A year after Health Minister Gaétan Barrette warned hospitals that he would no longer tolerate emergency-room patients languishing on gurneys for longer than 24 hours, the government’s own statistics show little to no improvement.
As of 11 a.m. Monday, 408 patients across Quebec were reported to be receiving care on gurneys for at least 24 hours, or 20 per cent of the total number of emergency admissions. In April last year, the government declared an average rate of 20.7 per cent in the category of 24-hour-plus ER patients.
What’s more, 102 ER patients on Monday had been receiving care on gurneys for at least 48 hours, or five per cent of total emergency admissions. In April 2017, the rate was also five per cent.
Reacting to the latest figures, Barrette suggested that Quebec faces constraints in its ERs that no other health system in the world faces.
“Look, we’re not in the United States where they have overcapacity” in their ERs, Barrette told the Montreal Gazette after announcing the province’s 40th superclinic at an already long-established facility in Verdun.
“We’re not in Europe where they have over- and overcapacity. We have the resources that we have … We are working under constraints that nobody has. Nobody else in the world has the kind of constraints that we have. So we do not have the capacity that other countries have. We do not have other options. We are within a very tight system under which we are doing really the best we can.”
Barrette’s remarks would appear to back, at least partially, the conclusions of a 2016 report that Quebec has the longest emergency wait times in the country and among the worst in the Western world.
Barrette has long expressed frustration with emergency-room overcrowding despite increased government funding. In April 2017, the minister warned that hospital administrators who keep patients in ERs longer than 24 hours risk losing their jobs under Bill 130.
ER congestion was particularly severe at several Montreal hospitals on Monday, despite the fact that a virulent flu season ended weeks ago. The Jewish General Hospital’s ER in Côte-des-Neiges reported an occupancy rate on Monday morning of 153 per cent — the highest in the city — with 15 patients waiting on gurneys for at least 24 hours.
The Royal Victoria Hospital’s ER at the Glen site in Notre-Dame-de-Grâce reported an occupancy rate of 124 per cent, with 18 patients on gurneys for at least 24 hours. Another 11 patients had been on gurneys for at least two full days — by far the highest in the province.
Officials at the MUHC, which oversees the Royal Vic, did not respond to email queries about the ER situation.
“My reaction is we are still improving as a whole,” Barrette said when informed of the Montreal ER figures. “There will always be short periods of time during the year when (the ER situation) is unbalanced.”
“Look at it one week from now, and it’s going to be back to normal,” he predicted.
Barrette contended that under his watch, the average ER wait has decreased from 16 hours across the province to 13 hours today.
“The amount of effort we have put forward to achieve that is unbelievable,” he added.
However, the opposition Parti Québécois argues that the three-hour drop in the average wait time is misleading, because many hospitals simply move emergency patients from their ERs to so-called overflow units to keep their numbers down. Patients continue to receive treatment in the overflow units as they wait for a hospital bed, but the temporary accommodations lack privacy and can lead to the spread of germs.
Patient-rights advocate Paul G. Brunet also accused the government of fudging the numbers.
“The reorganization of front-line care is not working, contrary to what our minister has promised us,” Brunet said on Monday.
Brunet added that hospitals, under pressure from Barrette, are moving ER patients to “hideaway spots so that they look their best in the eyes of the big boss.”