ER closure a wake-up call

Dozens of people gathered recently for a candlelight vigil outside a small hospital in Minden, Ont. They weren’t there to mourn the loss of one specific life. They were there, rather, to mourn the loss of a critical service that has saved so many lives.

This month, in a controversial decision, the Haliburton Highlands Health Services officially closed Minden’s emergency department. Minden’s ER services have been “consolidated” with the emergency department in Haliburton, a 25-minute drive away.

The Minden site will provide physiotherapy, bone densitometry and outpatient X-ray services by appointment.

But the heartfelt display of gratitude for the health-care workers that kept Minden’s ER up and running for nearly thirty years could not reverse its fate.

Going forward, local residents and cottagers who descend on Minden in the summer months — more than tripling the town’s population — will be forced to seek emergency care elsewhere. This outcome will be felt acutely not only by Minden residents who require urgent medical care, but by those who provide it.

“We will have an increased demand for our paramedic services and ambulances,” Minden Hills Mayor Bob Carter told the Star in April, speaking about the looming closure of the department.

“This demand will need to be paid for by the county. On top of that, if the paramedics are busy due to their increased workload, the responsibility for answering medical calls will need to be answered by our volunteer fire departments,” Carter said.

The reason for the closure, according to the HHHS, is severe staffing shortages, particularly when it comes to nursing. According to reporting by the Star’s Kenyon Wallace, the health agency said the consolidation of the Minden ER was necessary in part, due to “severe and persistent” nursing shortages, as well as physician shortages at the Haliburton ER.

Yet whatever the reason behind this specific ER shuttering, or “consolidation,” the tragic closure is a symptom of a widespread problem crippling the province’s health-care system.

Last year, hospital emergency departments were forced to close across Ontario 158 times. The shutdowns occurred at 24 hospitals, most of them in rural areas, ranging in time frame from 12 hours to a full day. In almost every case, according to the Star’s investigation, “the reason given for the closures was a lack of adequate staffing.”

This is a crisis that exists far beyond Ontario borders. Even with what appears to be the worst of COVID-19 behind us, hospitals everywhere are finding it difficult to attract and retain nurses. Indeed, a few months ago, the International Council of Nurses declared the nursing shortage “a global health emergency.”

However, just because the crisis has roots in factors beyond the provincial government’s control doesn’t mean the government isn’t responsible for making it worse here at home.

It is simply egregious that Ontario’s nurses were subject to wage restraint legislation in the middle of the pandemic. Though that legislation — Bill 124 — has since been declared unconstitutional, and arbitrators have ruled that nurses should receive retroactive pay for lost wages, it isn’t difficult to understand why many nurses or would-be nurses would rather not seek employment in Ontario.

“After years of wage suppression and disrespect, tangible evidence is needed that their work-lives must improve in order to retain them,” a spokesperson for the Ontario Nurses’ Association told the Star in April.

The province must make attracting health-care workers an urgent priority — not by offering them bonuses or by renewing funding to rural and northern hospitals on a temporary basis (as Health Minister Sylvia Jones did this month), but by fostering the long-term conditions for a healthy workplace and workload. Premier Doug Ford must display the same respect for nurses and PSWs that he does for police officers.

Moreover, the province must get serious about its approach to solving the health-care crisis. According to a damning report from the Financial Accountability Office of Ontario, between 2022-23 to 2027-28, the province has allocated $21.3 billion less than will be needed to fund current health sector programs and deliver on its program expansion commitments in hospitals, home care and long-term care.

The report concluded that while the provincial government’s measures do “address physician shortages in rural emergency departments” it does not “provide for a sustained increase in emergency staffing across the province.”

Canadians are rightly proud of our nation’s universal health care. But there is nothing universal about health care that is available to some people and unavailable to others, depending on their address. Unless the provincial government makes a sustained, honest commitment to health care funding and staffing, we fear that ER closures like the one in Minden will not be an anomaly in Ontario, but the norm.