This post follows up discussions at recent meetings of Parry Sound Council concerning emergency medical services (EMS), basically ambulance services, in West Parry Sound District, with a focus on the north eastern portion of the district. The most recent meeting was held August 26th and is well covered in a pair of articles that can be found in the online edition of the North Star. Here are the links: Article 1 Article 2

It’s an interesting challenge for Parry Sound Council. They essentially are stewards reviewing and approving EMS deployment in the West Parry Sound District, stretching from Georgian Bay on the west to Highway 11 on the east. They are supported by an EMS advisory committee, but ultimately it’s Parry Sound Council that needs to make the decisions. For the most part the decisions aren’t too hard – new ambulance purchases, new stretchers and overall budget approval. This time, it’s not so easy. The challenge is the redeployment of personnel or approval for an increase in personnel and equipment on the order of $600,000 annually. These are costs that would be shared by all West Parry Sound municipalities.

The current status of the situation is that Parry Sound Council has requested a study be done on the EMS servicing levels of the district. The report with recommendations is expected in a few months. In the interim certain temporary arrangements are being implemented.

I have no suggestions on how the matter could or should be handled. But I do have a few questions on the more general concept of what level of services can and should be provided to all residents of the West Parry Sound District and where the funding might come from. It seems to be a case of Great Expectations.

What services can you reasonably expect when living in a town or city? What if you live out in the country far from the nearest urban centre? Can you expect fire protection that arrives in a few minutes in both situations? What about water and sewer? Should you expect a shopping centre just minutes away? Public transportation? School bus service? The list goes on.

There are many small satisfactions that come with living out in the country, away from the hustle, the bustle and the rat race. Not only are you offered a more private situation you generally are able to buy property at a lower cost and pay lower taxes. In some unincorporated municipalities its possible you pay no property taxes or have any type of by-law constraints on what you can do with your property, or on your property.

So what services should you reasonably expect to receive? In theory and in practice you should be able to receive all ‘critical’ services that can be delivered ‘on demand’ and don’t require extensive infrastructure investments like sewers. These services would include core services like fire and police protection, schools, and emergency medical care. Given the significant capital costs it would not be reasonable to expect non-critical services like municipal water and sewers, or public transportation.

There is a general truism that you can expect to be satisfied in any two of three variables in a ‘transaction’: price, quality and timeliness. That means if you get a great price on a product or service and it is delivered in a timely manner you may not reasonably expect to get great quality. If however you get a good price and great quality you should reasonably be willing to wait longer than you would like. If you get all three, that’s remarkable and defines excellent service, exactly what sets some companies above others. If you get only one, let’s say timely delivery but the price is high and the quality is lacking, you will feel taken advantage of.

How does this apply to certain public services like EMS, fire protection, and road maintenance (winter and summer)? How do these three parameters, price, quality and timeliness, apply to services in town and in the country? How should they apply? It seems that there are certain trade-offs that come with living in either the country or a town that go beyond these three simple factors. We want all of the services provided with quality and in a timely fashion but we would prefer not to pay the full cost. But are we willing to accept poor quality services that arrives in a timely manner and aren’t too expensive? Or would we prefer good quality and low cost with slow or delayed delivery? Think about this in the context of EMS services.

I live in Parry Sound and enjoy high speed internet, responsive fire, police and EMS service, and a choice of grocery stores nearby. But this comes with the downside of traffic in the summer, neighbours on all sides, trains and their noise/pollution and threat of derailment running behind my backyard, certain by-law restrictions, and of course higher taxes for what many people believe is over-priced real estate.

In outlying areas it’s often the exact reverse, lower costs but fewer services the further you get away from an urban centre.

So back to EMS services. What level of services should be provided to those who decide to live in the ‘country’? What is an acceptable response time? What is an acceptable cost, and who should pay for it?

The first instinct is to provide timely first-rate health and safety services, including EMS, to everyone regardless of location. So if I have a fly-in home in northern Ontario should I expect timely EMS, fire and police service? What about a cottage at the end of 40 kilometer unpaved road? Where does one set the line for what is reasonable and what isn’t? What costs are reasonable? Who should pay for these services?

(As an aside, it’s like the current delivery of Ontario health care. The price is right (it’s free to the user but not the taxpayer) and the quality is really world-class, but you often have to wait longer than you would like. Want to trade it for the US system; world-class quality, pretty much immediate service but costs that not many of us could afford?)

In the case of the EMS situation facing Parry Sound Council the costs are pretty well understood – about $600,000 or so per year to provide additional dedicated services to the Argyle area if the same level of service/staffing is maintained in South River. The cost would be spread over all of the district’s municipalities with the largest hit being to Seguin Township, Carling Township and the Town of Parry Sound. Seguin has already gone on record as rejecting any change in EMS services that would increase their costs.

Parry Sound Council is hoping that the new report and recommendations will provide a solution that solves the issue of cost and service level. I believe that it will be disappointed, there is no easy solution. It’s limiting services or increasing taxes. Hopefully the report perhaps will suggest a course of action that provides an ‘acceptable’ level of service at a not too much higher cost.

Back to the issue of great expectations. The Smart Community is a similar attempt to satisfy expectations, in this case at the expense of others. As I have previously noted, the Smart Community is an initiative to ‘wire’ all of the district municipalities with high speed internet (Parry Sound is already wired). The current cost estimate for this service is on the order of $40 million to be funded federally, provincially and private enterprise. Is this a reasonable expectation? Who should be responsible for the cost? Should there be compromises when living ‘in the country’? The Smart Community can be a reality if the municipalities want to take on the cost themselves. If it’s that important a forty year bond does not seem to be that onerous especially if today’s lower interest rates could be locked in. But it’s better of course to have someone else cover that cost.

What’s more important, EMS service or high speed internet? It’s not an either/or situation but it does beg the question of what services are we as a public expected to provide for people who make a choice to ‘get off the grid’ in search of a simpler lifestyle, a closer connection to nature, or lower costs? What are the minimal services we expect everyone to have access to? Health services? Schooling? Clean air and water? Police protection? Cheap electricity? High speed internet?

A final thought – what should our expectations be with regard to policing costs? With the recent change in OPP pricing for municipalities Parry Sound will see a cut of about half in its $600 or so per residence charge, to about $300. Surrounding municipalities will see a doubling of cost from about $100 per residence to $200. The surrounding municipalities think this is unfair. But is it? Is Parry Sound really so ‘lawless’ that it deserves to be charged six-times the rate charged Seguin or Carling? Is it only Parry Sound residents who get stopped in Ride-Check programs? Pretty much all of Parry Sound could be ‘patrolled’ in less than an hour by the OPP in a single vehicle. It would take that long just to get out to and return from Seguin, Carling or McKellar. The expectation of the surrounding communities is that costs should be allocated as they always have, even if they never really were ‘fair’.

We all have expectations of others, our governments and ourselves. These expectations all come at a price. Parry Sound Council has the unenviable task of making the decisions for the whole district when it comes to emergency medical services. Better service at a higher cost, ‘uneven’ service at the same cost, or…? I’m not sure this is what they signed on for and I wish them good luck.

Even Greater Expectations? (Parry Sound in Black & White)