Quebec pulls first responders from lower-priority calls, sparking rural pushback

Tashi Farmilo

The Municipality of La Pêche is demanding that provincial health authorities cancel a policy change it says leaves rural residents more vulnerable in medical emergencies, after Santé Québec removed local first responders from an entire category of calls last fall.

Since September 2025, first responders across Quebec have been barred from responding to calls classified as Priority Level 3, a category covering situations where a phone dispatcher has judged the patient to be in no immediate mortal danger. Examples include dizziness, shortness of breath, or general feelings of illness. Only an ambulance is now dispatched for such calls, with the directive applied province-wide through agreements concluded with all Quebec municipalities.

Santé Québec has defended the change as a matter of resource management. Fire departments had signalled a need to concentrate on their primary mandate of fire risk coverage, and the agency concluded that first responder efforts should be reserved for Priority 0 and 1 calls, where seconds count and the stakes are unambiguous.

La Pêche's municipal council is unconvinced. It adopted a formal resolution in late April calling on Santé Québec to reverse course, sending it to the CISSS de l'Outaouais as well as to provincial ministers and members of the National Assembly, with the aim of building a coalition among rural Outaouais municipalities facing the same situation.

The municipality's central argument is that a telephone assessment made from a dispatch centre is a poor substitute for eyes on the ground. A patient's condition can deteriorate sharply between the moment a call comes in and the moment paramedics walk through the door, and in rural areas where ambulance coverage is thin, that gap can be dangerously long. In parts of La Pêche's territory, there is no ambulance permanently stationed nearby, meaning some calls are answered by paramedics driving in from Gatineau. The municipality's fire and civil security department has operated a first responder program since 2021, fielding roughly 140 Priority 3 calls per year at a total annual cost of around $20,000. Some of those calls, the municipality says, ended with lives saved.

The dispute lands in the middle of a long-running crisis in Quebec's pre-hospital care system. A May 2025 report from the province's auditor general found that roughly half of Quebec's population lives in communities with no first responder coverage whatsoever, and that nearly half of high-priority calls in those municipalities saw ambulances take more than ten minutes to arrive. The auditor described the government's plan as a failure, particularly in rural areas. The stakes of slow response times are not abstract: medical evidence shows that a cardiac arrest victim's odds of survival drop by seven to ten per cent with every passing minute.

La Pêche says the Priority 3 policy was imposed without meaningful consultation with the communities it affects most. The municipality has made clear it will keep pressing for a formal exemption at the provincial level, and it is hoping it will not have to do so alone.

Photo: La Pêche is challenging a province-wide Santé Québec directive that has stripped local first responders from lower-priority emergency calls, arguing the policy puts rural lives at risk by leaving patients to wait alone for ambulances that may be kilometres away. Photo: Courtesy of the Municipality of La Pêche