Wait times at emergency rooms across Winnipeg have hit a seven-year high and one doctor says more could have been done years ago to address it, but senior leadership failed.
“There has been, and I say this with as much respect as I can muster, a profound failure of leadership on this file. People at the most senior levels in our Department of Health, Shared Health need to come out and admit there’s a problem, show their faces,” Dr. Alecs Chochinov said.
Chochinov, an emergency room doctor at St. Boniface hospital, said wait times continue to get worse.
“Wait times have been a problem for many, many years, for most of my career, in fact. But they have worsened significantly,” he said.
Chochinov said the government has had the ability to fix this for ages and that the playbook has been in their hands for four years.
In 2016 Chochinov was one of the members of the Wait Times Reduction Task Force established by the current government. The group was commissioned to put together a report on the state of the province’s hospital wait times and recommend actions to shorten wait times in ERs around the province.
They delivered the final 300-page document to the Pallister government in December 2017 that outlined a number of recommendations.
“They’re not easy. They’re very complicated. They take a long time,” Chochinov said of the recommendations.
“I don’t know whether anybody in this government even read that report because I received no feedback and no questions about it,” he said.
“There aren’t simple solutions. But at some point we have to start and we haven’t even started.”
The report not only outlined a number of key recommendations but also guidelines for the Pallister government as it moved forward with a drastic health-care overhaul which included shuttering emergency departments.
“The hospital/ED consolidation announced in April 2017 is seen, conceptually, as a positive stride forward, but the devil is in the details—it must be properly evaluated, phased in, and coordinated with rural ED care, under a unifying governance structure,” a portion of the report stated.
Chochinov said they warned then Premier Brian Pallister and his government to “hasten slowly.”
“We urged the government of the day not to make precipitous changes without making sure that the structure of the system itself could absorb those changes.”
They also told the government not to make any further changes until the new ER was built at St. Boniface hospital because that system was already under tremendous strain.
“We urged that the necessary behavioural and cultural changes, that need to happen in a complicated system, be in evidence before they made any closures of emergency departments or major changes.”
But according to Chochinov, they did the opposite.
“They were in a hurry. They hastened quickly,” he said. “And I believe the reasons for those decisions were economic and the costs of acting precipitously are far, far in excess of anything they would have saved by hastening slowly.”
“And when I say costs, I mean the economic costs, which have been economically catastrophic; but more important, I mean the cost to patients’ health.”
Chochinov said the current COVID-19 pandemic has added to the problems hospitals and ERs were already facing but because the previous issues were never addressed, the situation has been exacerbated.
“Obviously (COVID) made it worse, but the big thing when you talk about emergency departments and planning for the future is you have to expect the unexpected,” he said. “You have to expect the surge – don’t cut to the bone, there’s going to be a surge – and that was in the report as well.”
What’s being done
While Shared Health refused Global News’ interview request, Chief Nursing Officer Lanette Siragusa has been open about the issues facing Winnipeg hospitals.
“It’s not a one-unit problem. It’s not a one-hospital problem. It’s a systemic problem,” she told Global News during an August interview.
Like Chochinov, Siragusa said the ER is the canary in the coal mine and signals wider issues throughout the health-care system.
“Some of the issues that we’re experiencing right now are age-old problems that we’ve had in the health system and they relate to patient flow and they also relate now to (staff) vacancies in emergency departments,” she said. “So that’s where our biggest challenges are right now. These were challenges before we had COVID.”
In a statement to Global News, a spokesperson for Shared Health said the wait times task force report was one of the driving factors that launched the development and subsequent release in 2019 of Manitoba’s Clinical and Preventive Services Plan.
“Since that time, clinical and system leaders have largely focused on responding to an unprecedented pandemic that has directly or indirectly touched virtually every aspect of patient care,” the spokesperson said.
“The resulting delay in our ability to implement the recommendations of the Clinical and Preventive Services Plan has been disappointing.”
The spokesperson said a number of recommendations made by the task force are “quietly being worked on behind the scenes or already in place,” including the expansion of Telehealth opportunities for rural and northern patients, improved coordination of land and air emergency response services and development of more proactive mental health services to reduce reliance on emergency departments.
Government response
Current Premier Kelvin Goertzen was the health minister at the time the report was handed over to the government, but he refused to speak to Global News when his office was contacted for an interview.
Instead, his team said current Health Minister Audrey Gordon would provide comment on behalf of the government.
Minister Gordon’s office refused repeated requests by Global News for an interview.
However, her team provided a statement that addressed none of the issues nor the 2017 report in question and blamed wait times on the COVID-19 pandemic.
“Emergency departments and urgent care centres have experienced a number of challenges in recent weeks including difficulty in accessing hospital in-patient capacity, ongoing staffing challenges, pandemic-related staff redeployments, and COVID-related processes, all of which have contributed to an increase in emergency/urgent care wait times as they are in other jurisdictions,” a government spokesperson said.
They said the ongoing pandemic and staff redeployments have impacted the system.
“Numerous necessary staff redeployments, changes in processes and protocols, and unusual demand on certain parts of the health system, have made matters even more challenging for our emergency and urgent care professionals,” they said.
While the pandemic has had a profound impact on hospitals, these recommendations were made three years prior to COVID and for Chochinov it all comes down to accountability.
“Our health-care system is a fundamental foundation of our of our system in Canada,” he said.
“We have to make it work for people. We have to get angry when it’s not working.”
“We have to let people know that we have to hold people accountable.”