September 21, 2001

Picco wants to revamp Nunavut’s medevac system

GN wants same service for less money

JANE GEORGE
Nunatsiaq News

MONTREAL — Nunavummiut needing emergency medical care in the South will soon have a new, Nunavut-wide medevac system to rely on.

When emergencies occur in the Baffin and Kitikmeot regions, medical personnel now call on aircraft and trained paramedical staff that are on standby in Iqaluit and Cambridge Bay for medical evacuations.

In the Kivalliq, however, the GN uses a different method to handle medevacs — a method they’re extending to the other two regions.

When a medical emergency occurs in the Kivalliq, a dispatcher contacts either Skyward Aviation or Keewatin Air for an air ambulance. The chosen company then finds an aircraft and crew that’s available to fly.

The GN is now looking at contracts for medevac services to see if it can save money while maintaining services at their currrent levels.

“I want to get the best bang for my buck,” said Health Minister Ed Picco.

A few months ago, Picco decided not to go to tender for a new contract for one sole medevac provider in the Kivalliq region. Instead, he decided to issue a call for someone to review how the GN manages medical evacuations and to recommend improvements.

“I want to study it and say, ‘Is this the best way to do it?’” Picco said. “Maybe there’s an opportunity to be more cost-effective.”

Every year, Nunavut’s health and social services department reserves and pays for blocks of flight time from two charter airlines, Adlair and Kenn Borek.

This commitment means that in the Baffin and Kitikmeot regions, these companies can afford to keep two aircraft, with crews and staff with medical training, on permanent standby.

But in the Kivalliq, the GN only pays for the number of medevacs that Skyward Aviation and Keewatin Air actually make.

This means that when Keewatin Air carries out a medical evacuation, the airline uses aircraft that are specially equipped and manned for medevacs. But it can’t count on a guaranteed number of hours for medevac flight time to pay up front for their availability.

Keewatin Air juggles aircraft used for medical flights with those flying scheduled runs under its passenger arm, Kivalliq Air.

Picco suspects the real difference between these two ways of providing medevac services may lie more in the cost than in the level of service.

That’s because buying a prepaid block of flight time can cost more than paying for medevacs on an as-needed basis.

Picco said a central dispatch service for all medevacs in Nunavut could turn out to be a more cost-effective option for the territory.

Under this scheme, the GN would pay a service fee to a central dispatcher and pay for any usage.

Randy Klym, vice-president of sales and marketing development for Keewatin Air, said for 30 years the airline has managed to operate within the region on a similar basis.

Klym said weather, not the availability of aircraft or the volume of calls for medevacs, is the main challenge that Keewatin Air faces in supplying the service.

Medical travel costs the GN’s health department about $20 million a year, around 20 per cent of its total annual budget. Travel is responsible for most of the department’s budget deficit.

Last year, guidelines for patient escort travel were tightened up, but the stricter policy hasn’t had much financial impact yet.

In February 2002, the contract for routine patient transportation also comes up for renewal.

Picco said changing the way contracts for medevacs are handed out will be the first step in revamping the “whole system” around patient transportation within Nunavut and between Nunavut and health-care centres in the South.