Ontario hospitals warn of more upcoming ER closures through the summer

Some Ontario hospitals, particularly those in smaller communities, are warning that recent emergency department closures may recur throughout the summer as they scramble to address staffing shortages.

Several ERs in communities such as Perth, Clinton, Listowel and Wingham have had to close recently for hours or even days at a time.

Others, such as in the northern community of Red Lake, have managed to narrowly avert pending closures, but say they expect further disruptions this summer. At Notre-Dame Hospital in Hearst, in northern Ontario, there is a full week in August during which no physicians are available, said Melanie Goulet, the hospital's recruitment co-ordinator for health professionals.

"It's the first time that it happened, we're having a huge stretch like that, with no local doctors available," she said. "We're running really thin right now. I mean, it's just a matter of time (before a closure happens)."

The community of Hearst has six doctors, three of whom work in the emergency department, so they cover shifts more than half of each month by using visiting locum doctors.

But recently, a regular visiting doctor from Montreal had her Air Canada flight to northern Ontario cancelled, so the hospital had to scramble to find a replacement at the last minute, Goulet said. Another visiting doctor who was scheduled to leave was able to extend his stay.

In Perth, in eastern Ontario, the hospital closed its ER on Saturday due to staffing shortages and had planned for the closure to last until Thursday, but several staff members contracting COVID-19 meant that they're now hoping to reopen next week.

"This is the first time that we've been forced to take the unfortunate steps to have to close a program at our hospital and certainly the emergency. I think it's unprecedented," said Michael Cohen, president and CEO of the Perth and Smiths Falls District Hospital.

"It really does reflect a very serious health human resource crisis that we're facing in our industry."

A lot of health professionals have been leaving recently, Cohen said. Early in the new year, the Perth site of the hospital system lost six full-time staff members. People are burned out after more than two years on the front line of a pandemic, and some have even left for lower-paying jobs in the community, he said.

The Canadian Association of Emergency Physicians said there are "record" resignations of health-care personnel, which also worsens wait times and acute care hospital access.

"The emergency department is a window on the health of health care," they said in a statement. "It has never been more important to pay attention to the current state of emergency departments."

The group called for a national health human resources strategy to increase the training and education opportunities in nursing and medicine.

Doris Grinspun, the CEO of the Registered Nurses' Association of Ontario, said nurses are exhausted and burned out, In Ontario, she said wage restraint legislation that has capped their salary increases at one per cent per year is not helping, particularly when inflation is now above seven per cent.

"Basically, nurses have gone down in their compensation by 6.5 per cent right at the time that that exhaustion has gone up by 1,000 per cent," Grinspun said.

She wants to see the province fast track foreign credential recognition and fund more post-secondary programs.

The Ministry of Health said in a statement that it has two programs to provide hospitals with staffing relief, and is expanding undergraduate and post-graduate positions at medical schools, among other measures to address the crisis.

"Hospitals lead their day-to-day operations, and we commend them for working tirelessly to keep operations running smoothly," spokesperson Anna Miller wrote in a statement.

Karl Ellis, president and CEO of the Listowel Wingham Hospital Alliance, said at one of the hospital sites four of their eight full-time staff are on maternity or sick leave, and it's difficult to backfill those jobs because they are getting fewer applicants than usual, pointing to a nursing staffing crisis across the province.

Staffing is always a challenge in the summer in smaller hospitals, but it is not usually this acute, he said.

"This is the first time in my history and working in health care for over 20 years that we've had to close an emergency department," Ellis said. "Obviously not a decision that we take lightly."

In Red Lake, where the hospital was forced to close its ER earlier in the year when no physician was available, they nearly had to do it again Thursday night, but found a last-minute solution.

The hospital is predicting a difficult summer, with more closures or near-closures.

"We are, and a number of Northwestern Ontario hospitals are," said Sue LeBeau, president and CEO of Red Lake Margaret Cochenour Memorial Hospital.

"We have a considerable number of shifts that are not filled as of the end of July and into well into August and in terms of obstetrical services, we will not have services from today until Aug. 3 at this point."

This report by The Canadian Press was first published July 7, 2022.