Emergency room closures skyrocketing
Western Zone had a 2,444-hour increase in closures, a 48.5-per-cent hike.
The number of unscheduled emergency department closures in Nova Scotia hospitals more than doubled in 2018-19 from the year before.
Twenty-one of the province’s 38 emergency departments experienced temporary closures from April 1, 2018, to March 31, 2019, according to an annual emergency department accountability report recently submitted to the legislature.
The province’s emergency departments were closed for 48,783 hours for the year, nine per cent of the time.
“There are just too many patients and not enough facilities right now,” said Dr. Robert Miller, an emergency room doctor at the Valley Regional Hospital in Kentville.
Miller said none of the family physicians graduating from Dalhousie University with an emergency certificate over the past several years stayed in Nova Scotia to work.
“They could make more money elsewhere, Nova Scotia was paying very low salaries,” Miller said. “These guys were graduating with fairly heavy student debtloads and residency loads, naturally they were going to the places that paid the best.”
The other problem Miller identified is the skyrocketing number of orphan patients, people without a family doctor.
“The (emergency) departments
are overcrowded,” he said. “You’re doing emergency medicine plus all sorts of family medicine that you are not being compensated for. Those family doctors just don’t exist anymore.”
The report had the Glace Bay hospital at the bottom of the pack with its emergency room opened only 33 per cent of the time. The Northside General Hospital’s ER was closed slightly more often than open.
Emergency room closures increased by more than 18,000 hours in the year that ended in March. All four health zones saw increases of at least 48 per cent, with the Central Zone of Halifax, Eastern Shore and West Hants showing an increase of 3,669 hours of closures, a whopping 72.4-per-cent hike.
The Eastern Zone of Cape Breton, Guysborough and Antigonish areas saw a 58.2-percent jump in closures, up by 8,137 hours. The Northern Zone, encompassing Colchester, East Hants, Cumberland and Pictou, experienced an additional 4,039 hours of closure, a 63.1-per-cent jump, and the Western Zone – Annapolis Valley, South Shore and southwest – had a 2,444-hour increase, a 48.5-per-cent hike.
“Emergency room closures have tripled since Stephen Mcneil became premier,” Opposition Leader Tim Houston said in a release. “I don’t know how the minister of health will be able to spin these numbers. The government is putting people’s health at risk. Too many Nova Scotians do not have access to primary care, and coupling that with skyrocketing ER closures is a dangerous situation.”
Houston said there can no longer be any denial that the province is in a health-care crisis.
“We can no longer accept minimal action by this government,” he said. “Nova Scotians are terrified that when they need emergency assistance it won’t be there for them.”
NDP Leader Gary Burrill said the premier does nothing year after year while emergency rooms across the province are closed or overcrowded.
“We can do better than that, and we did do better,” Burrill said. “Under the NDP government, emergency room closures went down every year. That’s what is possible when you have a government that actually invests in the health-care services people need.”
Houston said the report paints a dismal picture of mismanagement by the Liberal government.
“This government is spending more and getting worse results,” Houston said.
Miller says he can explain that equation.
“We actually pay the highest per-capita cost for health-care administration, we pay 35 per cent more than the national average,” Miller said. “We pay 35 per cent less (per capita than the national average) for physicians. There might be some priorities getting mixed up there.”
Miller said 40 per cent of provincial expenditures go to health care but that the centralized Nova Scotia Health Authority the Liberals brought in five years ago has been a failure. Miller said he wrote to the premier and health minister requesting a forensic audit of the health authority, where he says administrative salaries are increasing rapidly.
“That’s a big concern, too much money is being spent on middle management and administration.”
The introduction to the report says compensation for emergency services was a focus during contract negotiations between the province’s health authority and Doctors Nova Scotia, which resulted in a five-year agreement last month.
Miller, too, is hopeful that the contract can reverse some of the problems in the health system.
“Primary care is where they should be putting a lot of this money,” Miller said. “We didn’t really recognize the value that family physicians were providing. You start at the bottom and things just collapse once the bottom is taken out.”
Miller said the new contract, which puts salaries of Nova Scotia physicians at the high end among other Maritime provinces, should start to make a difference.
“We might see a change in a couple of years but I wouldn’t be surprised if it got worse before it got better,” he said.