A new auditor general report has found that about half of Quebec's population lives in communities with no first responder service, despite numerous calls over the years to improve access to potentially life-saving first aid.
Alain Fortin, Quebec's interim auditor general, noted that first responders, who can include firefighters and other people with first aid training, are usually first on the scene to provide basic care until paramedics and ambulances arrive.
His report published Thursday noted that 45 per cent of very urgent calls in municipalities without first responders have an ambulance response time of more than 10 minutes.
"However, it has been shown that a rapid response to very urgent calls can reduce deaths, and reduce the length and cost of hospitalization, as well as the risks of long-term effects," he told reporters in Quebec City.
The need for first responders is greatest in rural communities, Fortin said, where there are fewer ambulances compared to urban centres, and where the size of the territory can delay response times.
The report noted that studies have found that the chances of survival for a person in cardiorespiratory arrest drop sharply every minute they have to wait for care. "After 10 minutes, the chances of survival are almost zero," the report noted.
A government-mandated committee recommended in 2014 that the province take steps to ensure first responders are available across the territory. But Fortin's report says that despite that recommendation, the number of communities with first responder service has remained "stable." As of September 2024, 70 per cent of communities were without such as service.
Earlier this month, a Quebec coroner pointed to a lack of first responders in the death of a 37-year-old man from hypovolemic shock and blood loss, which occurred after he cut himself on a glass door in Rivière-à-Pierre, Que., a rural community northwest of Quebec City.
"Rivière-à-Pierre does not have a first responder service, a solution which could have allowed (the deceased) to receive care more quickly," coroner Audray Tondreau wrote.
The government's pre-hospital care plan includes the objective of increasing the percentage of the population who have access to first responders from 50 to 80 per cent by 2028. But, as of the winter, a committee made up of the Health Department, the Crown corporation that oversees health care, and the province's union of municipalities had not reached an agreement on how to finance such services.
Fortin's report also noted that ambulances have to spend close to 50 minutes on average waiting at the emergency room for their patients to be admitted and preparing their vehicles to return to service. The report suggested the government find ways to expand other forms of medical transport in order to free up ambulances for the most urgent cases.
In response to Thursday's report, opposition parties in the legislature were quick to accuse Premier François Legault's government of failing to act to improve care. The lack of services for Quebecers "has been going on for years," said Québec solidaire member Vincent Marissal. "It doesn't interest the government."
He described the government action plan to increase first responder access to 80 per cent as a "failure all down the line," especially for people living in rural areas.
"If you get sick … good luck. That's what we're telling people," he said.
Legault told the legislature that ambulance service in the province was "heading in the right direction," and noted that the amount of time ambulances spend waiting at the hospital has decreased.
"But we understand … and Quebecers can understand that with the size of territory to cover, we can't have an ambulance on every street corner in Quebec," he said.
This report by The Canadian Press was first published May 22, 2025.
Caroline Plante and Morgan Lowrie, The Canadian Press
