Commissioner’s report assesses health services wait-times

The Commissioner of Health and Welfare (CSBE) sees positive effects in emergency response times in her latest report, but these are partly offset by the effects of an aging population.

Two days before the final closure of the agency's offices, Acting Commissioner Anne Robitaille wrote Tuesday that Health Minister Gaétan Barrette's reforms appeared to have produced "certain effects" between 2014-2015 and 2016-2017. She adds, however that the increase in the number of elderly people has led to an increase in the clientele in emergency rooms resulting in longer wait times.

The 86-page report warns that effort needs to be "redoubled" to ensure that the public can actually benefit from an improved emergency situation in the province.

The report points out that from 2014 to 2016, the average length of stay in an emergency department decreased from 9.24 hours to 8.93 hours. It rose again, however, in 2016-2017, reaching 9 hours.

The increase in wait time is attributable specifically to older patients with greater needs. If this variable is excluded, the average stay in the emergency room would be 8.75 hours, down 5.5% per cent over two years.

Robitaille also examines the use of mental health emergency services, highlighting very long stays and significant disparities across regions.

Another report from the CSBE published Tuesday reveals that people over 75 years wait on average nearly 10 months for a place in a CHSLD in Quebec. Currently, they are roughly 2,407 on waiting lists.

Robitaille also points out that Quebec is facing an accelerated aging of its population. In 2016, almost 8 per cent of the population was 75 years of age and older. In 2016-2017, 4.4 per cent of people over age 75 were living in a CHSLD, representing 28,427 people out of a total of 641,501 in this age group. Between 2010-2011 and 2016-2017, the number of beds in public CHSLDS decreased by 2.5 per cent (926), while population estimates suggest the population over 75 years has increased by 15 per cent, she says. "However, we note that since 2014-2015, the number of beds in private and public CHSLDS has increased somewhat."

To counteract some of the decline in the number of beds in CHSLDS, there has been some improvement in other services that support autonomy, such as home assistance, intermediate resources, and family-type resources, Robitaille adds.

"Home support and intermediate resource or family-type resource services may delay the need for accommodation in CHSLDS,” she says.”however, for clients already experiencing severe loss of autonomy, these services are no longer adequate, since they can’t offer the level of care required by a CHSLD resident. Unfortunately, waiting lists to access a CHSLD are long and many seniors wait several months, despite the fact that they are already known to the network and their need for CHSLD accommodation has been confirmed."

The position of the Commissioner, whose mission was to shed relevant light on public debate and government decision-making, was abolished in the March 2016 budget. Outraged by the announcement last year of the abolition of the position, health groups have criticized Health Minister Barrette has denied himself of a valuable tool – one that advises and evaluates reforms and question whether These he is trying to avoid any critical and independent evaluation of his actions.