2023-07-01 11:27:28
The current state of affairs
The best known situation is that of Minden, a municipality 200 kilometers north of Toronto. The local health agency chose to lock the local hospital’s emergency room doors on June 1 due to a staff shortage, a move that prompted residents to protest in Queen’s Park.
A provincially funded urgent care clinic has been open since June 30 to accommodate the ER closure, but its hours are limited, care is not provided by physicians, and at this time the clinic is only open on weekends.
Minden residents rallied to oppose the closure of the local hospital emergency room.
Photo: The Canadian Press / Courtesy of Patrick Porzuczek, “Save Minden ER”
The Niagara region will be the next to have to deal with closures. Beginning July 5, the Fort Erie and Port Colborne Urgent Care Clinics, operated by Niagara Health, will be unavailable daily between 10 p.m. evening and 10 a.m. the following morning. At night, patients will have to go to emergency rooms in Welland, Niagara Falls or St. Catharines.
Enlarge image (New window)
The shortage of staff is invoked to explain the closure of two emergency rooms as of July 5.
Photo : Radio-Canada / Camile Gauthier
Other ERs have had to reduce their opening hours recently. In Carleton Place, near Ottawa, the local hospital ER closed from 4 p.m. Friday, June 23 to 7 a.m. Saturday, June 24, then from 7 p.m. that day to 7 a.m. Sunday, June 25 .
In Northern Ontario, in Thessalon, the emergency room closed several times in May. In Durham, south of Owen Sound, the emergency room is not open (New window) from July 1 from 5 p.m. to Monday July 3 at 7 a.m.
Can this happen near me?
Most small municipalities in Ontario are at risk of having their emergency rooms closed, said Dr. Alan Drummond, spokesperson for the Canadian Association of Emergency Physicians. These small hospitals are threatened, he warns.
But the ER crisis is not limited to rural Ontario, two experts point out. Even in the big cities, these departments are suffering, without making headlines.
Hospital emergency rooms in urban areas are also at risk of having to reduce their services, according to Dr. Catherine Varner. (File photo)
Photo : Radio-Canada / Esteban Eduardo Cuevas Gonzalez
According to Dr. Catherine Varner, a Toronto emergency physician and associate editor of the Canadian Medical Association Journalsome ERs dealing with a large volume of patients will close a section of the ER for a period, usually because they do not have enough staff.
Why is the province in this situation?
Emergency rooms are closing mainly due to the shortage of nurses and emergency physicians, according to various experts.
In a message to the public on June 28, Niagara Health said it simply does not have enough emergency physicians to properly operate. [ses] three emergencies and [ses] emergency clinics.
“Honestly, using our specialized resources to run our emergency clinics at night is not efficient. »
— A quote from Niagara Health
There is a shortage of nurses in the province and the shortage is expected to continue, forecasts the Financial Accountability Office of Ontario (FAO). He estimates that Ontario will have a shortage of 2,867 nurses by 2027, despite steps taken by the province to tackle the problem.
Rural hospitals have difficulty recruiting staff, says Professor Abi Sriharan, research director at York University’s Kembril Center for Health Management. According to her, new graduates prefer to live in urban areas.
Ontario is facing a shortage of nurses that is expected to continue for the next few years, predicts the Office of Financial Accountability. (File photo)
Photo : CBC / Evan Mitsui
Dr. Alan Drummond believes that hospitals must above all keep the nurses they have and repatriate those they have lost.
Nurses leave the profession for many reasons, including lack of manpower. Overwork by nurses has been one of the main reasons the setting has been losing staff since the 1990s, according to a report by the Canadian Federation of Nurses Unions published in 2022.
No matter their workload or their courage, they can never overcome the shortage caused by the underfunding of the health care system, laments Michael Hurley, president of the Council of Hospital Unions of Ontario.
According to the FAO, in 2020, health spending was $4,800 per capita in Ontario, the lowest amount in the country. By way of comparison, Quebec, that year, spent $5,938 per capita.
According to the Ontario Nurses Association, Bill 124, which limited wage increases for public sector employees to 1% per year for three years, has also had a huge effect on staff retention and recruitment.
Hospital workers, including nurses, demonstrated once morest the Ford government’s Bill 124. (File photo)
Photo : CBC / Susan Goodspeed
The province is currently appealing a lower court decision, which ruled that Bill 124 was unconstitutional.
At the start of the pandemic, people were banging their pans in support of the nurses, and I think they expected them to be rewarded for their work when things calmed down. But now Doug Ford has introduced Bill 124, laments Dr. Alan Drummond.
“It was insulting to the nurses. »
— A quote from Dr. Alan Drummond, regarding Bill 124
How does the government intend to solve the problem?
The province has introduced several measures in an effort to restore order in emergencies. In the immediate future, she financed the opening of an emergency clinic in Minden.
This is a very bad exchange for the community, regrets Michael Hurley. They lost a 24-hour hospital staffed by doctors and replaced it with an emergency clinic, he continues.
“It’s like comparing apples to oranges. »
— A quote from Dr. Catherine Varner
Urgent care clinics can’t put someone on a ventilator, says Dr. Alan Drummond.
The provincial government is trying to recruit more nurses in regions where the needs are great, among other things through the program Learn and stay. In this case, Ontario pays for the training of the student who, in return, must work two years in the region in question.
According to Ontario Minister of Health Sylvia Jones, the Learn and Stay program helps communities where needed. (File photo)
Photo: The Canadian Press/Tijana Martin
But Learn and Stay has loopholes, notes Professor Abi Sriharan: the funding turns into a loan if the student chooses not to spend two years in the region.
“If you are recruited by an American employer offering you a good salary, will you stay two years in the region or simply pay off the loan? »
— A quote from Professor Abi Sriharan
According to Hannah Jensen, spokeswoman for Health Minister Sylvia Jones, the emergency department locum program has also prevented the closure of 1,500 emergency rooms in 2022.
Dr. Alan Drummond calls for a more radical change of vision on the part of the government. We need to get away from the idea that every small town can maintain a full-time emergency room, he says.
But the government will never promote this idea to the population since it does not want to be the bad guy in the story, thinks Dr. Alan Drummond.
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