The escalating trend of emergency room closures nationwide manifested in a harrowing incident when three teenagers, victims of a triple stabbing at a house party in Clinton, Ontario, were transported to a nearby hospital, only to discover its emergency department had ceased operations after 6pm. The injured teenagers, who had been celebrating a Sweet 16 party, were then transported to another medical facility located a challenging 20 kilometers away.
Mayor Jim Ginn of Central Huron, home to the Clinton hospital, has expressed his deep concern over this scenario, akin to playing Russian roulette. He warns that these escalating closure incidents in rural hospitals can potentially lead to life-threatening situations. Ginn laments that the current situation was perilously close to turning into a fatal incident.
These emergency shutdowns are an alarming part of the significant number of emergency department closures that have been recorded across the country in 2023. Over 1,284 cases have been found where hospital ER units, typically in rural areas, have been shuttered, either temporarily or indefinitely. This record, however, may be underestimated as data is inconclusive; some provinces offer online updates, others cannot provide data or fail to respond, some information comes from health authority websites, and others draw from news reports.
Alan Drummond, a rural emergency physician, lamented on the severely detrimental impact these closures have on an estimated 7.1 million Canadians living in rural areas, pointing out that the government is failing in its social contract to its citizens by not providing assured access to quality emergency care.
Indeed, having to travel an extra 20 kilometers or more just to reach the next available ER department can potentially cost lives, especially in situations where each minute is crucial to the patient’s survival. This was the expressed sentiment of Rev. Craig Bartlett, a minister residing in Chelsey, Ontario, who has been struggling to find a family doctor for two years since his return from South Korea. He expressed his dismay at the situation and his desperate need for a solution.
Emergency physician David Savage from Thunder Bay, Ontario, is all too familiar with the tragic scenarios that can occur due to ER closures. He started tracking Ontario’s ER shutdowns after a closure in Red Lake, Ontario, in 2022, forced patients to embark upon a 200 kilometer journey to the nearest open ER. His count of closures across the province since 2022 tallies up to 1,348, a number that includes both temporary and permanent shutdowns.
Meanwhile, the healthcare industry grapples for sustainable solutions. Experts predict an ongoing trend of ER closures attributed in large part to a severe shortage of nursing professionals. There is also an urgent need for foresight and strategic planning to counteract the surge in emergency room closures, which coupled with a growing and aging population, and a pandemic backdrop, puts heightened pressure on health services.
This general consensus is punctuated by Nova Scotia-based doctor Tania Sullivan who strongly advocates for the retention of existing healthcare workers to keep hospitals operational. On this note, Peta, a registered nurse, and co-president of the National Emergency Nurses Association of Canada pinned hopes on immediate changes necessary to uplift the healthcare situation in hard-hit rural areas.
Without urgent measures, however, Savage is reluctant to harbor hopes for a reprieve from ER closures. He warns that the dire staffing situation in many centers could extend these shutdowns indefinitely.
In the meanwhile, a list of data shedding light on the ER crisis in various provinces collated from health ministries paints a grim picture, with Newfoundland and Labrador, Nova Scotia, and Quebec showing high rates of ER shutdowns. While rural hospital ER closures seem to be a nationwide problem, Alberta, Saskatchewan, and British Columbia indicate more promise, with lower numbers of reported temporary shutdowns. Nunavut and Yukon show no noted closures, offering a ray of hope in this otherwise bleak landscape.
