In the early 1980s Quebec’s ambulance sector was a mess. Hospital congestion and low job quality lead to union organizing and increased government regulation. Many private ambulance company owners looked to sell, rather than face the new reality. The labor federation Confédération des Syndicats Nationaux (CSN) saw an opportunity to launch worker cooperatives to buy the companies, and to directly negotiate for government service contracts. CSN helped launch a six cooperatives from 1988-90 with the support of government funding.
One co-op has since bought out eight other private companies and now has 500 workers, 350 of them worker-owners. Several others have around 200 workers. In the 2000s a new wave of paramedic co-ops launched, and a federation was formed. All told, the network employs more than 1,500 workers. A third of the ambulance calls made in Quebec are responded to by a unionized worker cooperative. The cooperatives are focused in more urbanized areas (excluding Montreal where paramedics are part of the public health system).
One outcome of the union-government partnership has been the professionalization of the sector. The job now requires more education, has more protocols and dictates – and it pays more. One cooperative reported in 2007 that members had around $50k in equity accrued.
Coopérative des techniciens ambulanciers de la Montérégie (CETAM) was one of the first organized, in 1988. 12 members founded the cooperative and now there are over 400.
- CETAM – Changer le visage du préhospitalier: une mission coopérative (2024) video
- CETAM – Le modèle coopératif – Comment fonctionne ma Coop? (2021) video
- Néomédia – CETAM: a $4.1 M project under construction in Saint-Lazare (2024)
- The Rover – Paramedic suspended after taking a stand for workplace safety (2023)
- Les Versants – La CETAM répond aux situations critiques (2021)
Coopérative des techniciens ambulanciers du Québec (CTAQ) was founded in 1989 after a decade of union organizing. Their founding 106 members bought and unified four companies, and then continued growing by acquiring other companies in the late 1990s and in 2010s. CTAQ is the largest of the Quebec ambulance cooperatives: they now have 500 workers, 350 of which are members.
- CTAQ – Historique
- FCPQ – Coopérative des techniciens ambulanciers du Québec
- Canada – Success story: Coopérative des techniciens ambulanciers du Québec
- Paramédics du Québec – Un reportage avec les paramédics de la Coopérative des techniciens ambulanciers du Québec à Saguenay (2022) video
- CTAQ – La CTAQ a 30 ans! (2019) video
Coopérative des paramédics de l’Outaouais was founded in 1989 by 45 workers and has grown to have more than 270. They acquired two other companies in the early 2000s and integrated their workers into their membership.
Coopérative des Ambulanciers de la Mauricie (CAM) was formed in 1989 and has grown to have around 180 members. In 1999 they bought out another company with a promise to their solidarity economy funders to cooperativize it, but then delayed about five years, holding it as a profitable subsidiary. When their funders put some pressure on them they started a process from 2005 to 2010 which spun off Coopérative de travailleurs d’ambulance de l’Estrie (CTAE). The process used a legal mechanism created in the 1980s, the worker shareholder cooperative (coopérative de travailleurs actionnaires), in which a workers can collectively own a minority stake in their company as it transitions.
- CAM – Notre Coopérative
- Proulx, Fouquet and Guillotte – Converting Ambulance de l’Estrie Inc. Into a Co-operative (2021)
Coopérative des Paramédics du Grand-Portage was the last of its wave founded in 1990. It now has close to 50 members.
Coopérative des paramédics du Témiscouata (CPT) (originally Témiscouata Ambulance Technicians Cooperative) was founded in 2000 with workers’ acquisition and merger of two ambulance companies.
Coopérative de travailleurs ambulanciers de l’Estrie (CTAE) had an unusual path to formation. Two ambulance companies merged in 1999, and in 2005 they were bought by Coopérative des Ambulanciers de la Mauricie with the support of provincial fund Fondaction, with the requirement that they either absorb the workers into their cooperative or convert it independently. CAM delayed for about 5 years while holding the company as a subsidiary, but with pressure from Fondaction began the process in 2005 and by 2010 CTAE was an independent cooperative. The transition used a relatively new legal form, the worker shareholder cooperative, which allowed for the worker ownership to grow within the company until it held 100%. In 2026 they had 215 workers, 160 of which were members. The member equity share costs $10,000 CAD.
- Proulx, Fouquet and Guillotte – Converting Ambulance de l’Estrie Inc. Into a Co-operative (2021)
- La Presse – Un modèle prisé chez les ambulanciers (2023)
- CTAE – Mission / Vision / Valeurs (2018) video
Services paramédicaux d’urgence Bois-Francs (UBF) was founded in 2006. Like CTAE it is a transitional worker shareholder cooperative, incubated by Coopérative des paramédics de l’Outaouais. It has around 40 workers.
In 2004 an association, the Fédération des coopératives des paramédics du Québec (FCPQ) , was formed. It currently has six member cooperatives, representing more than 1,500 worker-owners. Among other services the federation hosts an online training platform.
- FCPQ – Une Fédération au service de ses membres (2014)
- Brève histoire des coopératives de paramédics au Québec (2023)
In a 2007 article HEC Montréal professor Daniel Côté wrote about the importance of the union in the sector:
Without union action, the ambulance co-operative sector would not exist. It could not take advantage of the economic intervention tools that have enabled the sector’s reorganisation. It could not take advantage of the various actors specialised in cooperative development accompaniment. The success experienced in this sector is thus due to the network of actors within the umbrella of the CSN.