The Yukon’s ambulance service has been blowing its budget for years, mostly because of staff overtime.
The overtime is not always driven by emergencies.
Rather, it’s because some paramedics were sitting idle waiting for a call.
“The entire service has been functioning on overtime – which you realize is quite expensive,” said Nicholas Tilgner, the freshly minted director of Emergency Medical Services, or EMS.
The overtime budget was run up by a policy meant to minimize medical risk to citizens. But it wound up turning Emergency Medical Services into a clunky, bloated and inefficient government service.
Before Tilgner brought in a new regime a month ago, Whitehorse’s Emergency Medical Services was effectively divided in two.
There was a ground crew, consisting of a minimum two ambulances ready to hit the streets at any moment.
And then there was the air crew, ready to staff the next medevac to Vancouver or Edmonton.
When someone on the ground crew called in sick, new paramedics were called in on overtime pay to take the shift.
They made a killing, and not necessarily because they were working any harder.
“They’ve been living off overtime for four or five years now,” said Tilgner.
On the air side, you had paramedics who spent most of their days bored out of their minds.
EMS handles around 7,000 calls across the territory every year.
Of that, only 600 require a flight.
That’s both within and out of the Yukon.
And of the 600, between 450 and 500 are scheduled flights.
That’s people flying south for planned surgeries, or people being brought back to the Yukon.
So there are only about 150 emergency flights a year.
If there was a call requiring an ambulance, the air crew wouldn’t be called on to help, said Tilgner.
They would be held in reserve in case one of those 150 air emergencies took place.
He felt this was too expensive and risk-adverse when he took over the director job in September.
So now, if a ground crew calls in sick, the air crew will replace them in the ambulance.
“Because (the air crew) is operating within city limits, we can comfortably use them as an asset to keep the ground cars fully manned,” he said.
“And if there is an air call, we’ll backfill from that point.
“But if there isn’t an air call, we’re not filling it with overtime.”
It takes one hour to prep a flight for a medevac, leaving enough time to call in back-up paramedics.
From a manager’s point of view, Tilgner’s melding the two crews together.
“Instead of having two distinct ambulance services, we have one where I can move paramedics back and forth from the air and the ground side,” he said.
“What that means is that we don’t have people on overtime.”
Earlier this week, the News received phone calls from people complaining ambulance service in Whitehorse was being cut.
And in effect, the vacancy for the ground crew is being moved to the air crew.
“It does create an opening, but what it does is create an opening by creating the smallest amount of risk to the Yukon public,” said Tilgner.
“So the service is the same, we’re just adjusting our resources a little bit.”
The change does not mean the air crew vacancy is simply left open.
It depends on the amount of calls EMS is getting, and their communications teams will triage the amount of staff needed.
“When I say we’re not running overtime, it is mission specific,” said Tilgner.
“If we feel that we’re in the position where there’s a sick (paramedic) involved, we will bring people into overtime, we’re just not doing it automatically.
“We wouldn’t take a ground car off to not pay overtime, that’s not the case.”
The Yukon has no law covering how many ambulances must be ready to hit the streets.
But from experience, EMS always has two dedicated 24-hour ambulances ready to go.
That number will not change with the shrinking of overtime pay, said Tilgner.
On the air crew side, there’s a dedicated team ready to head out of the territory, and another devoted to the communities.
That’s where there might be an opening, but EMS will call in overtime paramedics to cover the vacancy should a medevac call arrive, he said.
“We can have calls that max out the system,” he said.
“If we have multiple calls for flu, we would staff cars.
“It’s all triaged at the communications centre.”
Tilgner couldn’t say how much money the policy change will save.
“In the climate of fiscal responsibility, we’re given a budget and EMS has to stay within the budget like any government department does,” he said.
But he’s aware the policy is angering some the paramedics who have lived off overtime for years.
“We do have some folks who are a little disenfranchised because it’s affecting them in the pocketbook,” he said.
“I was expecting your call.”
Contact James Munson at