what sort of 'consultations' the Ministry was involved in over regulation of the private patient transfer industry.  Or who they consulted. 

Moreover, the report and recommendations to the Ministry (revealed by the Ombudsman above) on patient transfer regulation remain secret.   There's no word on when, or if, they will be revealed.  

According to the Toronto Star, the Minister of Health and LTC responded to the new Ombudsman report by promising, again, to regulate the patient transfer industry by this time next year.  (Notably, two years ago the government promised to legislate “at the earliest opportunity”.)

Just shortly before the public release of the Ombudsman's new report, the Minister of Health and LTC strongly endorsed the restructuring of the private patient transfer industry in the South West LHIN.    The restructuring would designate a sole patient transfer provider for the LHIN.  

Photo: extranoise, Berlin ambulance.


  1. Speaking as a paramedic - I fully support public healthcare, but there is a role for these non-paramedic patient transfer services. Taking a fully equipped emergency ambulance off the road, staffed with highly trained paramedics, to take a patient home (or commonly to a nursing home) after they've been discharged is a waste of resources. It affects emergency coverage and availability of resources. While they often are returning to a place where they need/have some assistance like a long term care facility, by definition they stable and do not require ongoing medical attention during transport.
    There is also the category of interfacility transfers, which is case dependent: while the ST elevation MI needs ongoing treatment and lights and sirens transfer, many non-acute transfers could normally be accomplished by the patients' own means, but in some cases require non-emergency transfer due to pre-existing disability, dementia etc.
    The point being, there is a role for these services, but hopefully in the framework of government regulation. And it would be nice if they could be clearly differentiated in the public's mind from trained emergency paramedic services... but that's probably just a pipe dream.

  2. Interesting points Josh. I agree there is definitely a role, but I am not sure the current system is working.

    Speaking only personally, I would consider integration with the EMS System. I think that would be the most likely route to an appropriate division of labour between ambulances and non urgent transfer, adequate regulation of non urgent patient transfer, and fair pay for non urgent patient transfer staff. Presumably such an arrangement would also allow patient transfer employees who have the appropriate training and credentials the opportunity for promotion to paramedic work, status, and pay when positions become available.

    In any case it is apparent that the next step from the government is not going to be that. We will see if it is a significant step forward to better health care and reasonable working conditions in the patient transfer industry.

  3. Hi,
    Well said Allan, I totally agree with you that government will have to do something for improving the medical transportation but I want to share something is that government have some rules and regulations for Non emergency medical transportation industry which government can inspect all the companies who involved in this industries time to time and makes a report and government can cancel their license or can not extend their contact if they are fail to provide better services according to the rules and regulations. I personally have some experience with Scottsdale, the USA based company who runs under “The Patient Protection and Affordable Care Act” and they put comfort and security at their first preference.