TORONTO — Several Ontario hospitals are warning of patient surges and longer wait times in their emergency departments, and the Canadian Medical Association says a lack of access to primary care is a major factor in ERs overflowing across the country.
Niagara Health, Oak Valley Health's Markham Stouffville Hospital, Queensway Carleton Hospital in Ottawa and Ross Memorial Hospital in Lindsay, Ont., are all advising patients to consider alternatives to the ER if their condition isn't urgent.
Terri Stuart-McEwan, the vice-president of clinical programs and chief nurse executive at Oak Valley Health, said Markham Stouffville Hospital is seeing a nearly 200 per cent increase in patient volumes from the same period pre-pandemic. That's in part due to respiratory illnesses such as COVID-19, influenza and RSV, she said, with many people not recently vaccinated and fewer people masking.
"We don't want to send people away because that is not the intention," she said. "Our doors are open (24 hours), but it is really about just trying to make sure that patients recognize that they may have to wait because our sickest of our sick are also in there at the same time."
Ryan Young, a spokesperson for Ross Memorial, said the hospital has been at about 110 per cent capacity on any given day for the past month, leading to patients being treated in hallways and other "unconventional spaces" such as a staff dining room.
"We do share in the staffing pressures being experienced by many health-care institutions," Young said.
"We've also seen patients coming through the door sicker than in the past. This being bolstered by respiratory illnesses, including COVID-19, influenza, and RSV ... they're coming in sicker than in the past, so more required admissions."
The Queensway Carleton Hospital in Ottawa said earlier this week it was at 115 per cent occupancy, with 35 patients admitted in the emergency department waiting for a bed and another 70 people waiting to be seen.
At Niagara Health, patient volumes in the ERs are higher across three hospital sites than the same time last year, with more patients requiring admission, said Heather Paterson, executive vice-president of clinical operations.
"Our inpatient beds are full and so when inpatient beds become full, we back up a bit into our emergency department," she said.
"It's a mixture of volumes, it's a mix of patients requiring admission that are still being housed in the emergency department because we don't have inpatient beds, and then, definitely, we do have staffing challenges, similar to other organizations across the province."
The Canadian Medical Association issued a statement Thursday calling attention to the crisis being seen in hospitals across the country.
"Many emergency rooms across the country are overflowing and patients across Canada are waiting far too long to receive necessary care," the association wrote.
"Despite the tireless efforts of physicians, nurses and other health providers, testimonies from around the country illustrate that patients in some jurisdictions are waiting as long as 20 hours or longer to receive care."
The CMA urged provincial governments to step up efforts to address the crisis, with a particular focus on access to high-quality, team-based primary care. One in five people in Canada don't have access to a primary care provider, the association said.
Ontario Liberal health critic Adil Shamji said what is unique about Ontario's situation is a "vacuum of leadership."
"This government shares a problem that many other provinces and countries do, but does not have any of the same intention, motivation, capability, or interest in addressing the root causes," he said.
Shamji suggested the Ontario government has focused too much on capital funding for hospital projects and not enough on ensuring there are enough workers to staff those new spaces.
"This government believes in brick and mortar and concrete and (couldn't) care less about the backbone of our health-care system, which is nurses, PSWs, physicians, respiratory therapists, paramedics," he said.
Ontario NDP Leader Marit Stiles also said the province needs to focus on health-care staffing, including establishing safe nurse-patient ratios and capping nursing agency pay rates to end the poaching of staff hospital nurses.
"We need to prohibit agencies from paying their workers more than 10 per cent above the rate in the public workplaces, if we're ever going to retain and recruit workers to our public health-care system," she said.
"Now, if we fix our health-care staffing crisis, we will reduce wait times. But without workers, our hospitals and our long-term care homes, they can't function."
There were more than 200 unplanned temporary emergency department closures in 23 Ontario hospitals between July 2022 and June 2023 due to doctor and nurse shortages, Ontario's auditor general found in a report late last year.
Amid that strain on the system, one in five patients who visited ERs were only there because they did not have a family doctor, and they did not need urgent care, the report found.
A spokesperson for Ontario Health Minister Sylvia Jones said Ontario is leading the country with some of the shortest wait times in Canada and is spending billions of dollars to further reduce them.
Ontario is spending $44 million more this year on reducing ER wait times, allowing more internationally and interprovincially educated health-care workers to practice in the province, and has introduced programs to help patients get more care through pharmacies and community health providers, Hannah Jensen wrote in a statement.
This report by The Canadian Press was first published Jan. 11, 2024.
Allison Jones, The Canadian Press
Note to readers: This is a corrected story. A previous version carried an incorrect time period comparison for patient-volume increases at the Markham Stouffville Hospital.
