Health-care issues stem from cuts, decades of poor planning: emergency medicine expert

Long wait times, closed emergency departments and growing waitlists for family doctors have exposed the pressures facing the health-care system this summer – specifically on emergency medicine.

Canadian Association of Emergency Physicians President Dr. Mike Howlett, who has spent almost three decades working in emergency medicine in Truro, Nova Scotia and Saint John, New Brunswick, says the situation is as bad as it seems.

And it didn’t happen overnight.

“It is a crisis, make no mistake. It is a serious crisis when you can't staff departments adequately, when you can't get people into hospital, eventually bad things will happen,” he said. “Emergency departments are not the cause of the problem. They're not the sole problem. The crowding is just a symptom of this lack of planning over the last 20 or 30 years.”

He noted that the crisis stems from cuts and poor planning made decades ago --- planning that didn’t consider a growing and aging population, or the possibility of a global pandemic.

“All that ended up happening was, by being more efficient, they took the means to produce good health out of system, such that there were no redundancies left,” he said. “There's no way for parts of the system to cover for each other when there's a crisis.”

The hope now is that governments and health authorities learn from the past and plan better moving forward, something the president of Doctors Nova Scotia, Dr. Leisha Hawker, says is critical.

“We have a lot of senior family doctors in Nova Scotia, many who probably would have wanted to retire five, ten years ago and have continued to work,” she said. “So in the future, we need to do a better job of human resource planning so that we don't get into this crisis again.”

According to the Nova Scotia Health Authority, 105,187 Nova Scotians are on the Need a Family Practice Registry as of Aug. 1 — up from 100,592 on July 1.

It’s an increase of 30,000 people in less than a year. The growing wait-list can be attributed to a range of factors, from population growth to doctors leaving or retiring.

The August report states that 37.6 per cent of people said they wanted to be added to the registry because they were new to an area, and 24.7 per cent reported their provider had moved or closed their practice.

But Hawker says peoples’ health must remain most important.

“Don't delay if you do have a serious health issue because we're also seeing people avoiding the emergency departments, so we also don't want that,” she said.

Howlett says emergency room doctors and nurses want to get back to doing their jobs, the way they were trained to do them.

“It's heartbreaking to treat people in the hallway,” he said. “It's heartbreaking to see them on chairs. It's really tough, and I really would like the public to know that.”