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Horse drawn VGH Ambulance in 1902

Ambulance service in British Columbia has roots dating back to the early 1900s. 

At this time, emergency medical services were provided by a wide range of commercial and municipal operators, some functioning from funeral homes, others partially subsidized by municipalities, some based with volunteer fire departments and others existing on paid subscriptions from the public. 

This diversity in providers resulted in great variations in response times, a lack of control over staffing levels or staff qualifications, inconsistencies in service delivery and differences in the quality of ambulances and equipment. Staff training and patient care standards were also virtually non-existent, as they were largely determined by the financial health of the providing agency or company.

The Foulkes Report: 1970

R. G. Foulkes, a physician and hospital administrator, developed the Health Security for British Columbians report for the Minister of Health, a document which identified and attempted to address many of the health care issues existing at the time. 

The key recommendation resulting from this report was that the Province of British Columbia should assume responsibility for all privately and municipally operated ambulance services in the province. Specifically, the Foulkes report advised that "the fractionated ambulance services provided by private companies, volunteer agencies and municipal fire departments be amalgamated under one jurisdiction." 

Amalgamation of the Ambulance Service: 1974

Following the release of the Foulkes report, the Health Emergency Act (HEA) was proclaimed, establishing the Emergency Health Services Commission (EHSC) as an agent of government. Through the Act, the EHSC was endowed with the legislated mandate to ensure the provision of high quality and consistent levels of pre-hospital emergency medical services throughout the province. Thus, the new provincial BC Ambulance Service (BCAS) was born. 

Transition Period: 1974-1980

1974-1980 became known as the transition period, during which time training and patient care standards were established and cross-boundary disputes were eliminated. 

This period also saw the implementation of Advanced Life Support units in a number of BC communities as well as the creation of the Infant Transport Team, a specialized paramedic team responsible for providing care to pediatric, neo-natal and high-risk obstetrics patients while en route to specialized care units. 

During this time, centralized dispatch/communications centres were also established, the air ambulance service was integrated with the ground ambulances, and BCAS began serving more remote communities that, at one time, had no form of emergency health care.

Dr. Peter Ransford, a retired pediatric physician, and Mr. Carson Smith, the owner of the Metropolitan Ambulance Service of Vancouver, became the driving force behind the new provincial BC Ambulance Service (BCAS). 

Dr. Ransford

Throughout his career as a physician, Dr. Ransford served on several local and national committees involving transport of the critically ill and injured. The papers Dr. Ransford compiled as the pre-hospital care subject matter specialist for Dr. Foulkes' focus group became the blueprint for the BCAS. Dr. Ransford received the Order of BC in 2008 in recognition of his pioneering work to help create the BCAS. 

It is with deep sadness that BCAS mourns the loss of Dr. Ransford who died on June 12, 2012. Dr. Ransford is an important part of our history and he will not be forgotten. 

Mr. Carson Smith

Mr. Carson Smith was the operator of the largest private ambulance service in British Columbia. A true visionary, Mr. Smith's knowledge of the inner workings of emergency medical services made him the natural choice to team up with Dr. Ransford in the development of the BCAS. 

The amalgamation of the large number of disparate emergency medical service providers into one provincial service was an enormous task. Through the efforts of Dr. Ransford, Carson Smith and their dedicated team, BCAS first took over the private operators and volunteer agencies, permitting municipal fire departments to continue providing pre-hospital emergency medical services under agreements with BCAS.

Since its inception, the BC Ambulance Service (BCAS) has evolved into a single unified operation, decentralized by design, but providing the organizational structure necessary for system improvements in operational efficiency, effectiveness and quality of care. This growth has taken a gradual path, as over its history the BCAS has assumed responsibility for ambulance service provision in communities increasingly more distant from the population centres of the Lower Mainland and Victoria. 

The stories of the "old days" have been passed on through time and some are now almost mythical. Many of the paramedics and support staff that began this journey over 30 years ago are still with the service today to see the vision of Dr. Ransford and Carson Smith realized.

SOURCE: History ( )
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