Rushing in Where Angels Fear to Tread - Medevac Services and Fort McMurray

This is a fight I have been observing closely over the last few months, and one I have written about more than once. This week I find it heavily on my mind as those fighting to retain medevac services at the Edmonton City Centre Airport ramp up their efforts before the March 15th deadline, the date when medevac services will move to the Edmonton International Airport. This is a controversial move, one prompted by the decision of Edmonton city council to close the ECCA in favour of development, and one that has many, many people very passionate. I understand that passion, and I respect it - but I am going out on a limb here to say I do not agree with fighting to keep the ECCA open to medevac services, at least not in the long term. Why? Because as a community advocate I actually don't believe it is in our best long term interests.

There are those who might be outraged by this, but I hope they will listen to my reasons and while they may not agree with them at least respect them in the same way I respect their point of view on this topic. I have two very fundamental reasons I do not believe we should attempt to intervene with the closure of the ECCA, at least in terms of expropriation, and I will detail them below. And let's be clear - I worry too about increased transit times for critical patients, and I worry too about the impact this will have on the people in our community. For me, though, keeping the long term picture in mind is important too.

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1. Slippery slope

There are those who argue we should advocate for the provincial government expropriating the land from the City of Edmonton in order to keep the airport open to medevacs. This is a dangerously slippery slope in my opinion and one that could have serious repercussions, especially right here in the heart of the oil sands. If we argue that the province should expropriate the land for health issues what stops another group from lobbying the government to expropriate land for environmental issues? What would stop a group from trying to claim that an oil sands company is exhibiting poor stewardship of the environment and fighting to have the province expropriate their property? It's unlikely to happen, and unlikely to be successful, but expropriation of the land in this case could open up a very nasty case of worms with potential economic and social impact right here in Fort McMurray. What if some other community decided our redevelopment plans for the Snye have a detrimental effect on them and decide to fight for expropriation? If we expropriate the land for the ECCA we open a door - and once the door is open we need to realize that others may walk through it, too, others who we don't even see coming. Besides the economic cost of expropriation there is the reality that it would set a precedent that would likely terrify most cities and municipalities in this province because it would make very clear they do not have autonomy within their borders, and that their decisions are all subject to the whims of whatever government is in power at the time. I find this deeply concerning.

2. Long-term

So, say we fight for expropriation and are successful. The provincial government buys the land from the City of Edmonton, and it costs anywhere from millions to billions of dollars (I've heard such a wide range of figures tossed around I don't even pretend to know what the truth is). Then add to that runway maintenance and all the other maintenance required to have a functioning landing strip in the middle of a city (and runways, especially those in the very middle of a city centre, require careful attention). The costs mount, but we have access to medevac services for patients from the north. What happens when five years from now we approach the province and ask them to build a tertiary care hospital in Fort McMurray, one that would end our reliance on medevac services? When we ask for what a city of our size deserves? Well, I would guess they would say no, because given the existence of medevac services why would they say yes?

Look, when I arrived here ten years ago we were medevacing out moms in preterm labour and babies in distress. Ten years later we still are, and I do NOT want us to be doing this ten years from now. It is troubling to me that in ten years we could be the third largest city in the province, with one of the largest industries in the world on our doorstep, and STILL be medevacing our residents out for medical care. If we ask the government to spend millions or billions on preserving the ECCA what is their motivation to build us a state-of-the-art tertiary care hospital? They can simply turn around and point to our medevac services and how they fought to maintain them, and we can still find ourselves on medevac flights for medical crises we should be able to treat right here in our community. Our hospital does the best it can with what it has but it simply does not have the capability to treat critical patients with certain conditions. And why? Because we have relied to this point on medevac services, thinking we could not aim higher. I want us to aim higher. I want us to advocate for a full-service tertiary care hospital where we can treat our critically injured and ill residents right in our community. And I worry that if we are successful in preserving the ECCA that we will kibosh any future chances to have that happen, and instead we will find ourselves on a plane twenty years from now with a critically ill loved one when we could be right here in a full service hospital instead.

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I realize not everyone will agree with my position, and it may even anger some. And that is fine, but again I ask that we do not forget that we are in this together and like everything else in life there is no one "right" answer. Perhaps I am entirely wrong and we should be preserving all medevac services and continuing our reliance on them regardless of the long term impact on the community. Perhaps we should not worry about slippery slopes and the potential for this to actually harm, not help, in the long run. For me, though, these two reasons are why I haven't thrown myself into the medevac fray. I am a huge supporter of this community, the residents, and what is best for it - but I may not always agree with others as to what that best interest is. I understand the concerns expressed by the doctors, and I respect them. I understand and respect the concerns of all those who are involved in this issue, but I do think we need to recognize that it is not simple and that there are potential long-term and unintended impacts of a decision to force another city or municipality to bend to our will. If we are willing to accept those long-term and unintended impacts - eg. challenges to expropriate other properties, or lack of motivation to build a tertiary care hospital in our own community - then perhaps forcing expropriation is the right course of action. For me, though? Well, I am not so certain that it serves our long-term interests. I find myself torn between thinking we should fight to preserve a small landing strip in Edmonton or fight to build a hospital here that means no one needs to be medevaced ever again (or at least only in the rarest of circumstances). For me, in my heart, it says fight for our own hospital so we are not subject to the whims of other cities and the changes they foist upon us. For me the fight must be to have autonomy, and our own tertiary care hospital right here in Fort McMurray. And so that is why today I rush in where angels fear to tread, and give my own thoughts on an issue that is contentious - and that impacts us all.