ER wait times do not have to be new normal By: Tom Brodbeck Posted: 2:21 PM CDT Thursday, Aug. 3, 2023

Hey there, time traveller!
This article was published 03/08/2023 (1160 days ago), so information in it may no longer be current.

What is stunning after six years of health-care reform in Manitoba is the Progressive Conservative government appears to have no plan to reverse the damage it caused when it closed three emergency departments and consolidated acute care services across Winnipeg.

Instead, the public is expected to accept patients languishing in ER hallways, sometimes for days, as the new normal.

Emergency room wait times have doubled since the Tories began implementing their “healing the health-care system” strategy in 2017, which included the consolidation of acute care services in Winnipeg at three hospitals.

Prior to consolidation, the median ER wait time across Winnipeg hospitals was just below 1 1/2 hours. It’s now hovering at close to three hours. The longest wait time for nine out of 10 patients (the 90th percentile) doubled from just under four hours to well over seven hours.

New data released last week by the Winnipeg Regional Health Authority show ER wait times have been largely unchanged over the past year, peaking last summer to record highs and returning largely to where they were in spring 2022 — twice as long as they were in 2017.

Wait times for surgical and diagnostic procedures have grown and the length of time it takes to see an ER physician is twice as long today as it was six years ago.

Today’s wait times are now the accepted norm for government. It has no stated plan to improve them.

That’s not what the Tories advertised in 2017, when then-health minister Kelvin Goertzen announced at a news conference at St. Boniface Hospital a new streamlined system would result in shorter wait times and improved services.

The opposite has happened. Wait times for surgical and diagnostic procedures have grown and the length of time it takes to see an ER physician is twice as long today as it was six years ago.

There is no acknowledgement of that by the Stefanson government, no apologies for getting it wrong, and no plans to make it right again.

Reasons for long waits well-documented

The reasons for the longer ER wait times have been well-documented.

Since consolidation, the province cut the number of staffed hospital beds in Winnipeg (3,024 in 2021-22, down from 3,160 in 2017-18).

During consolidation, the province deleted and reposted more than 3,000 hospital jobs, forcing some staff, particularly nurses, into positions many felt unqualified for. The province failed to consult with front-line staff prior to the changes (which the WRHA acknowledged in a report) and hundreds left or retired early. It was disastrous.

At the same time, the Tory government cut funding for acute care hospitals, forcing them to find $83 million in “savings” during the largest reorganization in recent Winnipeg history. Hospitals never recovered. The problem was made worse by the COVID-19 pandemic.

The funding cuts and reductions in staffed beds worsened overcrowding, causing admitted patients to back-up in emergency departments in greater numbers, which in turn drove up ER wait times.

The data shows the median length of stay for admitted ER patients in Winnipeg hospitals jumped 64 per cent from 2019 to 2022 (13.1 hours to 21.4 hours). It fell slightly to 19 hours in May 2023, but is still significantly higher than it was four years ago.

Despite that, neither Premier Heather Stefanson, Health Minister Audrey Gordon nor anyone from Shared Heath (the added layer of bureaucracy the Tories created in 2017) has laid out a plan to reduce those wait times.

Instead, they repeat how they’re trying to divert low-acuity patients from ERs to more suitable places, such as clinics or doctors offices, even though studies have shown repeatedly low-acuity patients do not drive up ER wait times.

Less-urgent patients not the problem: report

“Contrary to popular belief, less urgent patients are not a significant cause of emergency access block. The reason for this is logical but rarely understood,” says a draft report on health-care reform by the Canadian Association of Emergency Physicians slated for release in the fall.

The report says to decrease emergency department bottlenecks, hospitals must increase nurse-staffed stretchers in ERs and/or decrease the number of patients in those stretchers (such as getting them to medical wards faster).

“Diverting low-acuity patients away from the ED accomplishes neither, because these patients do not occupy nurse-staffed stretchers,” the report says. “Sadly, ignoring the bottleneck and spending time and money ‘fixing’ unrelated issues like low-acuity patients has not succeeded and will not succeed in the future.”

Yet, Manitoba politicians and health-care bureaucrats keep peddling the falsehood that diverting low-acuity patients away from emergency departments will reduce ER wait times.

There are no silver bullets to solving the ER crisis in Manitoba. But it’s obvious from the data and the available evidence hospitals require more targeted resources, increased staffing, and a new funding model that takes patient volumes into account.

There are solutions. The status quo imposed on Manitobans by the Tories’ failed reforms does not have to be the new normal.

tom.brodbeck@freepress.mb.ca