A Condensed History Of The British Columbia Ambulance Service

Prior to 1974, emergency medical services (EMS) in British Columbia were provided by many different organizational entities. This variety of agencies meant there were many inconsistencies in service delivery, great variations in response times, no control over staffing levels or staff qualifications, and differences in the quality of ambulances and equipment.

Staff training and patient care standards were virtually non-existent insofar as they were largely determined by the financial health of the providing agency or company. In the context of disaster response, one of the major responsibilities of any ambulance service with any event involving mass casualties or major disaster would have been met with a disorganized response and poor coordination due to the involvement of so many separate providers.

The Health Security for British Columbians report to the Minister of Health by R. G. Foulkes in the early 1970s, identified and attempted to address many of the health care issues that existed at that time. The key recommendation flowing from this report was that the Province assumes responsibility for all privately and municipally operated ambulance services in the province. The Foulkes report recommended, " that the fractionated ambulance services provided by private companies, volunteer agencies and municipal fire departments be amalgamated under one jurisdiction".

Consequent to this, the Health Emergency Act (HEA) was proclaimed in 1974, which established the Emergency Health Services Commission (EHSC). The HEA (The HEA replaced the Ambulance Service Act of 1973) provided the EHSC with the legislated mandate to ensure provision of high quality and consistent levels of pre-hospital emergency health care services throughout the province. Thus, the British Columbia Ambulance Service came into being.

Dr. Peter Ransford

Carsen Smith

Two individuals, Dr. Peter Ransford a retired pediatric physician and Mr. Carsen Smith, the owner of Metropolitan Ambulance Service of Vancouver became the driving force behind this new provincial service. Dr. Ransford had served on several local and national committees in his career as a physician that involved the transportation aspects of the critically ill and injured. Dr. Ransford was also the key figure in Dr. Foulkes group as the subject matter specialist on pre-hospital care. The papers Dr. Ransford compiled became the blueprint for the service we would see develop into the British Columbia Ambulance Service. Mr. Carsen Smith was the operator of the largest private ambulance service in British Columbia. Mr. Smith was a true visionary and his knowledge of the inner workings of EMS made him the natural choice to team up with Dr. Ransford in the development of this new service.

The amalgamation of the large number of disparate providers was an enormous task, and was carried out in an orderly and coordinated manner by Dr. Ransford, Carsen Smith and the team they had assembled. Dr. Ransford became known by most people affectionately as " Dr. R" and Carsen Smith, who was known as " J.C." by his " Metro Men", would also have this term of endearment follow him throughout the province. BCAS first took over the private operators and volunteer agencies. Municipal fire departments were permitted to continue providing pre-hospital emergency medical services under agreements with BCAS. In 1974, there were 40 municipal fire departments providing service on behalf of BCAS.

The period from 1974–1980 became the transition period during which many existing problems were resolved such as the establishment of standards of training and patient care and the elimination of cross boundary disputes. The EMA 1, 2 and 3 (advanced life support) and the ITT (infant transport team) were created and implemented in many BC communities. As time and budget permitted, other components were designed in centralized communications centres to better serve the diverse province. The Air Ambulance Service became an integrated service with the ground ambulances and began serving more remote communities that, at one time had no form of emergency health care.

The foregoing is a brief snapshot of the early days of the BCAS. The deeds and accomplishments of the people and the BCAS in its 30-year history would fill volumes. The stories of the " Old Days" have grown and some are now almost mythical. Many of the paramedics and support staff that began this journey 30 years ago are still here and still watching the dream unfold. Not many people in life have the opportunity to see their vision come to fruition, therefore it must be extremely gratifying to Dr. Ransford and Carsen Smith to see so many of the plans they envisioned 30 years ago in place today. Both of these individuals keep in touch and are still interested in the ever-changing process that will take place in our next 30 years.

" ONE TEAM-ONE GOAL ... WORKING TOGETHER FOR LIFE"

Published: December 10, 2000 | Last Edit: Thursday, May 3, 2007