WATERLOO REGION — The region was surprised to hear second-hand of the province's plan to drastically cut local ambulance centres, replacing them with fewer services covering a larger area.

"This was not an anticipated change in direction for paramedic services," said Stephen Van Valkenburg, chief of the Region of Waterloo Paramedic Services.

He said the region was informed late Monday evening by the Ontario Association of Paramedic Chiefs that the provincial government intends to reduce the number of paramedic services from the current 59 to 10.

A merger of ambulance services is in line with the Progressive Conservatives' plan to centralize public health units outlined in last week's budget, dropping from 35 to 10 by 2021.

The budget also mentioned streamlining land ambulance dispatch services by "better integrating" emergency health services operators and dispatch centres, although no specifics were included.

Van Valkenburg said in an email that he would continue discussions with the association's board and "gather as much information as possible to better understand what the provincial government's intent is with regards to consolidation."

The work that paramedics do in the region each day is important and valued by residents, he said. "We are committed to continuing this work and to providing excellence in patient care to everyone in our community who requires paramedic services."

Waterloo MPP Catherine Fife said she is concerned about the reported plan.

"This is a vast province," the New Democrat said, adding that northern and rural communities already have concerns about slow ambulance response times.

Fife said it's another example of the Ford government making drastic changes without evidence and not consulting those most involved.

In Queen's Park on Tuesday morning, NDP Leader Andrea Horwath asked Health Minister Christine Elliott to confirm the elimination of all but 10 of Ontario's land ambulance services.

"The health minister did not deny that this drastic cut was coming to ambulatory care," Fife said.

Elliott responded to Horwath by saying the health budget is increasing by $1.3 billion next year, and services will be increasing.

"We're also modernizing emergency health services in Ontario by building a more integrated and efficient dispatch service and communication delivery service that's going to make sure that Ontarians receive the care they need in a more timely manner," she said.

Fife said she wonders who would run the 10 services covering a large geographical area. She points to ambulance dispatch as an example of how centralization didn't provide better service.

"Moving the Cambridge dispatch to Hamilton was not in the best interests of Waterloo Region," she said. "They continue to have staffing issues because the working conditions are so poor."

The Association of Municipalities of Ontario said the province should work with municipal governments if it wants to make changes, and on Tuesday the province confirmed it would.

"The Ontario government has assured us that it will be working with and collaborating with AMO, municipal governments and stakeholders as it looks at ambulance services and public health services. The people of Ontario are best served when both orders of government work together," executive director Pat Vanini said in a statement.

The CUPE local representing Waterloo Region paramedics and fleet staff declined to comment.

A spokesperson for Elliott didn't directly address a question about the reported cuts on Tuesday afternoon, responding instead that no paramedic will lose their job and the government is spending health-care dollars in front-line care, where they will do the most good for residents.

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"As we move our modernization agenda forward, we are working directly alongside front-line paramedics and our municipal partners to ensure emergency health services can better meet the needs of Ontario's communities," Hayley Chazan said in an email.

jweidner@therecord.com

Twitter: @WeidnerRecord