NDP’s plan to reopen ERs could further harm health-care system

Hey there, time traveller!
This article was published 07/09/2023 (774 days ago), so information in it may no longer be current.

The Manitoba NDP is promising to reopen three emergency departments in Winnipeg that were converted to urgent care centres by the Progressive Conservative government.

Sounds like an effective election strategy that may help the NDP win votes in key Winnipeg ridings, including Fort Richmond — home to Victoria Hospital, where the party has promised to reopen the first ER if it wins on Oct. 3.

From a patient care perspective, though, the plan may do more harm than good.

The Tory government didn’t just close three ERs when it revamped hospital operations in Winnipeg between 2017 and 2019. It consolidated acute care services at three facilities: Health Sciences Centre, St. Boniface Hospital and Grace Hospital.

Prior to the changes, six hospitals in Winnipeg operated as acute care facilities – including Victoria, Seven Oaks and Concordia hospitals. Each had its own ER, intensive care unit, diagnostics and other medical resources required for full-service hospitals.

The principle behind consolidating those services at three facilities was that acute care services were spread too thin in Winnipeg. Pooling them at fewer sites would reduce wait times and cut down on the number of patients transferred between hospitals, the architects of the plan argued.

On paper, it had merit.

The problem was how government implemented the plan. It was rushed, front-line workers weren’t consulted or prepared for the massive change, many were transferred to new positions they didn’t feel qualified for and hundreds left.

The province also seized on consolidation as a way to cut costs, which was not part of the original plan (the stated objective of consolidation was to improve patient care, not save money). Government reduced hospital capacity by cutting the overall number of medical and ICU beds in the system, resulting in hospital overcrowding and longer wait times (also not part of the original plan).

Government, health officials dismantled Manitoba's hospital system, ignoring warnings from those on the front lines

To make matters worse, the Tories cut acute care funding during the consolidation process when hospitals needed funding the most, including to cover one-time costs associated with the changes. It was a recipe for disaster, the impact of which is still felt today.

But what to do about it now? It’s not as simple as just reopening ERs, which are normally attached to acute care hospitals that include a wide range of medical services, including ICUs, needed to support emergency departments.

By pledging to reopen three ERs, is the NDP planning to operate six acute care hospitals again in Winnipeg? That would require massive reorganization, with questionable benefits. It would probably be a mistake.

There was, and probably still is, consensus in the medical community that consolidation was necessary. The only question was how many acute care facilities Winnipeg needs and how quickly change should occur.

There was, and probably still is, consensus in the medical community that consolidation was necessary. The only question was how many acute care facilities Winnipeg needs and how quickly change should occur.

“Consolidation of hospital and emergency services is sensible in concept, as it aims to bring together specialty, diagnostic and consultative services in a limited number of well-resourced centers, eliminating the dilution inherent in multiple acute care facilities,” a 2017 Manitoba task force report on wait times concluded.

At the same time, the report — commissioned by the PC government — offered the following caution: “Ultimately, the number of Winnipeg’s (emergency departments) does need to be reduced, but concerns remain as to how many and how soon… The timing and proper planning of these changes can spell the difference between success and failure.”

The task force recommended a slower, more methodical approach to consolidation and a re-evaluation of the optimal number of acute care facilities. The recommendations were ignored by the Tories.

The solution now, though, isn’t simply to reopen emergency departments, as the NDP is promising. The first step should be to determine the right number of acute care hospitals for Winnipeg. Maybe it’s three. Maybe it’s four. Only then can health planners decide how many ERs Winnipeg needs.

Reopening ERs without due diligence is almost as reckless as consolidating acute care hospitals without proper planning. Both are driven by political considerations, which ultimately compromise patient care.

Reopening ERs without that due diligence is almost as reckless as consolidating acute care hospitals without proper planning. Both are driven by political considerations, which ultimately compromise patient care.

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The most immediate crisis facing hospitals in Winnipeg today is not a lack of emergency departments. It’s a lack of hospital capacity, namely staffed medical and surgical beds.

It’s the main reason ER wait times have doubled and why patients languish sometimes for days on gurneys in emergency departments. There are no silver bullet solutions to solve that, especially in the midst of a national shortage of health-care staff.

All political parties in this election are promising more resources to recruit front-line workers, but none can promise immediate relief. That will require long-term commitment and an adherence to evidence-based decision-making.

Promising to reopen three ERs may make for good politics during an election, but it won’t solve the province’s health-care crisis. It could make things worse.

tom.brodbeck@freepress.mb.ca

Tom Brodbeck
Columnist

Tom Brodbeck is an award-winning author and columnist with over 30 years experience in print media. He joined the Free Press in 2019. Born and raised in Montreal, Tom graduated from the University of Manitoba in 1993 with a Bachelor of Arts degree in economics and commerce. Read more about Tom.

Tom provides commentary and analysis on political and related issues at the municipal, provincial and federal level. His columns are built on research and coverage of local events. The Free Press’s editing team reviews Tom’s columns before they are posted online or published in print – part of the Free Press’s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.