This is horrible. What is going on in Toronto that ambulances take 30 minutes to respond?

https://www.cbc.ca/news/canada/toronto/toronto-paramedic-sta...

> Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019.

> CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.

Healthcare funding is managed provincially and the Ontario government has been poorly managing the system, pretty consistently, for over a decade. Some would argue decades, but things do seem to be steadily declining post Covid, as they were pre-Covid. Over the last few years, several ERs have been experiencing intermittent closures, and at least one was closed permanently, due to staff shortage.

What's worse is that the closures are poorly communicated. I know of at least two people who, within the last couple of years, went to an ER only to find it closed.

With respect to Toronto, and more specifically ambulance services, they are jointly funded by the province and the city, but I understand that provincial funding is more significant.

All parties recognize things are not functioning well, and various attempts at increasing spending have been made, but any effort will take significant time before results are visible. I'm not particularly optimistic, and the current provincial government's track record here is dismal. Their policy is to be tight-fisted.

I’d assume it’s there’s X ambulances and Y calls and occasionally Y>X.

The bigger issue is the dispatcher not being aware of overloaded status nor conveying that information to the caller.

Toronto healthcare generally is quite below the bar. When I moved here 5 years ago, I was told that hospitals are short staffed, ambulances have significant delays, and when you do finally get care you are rushed through the system.

Fortunately I only had one encounter with a situation requiring ambulance (and subsequent hospital visit). Ambulance arrived in about 10 minutes, triaging before seeing a medical professional took hours. There were no rooms so I was kept in a hospital bed in the hallway along with other patients but with some monitoring.

Now to be fair - this was during Covid which understandably put pressure on medical resourcing.

like in many places people live too scattered (higher density would provide more healthcare facilities closer to people), service costs are enormous, and productivity is abysmal

TL;DR chronic underfunding of the system, here's one example article:

https://www.cbc.ca/news/canada/toronto/ambulance-response-ti...

The federal government shifts the responsibility to the provinces, the provinces in turn try to download as much as possible onto the cities. There's not enough money for everything on every level of the government.

This also reflects on 911/dispatch systems, where there indeed might not be easy visibility of when an ambulance might be available, and even then it could be preempted by a higher priority call -- although a heart attack has to be close to the top of the list.

There are also occasional weather events, like the storm two days ago, that cause a surge in demand (>300 crashes reported and many of them needed attending to).