ER doctors have documented 322 cases where patients received substandard care in Alberta’s emergency rooms over the last 2 years. These cases are real people–our husbands, wives, parents and children–who have suffered and in fact died as a result of the overcrowding in the emergency rooms because 50% of the ER beds are occupied by patients who have been admitted but can’t be transferred to the wards.
Premier Stelmach, Health Minister Zwozdesky and the head of the AHS Superboard, Dr. Duckett, have been aware of this crisis for over 2 years because Dr Paul Parks, the head of Emergency Medicine, has documented the failure of the ER system and has pleaded and advocated on our behalf. In Feb 2008 Stelmach pledged to address the situation immediately, Duckett received a billion dollars to improve the system (it got worse) and Zwozdesky has been empathetic but ineffectual.
So where are we now, 2 years later. Worse off than we were before. Dr Parks warned Zwozdesky in his letter of Oct 18, 2010, that the overcrowding problem has worsened and “…we anticipate the potential catastrophic collapse of timely emergency care delivery”..
Here’s how the government and the AHS responded:
- Stelmach says “We have acted” (Herald Oct 29/10). “We’re seeing progress. Sure, we’re having our challenges. Refining a health-care system isn’t easy”. (Herald Oct30/10) True, but he’s known about this problem for over 2 years and the “progress” he’s referring to has made the situation worse, not better. Stelmach also refers to a new 5 year funding commitment to the health superboard which will put more money into the system, train more people and add more continuing care beds. But he doesn’t tell us how much money will be earmarked for this endeavour, where it is coming from, when it is coming, who gets it, or even who makes these decisions.
- Stelmach offered the following additional help (Oct 29/10 Herald) — a Health Care Charter and a patient advocate. The Charter will not entrench the target benchmarks aimed at reducing wait times and the advocate will report directly to Minister Zwozdesky, who has been remarkably unresponsive to date. This solution is meaningless.
- Zwozdesky has set up administrative goals in the form of bonuses to be paid to senior administrators for achieving performance objectives. One of these performance objectives is a target benchmark of no more than a 4 hour wait from the time a patient arrives in ER until he’s treated and sent home and no more than an 8 hour wait before they’re given a bed in another ward. In order to achieve the 8 hour target AHS has been told to speed up bed openings by discharging patients to make room for in-coming ER patients. He’s also admitted that these benchmarks, which are already “informally” in place, are only being met 20 to 40 percent of the time. Did the senior administers “informally” receive a 60 to 80 percent reduction in their bonuses last year?
Yes, this is a complex problem, and yes, we need to address long term issues, but promising to provide funding with no idea of how best to use it and setting meaningless targets with no accountability on the part of the very people who are charged with the responsibility of providing decent health care to Albertans is not the answer.
Incidentally, we already have a patient advocate. His name is Dr. Paul Parks.