Following a string of emergency room fatalities and the current controversy over delayed surgeries, the head of Quebec's College of Physicians said yesterday it would take a miracle to revive the ailing health care system.
In an open letter, Dr. Yves Lamontagne said that listening to politicians and commentators rattle on about the provincial health care system crisis makes him want to resuscitate Montreal saint-to-be Brother André - and then have him named Quebec health minister so he could perform more miracles.
Despite a billion dollars injected into the system every year for the last decade, "plus ça change, plus c'est pareil," Lamontagne said. (The more it changes, the more it stays the same.)
After ducking questions on the crisis earlier in the day, Quebec Health Minister Yves Bolduc said yesterday afternoon that when it comes to the health system, some people expect miracles.
Speaking in Montreal, he said Quebec's busy ERs had 3.4 million visitors last year and most got excellent care.
Lamontagne's comments came within hours of published reports that Quebec's director of emergency services had resigned a month before his contract was to be renewed. Two years ago, the province had asked Dr. Pierre Savard to come up with ways to cut wait times for emergency services.
Savard has been replaced on a temporary basis by ER physician Daniel Lefrançais, of Pierre Boucher Hospital in Longueuil.
Savard's exit comes at a bad time. ER occupation rates have climbed to 200 per cent. Several deaths have been linked to crowding and staff shortages that have crippled ERs since last month.
- Last Friday, Jean-Guy Pitre, 65, died after waiting six months for surgery to fix a blocked aorta. A lack of beds in the intensive care unit delayed his operation.
- Mariette Fournier, 86, died Feb. 23 after spending four days in a corridor of Maisonneuve-Rosemont Hospital's ER.
- Mieczyslaw Figiel, 75, died in the Maisonneuve ER hallway. He was having trouble breathing, but his family couldn't flag down a nurse.
Yesterday, Montreal Island's hospital occupation rate was at 123 per cent - or 629 patients in ERs that have gurneys for 512 patients.
Bolduc would not comment on Figiel's death.
As for Pitre, who died after waiting months for surgery, Bolduc said: "It's not acceptable that someone dies while on a waiting list."
Health officials are working on relieving the bottleneck within the next few weeks, particularly at "problem" hospitals, by opening more beds in nursing homes and rehabilitation centres, he said.
Asked if it's to be expected that patients die in hospital hallways, Bolduc said: "We want as few as possible."
People should keep going to ERs, where they will be evaluated and given priority care according to need, he added.
Who is responsible when patients die for lack of services at overcrowded ERs? he was asked. "It's not a question of responsibility, but of working together to avoid this issue," Bolduc replied.
Bolduc said he wouldn't hesitate to take his parents to Maisonneuve-Rosemont or any other Montreal emergency room because they are equipped with excellent personnel who provide adequate patient care.
But Régine Laurent, head of the Fédération interprofessionnelle de la santé du Québec, representing 58,000 nurses and health workers, has called on Bolduc to justify the current crisis. "Health- care workers are exhausted, the ERs are overflowing, wait times are growing and tragic deaths occur," Laurent said.
Upset by the lack of manpower, nurses' union consultant Jean Parris said Quebec isn't doing enough to relieve the nursing shortage.
"The government is interested in balancing its budget more than in giving health care," Parris said.
Lamontagne's letter spared Bolduc, but lashed out at politicians of every stripe, civil servants, health agencies, health professionals, unions and journalists for not coming forth with solutions "for this crisis, which resembles every other crisis."
Quebec would have taken a huge step forward if various officials had not failed to implement a recommendation from the now decade-old Clair Commission on health care, which was to create an arm's- length provincial health agency, Lamontagne said.