Health minister’s demand for wait-time ‘fix’ evidence of government in need of acute care

The already-interminable wait to see a doctor in a Winnipeg hospital emergency department is headed in the wrong direction.

Data released Thursday by the Winnipeg Regional Health Authority shows wait times in the city’s three ERs continued to rise in March.

The longest wait times across all hospitals was 7.6 hours for nine out of 10 patients. That’s up from 6.9 hours in February and 5.6 hours in March 2021.

Adult wait times at Health Sciences Centre continue to be the worst at 10.5 hours, up from 10 hours in February and eight hours in March 2021. Median wait times at all ERs and urgent-care centres was 2.8 hours, up from 2.2 hours in February and 1.8 hours in March 2021. It’s the highest they’ve been since at least 2014.

So, will tripling the size of St. Boniface Hospital’s emergency department help bring those wait times down? Not unless there’s more capacity added to medical wards.

That’s not to say there are no benefits to the $141-million ER expansion that was re-announced this week. There are, including improved on-site diagnostic imaging and an expanded resuscitation area. Those measures will improve patient care and speed up the input process. The problem is what occurs after that. When patients are sick enough to be admitted to hospital and can’t get a bed on a medical ward, they will continue to languish for dozens of hours — sometimes days — in emergency departments.

Expanding the size of the ER won’t solve that.

"Access block," the inability to get admitted patients into medical beds, has been identified as the main cause of long ER wait times across Canada for at least 25 years. The Canadian Association of Emergency Physicians has published several evidence-based reports on the subject since the early 1990s. It’s not new. Everyone in the system knows it, but governments have largely ignored the problem.

The situation has worsened in recent years, for several reasons. The province rushed its hospital consolidation plan in 2017, even though experts on the front lines — including the authors of a government-commissioned wait-time task force report — strongly urged government to delay implementation. The province failed to ensure the three designated acute-care hospitals in Winnipeg (Health Sciences Centre, St. Boniface and Grace) had adequate in-patient bed capacity to absorb higher admission rates.

The percentage of ER patients requiring admission to hospital has been growing since consolidation.

The COVID-19 pandemic made it worse, but it also exposed weaknesses in the system.

The percentage of ER patients requiring admission to hospital has been growing since consolidation. At St. Boniface, it increased from 17 per cent in 2017 to 23 per cent in 2020. At Grace, it rose from 13 per cent to 17 per cent during that period. That has placed further pressure on medical wards and caused longer delays in emergency departments.

More funding alone isn’t the answer. If hospitals increase the number of beds on medical wards and do nothing else, those beds will fill up quickly, sending the facilities back to square 1. It has been tried, and it doesn’t work.

Steps have to be taken to improve patient flow, the process of moving people through the system quicker — without compromising care — to allow for new admissions. It requires planning, long-term commitment and a culture change in all areas of hospital operations.

Still, improvements can’t be made without more resources. Better management and sustainable funding are both required.

Unfortunately, that’s not happening. In its 2022-23 budget, Premier Heather Stefanson’s government allotted $2.525 billion to acute-care services, largely unchanged from the $2.512 billion in 2019-20, the year before the pandemic. Adjusted for inflation, that’s a funding cut.

Demanding hospitals simply "fix" ER wait times, as Health Minister Audrey Gordon did this week, doesn’t work either.

"My expectation as a health minister is that they will address this," she said, when asked what she plans to do about growing ER wait times.

That’s pretty rich. Government forced consolidation on hospitals, cut $83 million from their budgets in 2017-18, ignored expert advice to delay implementation, failed to provide hospitals with sustainable funding and, for the past five years, has micromanaged hospitals through its politically controlled Shared Health agency.

Now the health minister insists hospitals should just "fix" the ER problem?

That’s not leadership, that’s sheer incompetence.

tom.brodbeck@freepress.mb.ca