Quebec ERs 'out of control' as patient influx overwhelms hospitals, doctors say

Quebec's emergency room doctors are calling on the province's health ministry to step up and take action as ERs grow more overcrowded and patients suffer while waiting for care.

In a letter addressed to Quebec Health Minister Christian Dubé, the Regroupement des chefs d'urgence du Québec (RCUQ), which represents the province's emergency room heads, paints a dire portrait of Quebec's ERs — calling the situation "out of control."

Penned by RCUQ president Dr. Marie-Maud Couture, it says ERs have predictably and dramatically deteriorated.

While ER heads have tried to get that message across to the ministry over the past few months, "inertia remains palpable at all decision-making levels and the crisis is only getting worse," she writes.

According to Couture, the health minister has been too caught up in passing Bill 15, Quebec's new health-care reform legislation adopted earlier this month.

"While all ministerial attention has been focused on Bill 15 and the reorganization of the health-care system, the system has completely frozen," the letter reads.

Overcrowding and long wait times — with some patients deciding not to get care all — contribute to a deadly problem, the letter says, calling the recent deaths in waiting rooms on Montreal's South Shore "just the tip of the iceberg."

"To date, very little effort has been made to remedy the root cause of overcrowding," the letter says.

Dr. Marie-Maud Couture says the health minister has been too focused on Bill 15 to stop the collapse of Quebec's emergency rooms. (Radio-Canada)

'No room to see new patients'

Dr. Sophie Gosselin, one of the ER heads representing the RCUQ, says the holiday season is always a difficult time, but with so many patients crowding ERs she worries about how hospitals will provide adequate care

"We don't know how we'll be able to make sure that every patient who is in urgent need receives it on time. We're very, very preoccupied by the fact that we have no room to see new patients," said Gosselin.

"There are critical patients and we have no physical room to see them. The nurses in the ER are busy taking care of patients that should be in a hospital bed ... things stall because our physical spaces are clogged up."

Gosselin is calling on the ministry to give what she calls clear orientation and accountability guidelines, so that ER patients who should be in hospital ward beds get more attention.

Guillaume Lacombe, vice-president of the Association des médecins d'urgence du Québec, the province's association of ER doctors, says things are similar at his hospital, where patients are placed fill the ER because stretchers and ambulatory care facilities are overcapacity.

The situation is critical, especially in and around Montreal, Lacombe said, where hospitals are understaffed and understaffed and health-care providers who've stuck around face heavy workloads.

"Everyone is overwhelmed because there are so many patients coming in," he said.

In Montreal, the stretcher occupancy rate at the Jewish General Hospital was 206 per cent as of Sunday afternoon, according to Index Santé. The Royal Victoria Hospital was at 179 per cent and the Lakeshore General Hospital was at 168 percent.

In the Laurentians region of Quebec, the Mont-Laurier Hospital occupancy rate was at 220 per cent while the Barrie Memorial Hospital in the Montérégie region was at 200 per cent.

Headed by Christian Dubé, Quebec's Health Ministry passed Bill 15 in early December. (Jacques Boissinot/Presse Canadienne)

Ministry says it's monitoring the situation 

Responding to the RCUQ letter, the Quebec Ministry of Health and Social Services told CBC it's keeping a close eye on the province's emergency rooms.

"The minister is visiting several Quebec ERs right now to meet with staff," it said in a statement, adding that representatives have visited hospitals in the Montérégie and the Laurentians.

The ministry said it's working to improve co-ordination between different health-care departments. It also says Bill 15 will enhance patient care across the province.

Couture told CBC that the ministry's concern needs to be reflected through decision-making and by taking accountability for the "catastrophic situation."

"Let's stop focusing on solutions to reduce patient volume and access to the front line, and really tackle the problem of ER congestion caused by patients waiting for a bed," Couture's statement reads.