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STARS air rescue service spreads its propellers

B.C. sticking to for-profit contractors for medevac missions
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Stranded high on a mountainside 25 kilometres northeast of Canmore, Alta., five high-profile CEOs had to turn to their business survival skills to get rescued.

Armed with only their cell phones, they each had to call on their friends to raise $100,000 before a Shock Trauma Air Rescue Society (STARS) air ambulance could swoop down and pick them up. By the time they'd all been flown back to Calgary, the Rescue in the Rockies for STARS fundraiser was a $1.3 million success.

Ever since it started its emergency medical air ambulance service in 1985 as a not-for-profit society, Alberta has stuck to a fundraising formula to minimize the cost to taxpayers.

The service, now with five helicopters on three Alberta bases, generates fundraising windfalls that in 2010 reduced the need for government funding to $6.079 million - 21.3 per cent of a $28.4 million operating budget.

This year in B.C., taxpayers paid $15 million to keep four choppers flying from bases in the Lower Mainland, Prince Rupert, and Kamloops - with fixed-wing medevac, the total comes to $41 million.

Eastern B.C. residents are already being served by STARS helicopters, which fly critically-care patients to trauma hospitals in Calgary and Edmonton at an annual cost of $375,000 to B.C. taxpayers.

Hans Dysarsz, a former STARS co-pilot who lives in Delta, says the key to saving money is to turn the air ambulance service over to a non-profit.

"We are one of the last jurisdictions in the western world to have a government-run ambulance service," he said. "Every time I hear somebody at the B.C. Ambulance Service say we have a world-class service, I think to myself 'These guys have been living under a rock in a cave for the last 30 years.'"

Wayne Drysdale, Alberta MLA for Grande Prairie-Wapiti, said the STARS service works well for his region.

"There are a lot of oil and gas companies and a lot of remote worksites in the area that are hard to get to with ground ambulances. The helicopter thing works good. Oil companies know their men are at risk in these remote sites so they actually put a lot of money into STARS because it helps service their workers."

And as a former Grande Prairie Region Emergency Medical Service board member, he thinks a non-profit would better serve a city like Prince George.

"Prince George is remote and I think it would work good there, but the community has to drive it because it's not some company coming in to make money."

But B.C. Ambulance Service (BCAS) chief operating officer Les Fisher disagrees.

"I think [switching to a non-profit service] would be a challenge and I think it would be a step backwards for us," said Fisher. "Comparing our system to any other system, regardless of where the funding comes from, our cost per patient is far lower than any other system.

"Even though there may be a non-profit entity operating things, there are still people making money in that. The cost for machine, the cost for pilots and the cost for hangars is still all there."

SERVICE EXPANDS OUT OF ALBERTA

Ontario copied the STARS model six years ago, turning to a non-profit operator (Ornge) to run its air ambulance fleet. Its $140 budget is funded entirely by the Ontario government. This year, Saskatchewan budgeted $5 million for two STARS bases to add to the province's existing fixed wing air ambulance. Supported by companies such as Enbridge, Potash Corporation and Husky Energy, which have employees working in remote areas of the province, STARS raised an additional $40 million.

Lotteries are another significant means of fundraising and the STARS lottery annually raises more than $10 million. B.C. is considering a similar project, but Fisher says there are no guarantees, pointing to hospital foundation lotteries in the Lower Mainland that lost money.

"There's a risk in... relying solely on charitable donations for such a critical service," Fisher said.

Dysarsz spoke from his own experiences as a chopper co-pilot, and said there are safety benefits to having a non-profit operator. He helped establish an air ambulance base in Prince Rupert in 1989 that started out as a project of the Lions Club and has since been taken over by the BCAS.

"If you want to make maximum money for the company owner you sometimes do stuff you're not supposed to do with aircraft or the maintenance doesn't get done," he said.

"Non-profits work the exact opposite way. They are focused totally on patient care and flight safety. Consequently, in 26 years of STARS they've never had an accident."

The Canadian Taxpayers Federation (CTF) plans to question the B.C. government about its air ambulance service at the spring session of the legislature.

"When you compare our service to the non-profit service in Alberta, Germany and Australia, the non-profit service is so much better, and it really comes down to volunteerism," said Jordan Bateman, the CTF's B.C. director.

"When someone is making a profit in the system, that is money that is not being put back into the healthcare system. We think you could save $9 million a year by moving to the non-profit model."

JOBS ON THE LINE

But Bateman says with powerful unions involved who like the system as it is, unless the political will is there to push that change, it's not likely to happen.

The BCAS is now deciding on bids for the contract to provide its fixed-wing air ambulance service. The current system operates with one jet and five turbo-prop planes provided by Carson Air of Kelowna and Prince George-based Northern Thunderbird Air.

Richmond-based Helijet International, which has been flying medivac missions for the province since 1998, derives about 40 per cent of its business from its air ambulance contracts using two Sikorsky S76 helicopters and one Lear jet. Last year the company signed an eight-year $104 million contract to deliver air ambulance helicopter service to B.C.

Blackcomb Aviation provides rotary and fixed wing air ambulance service and its Eurocopter AS355 twin-engine helicopters fly an average 60 to 70 air ambulance missions per year.

Dysarsz estimates that if the government had purchased its own air ambulance aircraft, then contracted out the flight and maintenance crews over the eight-year term, it would save taxpayers $30 million over the length of that contract. If levels of government funding remain the same, B.C. will have spent $75 million more for its air ambulance service than Alberta will.

"What bothers me is these contracts are eight years with a four-year potential extension," he said. "Who rents multimillion dollar helicopters for eight to 12 years? We're paying those things off for those guys two or three times in the contract period. It would make far more sense to buy the equipment and rest the crews. That's how an efficient business operates, why not the government?"