Patients are dying every day, and even the best medicine can’t help it. In Quebec, however, it is also possible to suffer from complications or even to die because the best medicine has become bogged down in the turpitudes of our network in distress, as illustrated by the unworthy death of a man over 70 years old. following an aortic aneurysm, after spending 16 hours in the emergency room without being seen by a doctor.
The worst thing is that it could happen again throughout the network, thundered the president of the Association of specialists in emergency medicine of Quebec when he was questioned by Radio-Canada. The situation has deteriorated so much in our emergencies, estimates the Dr Gilbert Boucher, that the population that transits and stays there (the average length of stay on a stretcher reached a record of almost 17 hours last year) is today “at risk”.
The formula captures. However, this is not the first time that emergency physicians are crying out for help. In June, around sixty emergency room physicians took to the keyboard to denounce the deterioration of their services. They already said they could count “several potentially avoidable deaths […] lack of access to a stretcher and the necessary care”. Monday afternoon, the Quebec average for the emergency room occupancy rate was 123%, with sixteen establishments posting rates exceeding 150%. Twelve regions posted so-called “very high” occupancy rates.
In ancient Greek, pharmacy designates both the poison and the remedy. Known to qualify our pharmacopoeia, sometimes beneficial, sometimes detrimental, according to the dosages used, the analogy stretches today easily to our disordered emergencies. We should at least start by admitting it head-on instead of cultivating the art of understatement and dodging as we do at the Ministry of Health and Social Services (MSSS) these days.
Even service interruptions sometimes continue to be rewritten, as evidenced by the example of the partial temporary closure of the emergency room at the Suroît hospital in Salaberry-de-Valleyfield, revealed last week by The duty. At dawn, patients bumped their noses on a poster stating “Temporary closure of the emergency room”. A mistake, argued the CISSS de la Montérégie-Ouest, which even denies that the emergency was closed overnight.
We can easily grant this small lexical and logistical fast to managers who hold the unmanageable at arm’s length. This tree will nevertheless hide the extent of the forest. With occupancy rates then exceeding 200% (and 147% on Monday) at the Suroît hospital, the work of emergency physicians is so difficult that, yes, let’s say it bluntly, the quality of care could be mortgaged. It is there, the knot, not only in the rupture or not of the services.
Our emergencies are made in such a way that when they get dirty or fall, they take the rest of the public network with them. More than 22,000 Quebec patients have been waiting for an operation for a year or more, according to the MSSS. As for the front line, it’s a sieve with just over 800,000 patients waiting at the Family Doctor Access Window last August. Each crisis takes us away from the possibility of catching up.
The stampede affects even pediatric hospitals. As reported The Press, the CHU Sainte-Justine is facing an unprecedented crisis due to a persistent staff shortage coupled with the virulence of respiratory diseases in toddlers. Even at the worst of the pandemic, the MSSS was able to deploy enough energy to protect this vulnerable clientele. Ditto during flu waves.
Not this time, when we navigate the pea mash without instruments. Inspired by flu clinics, the very effective network of designated pediatric clinics deployed a year ago to relieve emergency room congestion was dismantled to the great despair of parents who had found a reliable and predictable structure there. This crisis formula is nevertheless known and proven. Why wait before relaunching it? Doesn’t the Minister of Health have free rein?
Last spring, to defend his decried Bill 28 aimed at ending the state of health emergency, Christian Dubé had insisted a lot on the need to maintain “agility” in anticipation of potential waves of COVID, in particular on the labor front. “Very small” and “very simple” in his opinion, this legislative tool is still valid until December 31. Couldn’t we use it to break down a few additional locks in order to administer a few electroshocks here and there, particularly on the front of the labor shortage?
COVID, not COVID, the emergency is now. The overhaul of the health care system, so dear to Mr. Dubé, and in which the network wants to believe — rightly — has no chance of even taking off if we do not take the trouble to put out the current fires.