Thursday, January 11, 2024

Murray Mandryk: ER crisis is culmination of a lot of things gone wrong

Opinion by Murray Mandryk • 

Saskatchewan’s emergency room crisis is an immediate mess, but it’s also a problem long in the making.



The crisis in Saskatchewan emergency rooms didn't happen overnight or in the last 16 years. It's been decades in the making.© Provided by Leader Post

Unfortunately, why it doesn’t seem to be getting any better is that we seem unwilling to invest in understanding the short- and long-term reasons for the problem — let alone the massive dollars we’d need to pour into the system to make any headway.

Again this week, we saw the NDP Opposition blasting the Saskatchewan Party government for emergency room disruptions at City Hospital in Saskatoon —  what health critic Vicki Mowat called “a complete lack of transparency”.

Admittedly, what we heard this week goes beyond problematic. It’s downright dangerous for the public to have to rely on social media posts from frustrated ER doctors to find out the emergency room services are “limited”  and that patients might be rerouted to other hospitals to seek help.

Surely we shouldn’t have to rely on doctors’ social media posts to find this out.

Surely someone must get that there is a serious problem when a Saskatoon fire department inspection determines overcrowding in the hallways of St. Paul’s Hospital is violating fire codes.

Surely this should be ringing alarm bells, warning us there’s something terribly wrong with emergency rooms and perhaps the entire health system. 

Mowat may be right in her theory that this is an ongoing effort by the Saskatchewan Party government to “attempt to paint a rosier picture than what we have in front of us right now … to distract from the system they have created after 16 years in government.“

But in reality, the problems are complex and likely go back much further than the last 16 years of Sask. Party governance.

And it would be considerably more helpful to break down the ongoing short- and long-term problem.

The issues begin with the insatiable appetite of the now $7-billion provincial public health budget, where, it seems, throwing more money at the problem has not always brought us closer to solutions.

As recently explained in a piece by the Leader-Post’s Larissa Kurz, emergency rooms are where many of the health-care system’s problems intersect.

City emergency rooms have been getting busier for decades, said Saskatoon Paramedic Association president Paul Hills, explaining the “multi-faceted issue” in which lack of EMTs, nurses and doctors, medical technologists and specialists is part of a massive and ever-changing jigsaw puzzle.

Also in play are policy requirements, like the need for ambulances to remain at hospitals until their patients are cleared, meaning clogged emergency rooms translate into fewer ambulances on the road.

All this has combined with the changing face of Saskatchewan, a province with both a growing senior population and record immigration that it hasn’t seen in 100 years. Seniors and newcomers are likely to put added strain on emergency rooms because of the added emergency needs of older people and because new arrivals may not have a family doctor or easy access to the health-care system.

However, lack of a family physician has become an increasingly widespread problem, causing more people to rely on emergency rooms to see a doctor. There is also the problem of more people becoming sick during and since COVID-19.

Even before the pandemic, which clearly made the problem worse, there was already a growing plague of new street drugs and more people winding up emergency rooms.

The government has made some attempts to address this with clinics adjacent to emergency rooms, but this solution has yet to come to fruition.

For now, the health system remains dependent on emergency service, and there is less emergency room service than three decades ago. It’s now 30 years since the closure of the Plains Health Centre and 52 rural hospitals, adding more pressure to the remaining city services.

We can debate until the cows come home the necessity for this, but less debatable is the impact.

It’s just one more factor that’s helped create the crisis in Saskatchewan emergency waiting rooms we see today.

Mandryk is the political columnist for the Regina Leader-Post and the Saskatoon StarPhoenix.

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