Quebec to free up 1,700 beds as urgent care chiefs say ERs are 'victims of a failing system'

Issues within Quebec's health-care network boildown toa "co-ordinationproblem," says the province's health minister hours after a letter underlining the dire state ofemergency rooms was made public Tuesday.

The lettermeant for hospital leaders and health officials said the province has systematically failed to support its overcrowded emergency rooms, leading to a tense and potentially deadly crisis.

"The situation in the emergency rooms that we have is not only in Quebec. It's all across Canada,"Dub said at anews conference."But that's not an excuse for not having done what we shouldhave done."

The minister said the province needed to focus on measures that "everybody knew of, butnever implemented."

"It's a question of execution," he said."We want to better co-ordinate our services before the patient gets to the hospital."

In response to the letter, Dub presented Quebec's crisis team's first recommendations to alleviate pressure on emergency rooms and encouragedQuebecers to call the 811 health line instead of immediately turning to the ER.

WATCH | Dub reacts to open letter:

'They're right,' says health minister of urgent care plea

2 years ago

Duration 1:00

Quebec Health Minister Christian Dub responded to an open letter by the province's chiefs of emergency during a press conference on Tuesday.

Quebec willmake 1,700 beds in private seniors' homes and long-term care homes available for patients recovering after anoperation.Dub says nearly 1,000of those beds will be ready in the coming days.

"We're very aware of the regional aspect, but the problem with emergencies is even more glaring in Montreal," he said."Everyone is fighting for the same bed."

As of Tuesday afternoon, for example, Montreal'sJewish General Hospital had 116 patients admitted, but only had 53 stretchers available. At least 27 of those patients were on a stretcher for more than a day, and 13 spent more than 48 hours on a stretcher.

Dub said 500 of those beds would be in Montreal.

Quebec is also planning to open two clinics shortly, where specialized nurse practitioners cantreatpatients for emergencies. One will be set up inMontreal's east end and the other in the city'ssouth-centre.

ERs 'disproportionately bear the burden'

The letter was penned by Dr. Marie-Maud Couture, the president of the Regroupement des chefs d'urgence du Qubec (RCUQ), representing the province's chiefs of emergency.

The letter was not meant for the public eye. Radio-Canada obtained a leaked copy Tuesday morning.

It says that the RCUQ wrote "to make management teams aware of the serious problems" earlier this summer, but found that ERs "have not received the support of our management."

The letter says that a lack of hospital beds in other departments forces ERs to "disproportionately bear the burden of hospital overcapacity," which has a ripple effect on urgent care.

"Emergencies are now condemned to sacrifice their primary mission, which is to treat,in a timely manner, people whose clinical condition is unstable, or even potentially deadly."

"Our emergencies are the victims of a failing system, and it's our patients, our staff and the population who suffer from a disorganization of our establishments."

The health boards have a responsibility to regain control of the situation, the letter says, especially as health-care providers prepare for another wave of COVID-19, coupled with the flu, this winter.

Lacking beds

Couture, the author of the letter, declined an interview request Tuesday morning.

Dr. Judy Morris, the head of the Quebec Association of Emergency Physicians, echoed the concerns laid out in the letter Tuesday morning, saying the letter was an "appropriate response" to the government's handling of the situation.

"People were hoping, regionally and across the health-care establishments, that people would take appropriate measures to solve the crisis. But very little has been done," she said.

She said the solution to overcrowding in emergency rooms is to make beds available in other departments, so patients can be transferred appropriately.

"But it seems that in the health-care network, everyone is able to close their door and say: 'no, we're full' or 'no, we're at maximum capacity,'"she said.

"In the emergency room, we're not able to close the door, and rightfully so. But it's led to the numbers we've been seeing."

Dr. Antonio D'Angelo, the head of emergency atSainte-Justine children's hospital in Montreal, said the situation is distressing and does not appear to be getting better.

D'Angelo said that at his hospitalthey're seeing about 250 to 300 children every day. Many of them require hospitalization, but he said they also struggle to find beds for them, saying some wards are "completely full."

"We have nursing shortages everywhere and we're very, very concerned about the safety of the patients in our emergency rooms," he said.