Cutting beds: ‘Where are they going to put those patients?’

Two months after Health Minister Gaétan Barrette pledged publicly that the Jewish General Hospital will be “supported correctly,” the Côte-des-Neiges institution has been left with little choice but to close a 22-bed unit as part of a cost-saving exercise, the Montreal Gazette has learned.

The 22 beds are located on 6 North, a section of the hospital reserved for older patients with medical conditions that are deemed less complex. The unit is not part of the geriatric department, which is not being affected under the reorganization.

Louise Miner, director of professional services for the West Central Montreal Health authority in charge of the Jewish General, said the decision to cut beds was made to improve efficiency at the hospital.

“There will be savings for sure, inevitably,” Miner said, although she was unable to provide precise figures.

Emmanuelle Paciullo, a spokesperson for the health authority, said by email that “the exact savings have not yet been ascertained.”

The Jewish General, like many hospitals across Montreal, has been beset by government funding cuts despite an increase in clinical volumes as Quebec’s population ages. The McGill University Health Centre is resorting to closing beds to make do with a decrease in provincial funding.

Carrie Bogante, director of finance for the West Central Montreal Health authority, told a board meeting in January the “JGH recently found itself in a unique situation: After cutting its budget by $23 million in 2014-2015, the hospital was ordered to make further reductions in 2015-2016,” according to minutes of that meeting.

Bogante said the hospital “will achieve the latest cuts through a one-time-only solution of transferring surpluses from three other network institutions to make up the shortfall at the JGH.”

Four days earlier, Barrette visited the Jewish General to inaugurate its critical-care Pavilion K, and he told a news conference that the “institution has to be supported correctly.”

Miner emphasized in an interview that Barrette was not behind the Jewish General’s bed-cutting plans.

“He didn’t tell us to close beds,” Miner said. “That’s our decision — how we manage with what we have and how efficient we can be.”

No one from the Jewish General’s Users’ Committee was available for comment on Friday. The bed cuts are to take effect in April.

Judy Phillipson, a retiree and former social worker at the Jewish General, expressed concern about the potential impact on clinical care.

“I’m very distressed at hearing this news because so many services for the elderly have been closing or reduced,” Phillipson said. “Where are they going to put those patients who have been using those beds?”

Miner noted that the decision to close the beds followed a careful exercise to assess the average length of stay of patients “department by department, almost doctor by doctor.”

“If we thought there was going to be a significant clinical impact, we wouldn’t have done it,” Miner said. “We looked at the math, we looked at the length of stay.”

Miner suggested that some of the savings from the bed cuts would be reinvested in the operating rooms for minimally invasive surgeries. The rationale behind such surgery is not only to improve the health outcomes of patients, but to have patients recuperate faster and return home sooner — hence the need for fewer beds.

“Closing beds has become the new norm all over the world, it’s not something we just do here, and we have to find ways to be more efficient in how long we keep patients in the hospital, how soon can we discharge them to be taken care of at home,” Miner added.

Hospitals have been cutting beds since the mid-1990s, but critics have complained that the funding for home care has not kept pace.

Miner vowed that “there’s going to be a push for more homecare support for patients, which is better,” but was unable to say when this would occur.

Still, Miner added that as the director of professional services, not just for the Jewish General but for CLSC clinics that are now part of the new local health authority, she would be in a better position to make sure there is more home care.