Posted at 1:00 p.m.
Huge challenges
The emergency room should be a place of transit where the condition of a patient is assessed in order to establish whether his condition allows treatment and follow-up on an outpatient basis or hospitalization. Quebec already has a significant lack of hospital beds in comparison with other Canadian provinces or European countries, and this lack is aggravated by the closure of beds caused by the lack of personnel. It would be important to know the hospitalization capacity not available at this time. Patients have realized that the emergency room often becomes the only route for quick access to see a specialist or receive a diagnostic test, when it would take months or even years on the front line. The challenges of Minister Christian Dubé are immense in order to restore a functional system.
Luc Laperriere
First line
Very just. To relieve emergencies, hospitals must be emptied of patients who should be in another location (13%) and less or non-urgent cases must be avoided (52%). Preventing pre-existing medical conditions from worsening is also paramount. Consequently, the solution to emergency room problems necessarily involves a first line that is functional, efficient, very accessible and, in my opinion, based mainly on family physicians in order to avoid the revolving door syndrome.
Marc Couturier, physician
Nothing has changed
Mr. Sirois, you could have written your editorial in 1982, 1992, 2002 and 2012… Nothing has changed in hospitals and emergency rooms in Quebec during all these years except that it continues to deteriorate… It will take more only promises from politicians to arrive at solutions: concrete actions that will ensure that Medicare exists for the beneficiaries and not for politicians, civil servants, employees, health professionals, corporations and unions.
Louis Marin
Convert old hospitals
Why haven’t we converted the Notre-Dame hospital or the Royal Victoria hospital — or any other closed hospital — into a care center for people waiting for CHSLDs? These people don’t need advanced medicine, and only need light care…it would free up the hospitals, which offer more acute care.
Danielle Gatto
To have lived it…
When you have experienced the journey of trying to find a place to stay for an incapacitated elderly person whose health is failing and whose safety is impossible to ensure in the natural environment, you quickly understand that the best way to get there in reasonable time is to take the person to the emergency room when they have a health problem and then say that it is impossible for them to go home. All of a sudden the person becomes a placement priority (because the hospital doesn’t want to keep them for long) and hop, the miracle happens, we go straight to the top of the list. When the system is made differently and that voices other than those of doctors are taken seriously to grant such a service to our elderly people with loss of autonomy, the problem will be on the way to being resolved.
Francois Bowen
Deep dysfunction
The situation has been documented for more than 30 years, it is an organizational problem. I find that we Quebeckers are very passive in the face of the intolerable that has gone on for too long. Worst of all, we have resigned ourselves to this system, which nevertheless occupies 50% of the provincial budget without adequate results… In the face of these facts, without major change, adding hundreds of millions to this dysfunction will not be of much use.
Johanne Normandeau
Blind spots
I also believe that the avenues set out are interesting. On the other hand, it seems to me that certain aspects of the problem are completely ignored. Union rigidity is certainly to be worked on. Just look at the difference with the English side. In addition, patient responsibility must also be addressed. Missed appointments or diagnostic shopping exist. This is unacceptable and very costly. But it will take courage for the minister to tackle it.
Diane Lamarche
Home Care
I worked as a nurse clinician in home care for 17 years in a CLSC, until 2009, when I retired. It was the time when we provided home nursing services — we could give up to 17 hours a week in support services. I can say that we have avoided many hospital stays while allowing the elderly population to stay at home. Then, around the time of my retirement, change of government, we leveled down by allocating only 5 hours per week for these services and putting patients/clients on a waiting list. Are we still talking about a committee, a crisis unit? Why not invest more in home care, the only proven solution to avoid going to the emergency room and finding yourself deconditioned by a stay in hospital or the emergency room, confined to a stretcher?
Jocelyn Paquin
Strongly the return of family doctors
The big problem is the lack of family doctors. It all starts from there. Christian Dubé must restore family doctors for everyone. It is the basis of the health system. Without this base, we currently see that things are going all wrong. Sick people go to the emergency room for all or nothing. With a family doctor, the situation changes completely. How many times my partner and I avoided going to the hospital because our family doctor found the solution! Currently, we don’t have any more, because he retired. We are helpless and aging. Our way out will be the emergency room… and it’s not good. We do not believe in the newly installed ATM. It is nonsense. We’ll be sent to anyone’s house… without any sense of belonging. At our ages, it’s consistency and stability that count. We can’t wait for the return of family doctors, that’s the key to success.
Francine Roy
And the CLSCs?
We rarely talk about the role of CLSCs. What are they doing ? How could they help emergencies and hospitals? It is said that the service one receives there is outstanding, the dedication, the low waiting times, the home services, etc. Those who “feel” sick and who go to the emergency room could go through the CLSC instead of going there for something benign and increase the occupancy statistics of the emergency room.
Michel Lemieux, Sainte-Marguerite-du-Lac-Masson