Half-baked plan for ER at Victoria Hospital more about politics than patients

Opinion

The Kinew government is trying to get as much political bang for its buck as possible from an NDP plan to reopen the emergency department at Victoria Hospital. But will it improve patient care and bring down ER wait times? Probably not.

Premier Wab Kinew and Health Minister Uzoma Asagwara re-announced plans for the project this week, making good on a signature campaign pledge in last year’s provincial election.

The NDP promised to reopen the three ERs in Winnipeg closed by the previous Tory government, including at Victoria, Concordia and Seven Oaks hospitals. ERs at all three hospitals were converted to urgent-care centres, which provide treatment to lower-acuity patients.

What the NDP government still hasn’t said is whether Victoria Hospital will become a full-service, acute-care hospital again. When the former government consolidated hospital operations in Winnipeg between 2017 and 2019, it transformed Victoria, Concordia and Seven Oaks hospitals from acute-care facilities to community hospitals.

Acute-care hospitals include things such as intensive-care units, specialists and a wide range of diagnostic services to treat the most serious cases, such as heart attacks and head trauma.

The purpose behind the consolidation was to concentrate those services at three hospitals instead of spreading them too thinly among seven sites (the urgent-care centre at Misericordia Health Centre was also closed as part of the consolidation process). The plan made sense on paper. Winnipeg was often criticized for having too many acute-care hospitals for a city of its size.

But it failed because it was poorly executed. Front-line staff weren’t consulted, hospital budgets were cut and the entire process was rushed. Many staff quit or retired early.

The result is an underfunded, poorly staffed system that can’t keep up with demand. There is a lack of capacity in the system (mainly staffed beds on medical wards) to treat admitted patients in a timely fashion. So patients wait hours and days in emergency departments for a medical bed, which drives up ER wait times.

Would turning the urgent-care centre at Victoria Hospital back into an emergency department help? It won’t if all that happens is renovating the existing space and putting up an emergency department sign instead of one that says “urgent care.”

Unless the province plans to turn Victoria back into a full-service acute-care hospital, most very sick or injured patients will continue to go to one of the three acute-care hospitals in Winnipeg – namely Health Sciences Centre, St. Boniface Hospital or Grace Hospital. They will go there by ambulance, regardless of where they live in Winnipeg, or they will be transferred there. Why? Because that’s where high-acuity patients are treated.

The reason the government has been silent on whether it plans to transform the Vic back to an acute-care hospital is because it would be a massive undertaking. It would require reopening and staffing an ICU, bringing specialists into the hospital and beefing up diagnostic services.

Would it even make sense to do so, even if government could find the staff and resources? Or would it make more sense to ensure the three existing acute-care hospitals are properly staffed and resourced so they can treat the most serious cases in the city, leaving Victoria, Concordia and Seven Oaks to treat lower-acuity patients (and provide other speciality services, such as orthopedic surgery at Concordia).

Right now, the province can’t even adequately staff the three acute-care centres it has. Where would it find the staff, including specialists, to convert Victoria back?

The more likely plan is that the province will do some renovations at the Victoria urgent-care centre, add a few more doctors and nurses and call it an emergency department, even though it won’t be an ER, as traditionally defined.

If that’s the case, this whole exercise is — as expected — more about politics than evidence-based health-care management. The NDP wants to be seen to be doing something to improve health care. Announcing and re-announcing the Victoria Hospital plans satisfies that political objective.

It may be an effective political strategy, but it probably won’t do anything to improve patient care or reduce ER wait times. If it causes existing resources to be spread too thin throughout Winnipeg, it could even worsen patient care and drive up wait times.

A better plan would be to properly assess where resources are needed the most, including at the three acute-care facilities. The province should make evidence-based decisions, not try to make good on a poorly conceived election pledge that was written on the back of a napkin.

tom.brodbeck@freepress.mb.ca