By Heather Killen
With staff shortages forcing regular emergency department closures at Soldier’s Memorial Hospital in Middleton and compounding the wait times at the regional hospital, many people are questioning promises about better care sooner.
Leslie Mulcahy, AVH communications, says Middleton’s emergency department closed 47 times in 2012 for 12-hour intervals; as well as a few closures of shorter duration.
So far in 2013 the department has only closed once and there are no other planned service interruptions scheduled for January, according to Mulcahy.
Overall the department was plagued with closures during the last half of 2012. The emergency department in Middleton was subject to 17 planned 12-hour closures in both the months of June and July.
It was also forced to close eight times for 12-hour periods in August; once in September; six times in October and at least twice in November, while in the month of December, the department was shut down six times for 12 hours; as well as two shorter intervals ranging from 2.5 hours to six hours.
“Annapolis Valley Health understands the integral role our emergency services play in the community,” she said. “We continue to work to ensure that they remain reliable and valuable for our residents.”
Leo Glavine, MLA for Kings West and Liberal health critic says these days he’s hearing too many troubling stories about long wait times to believe any promises for better care sooner.
“This is not the reality that we are experiencing when it comes to emergency care,” he said. “I’ve heard whenever people find out the emergency department at Soldiers’ is closed and someone has to go to Valley Regional they now say, better pack a lunch. What an indictment.”
Glavine says these frequent closures are not only a direct disservice to the communities, but are compounding the wait times experienced at the regional hospital’s emergency department.
He added that one of the more troubling stories involved a man with a family history of heart problems, who waited from 1:30 a.m. until 7:30 a.m. to see an ER doctor about his chest pains.
Another disturbing story involved a person reacting to a severe bee sting. Without realizing the ER was closed, the family transported the person to Soldiers Memorial Hospital.
Fortunately an ambulance was nearby and quickly transported the patient to Kentville.
One of the main contributing factors is the unequal pay rate offered in emergency departments, Glavine says.
Emergency room doctors can make about $50 more per hour at regional hospitals with more support services, than at the smaller hospitals. He said this pay inequity is particularly unfair, as physicians in smaller hospitals are working with less support and diagnostic tools than their counterparts in the regional hospitals.
Glavine added that in the past, the system worked very well and the emergency room was open 24/7, but these days there is a growing dissatisfaction with the service.
“To reduce services in a growing community, with an aging population and military personnel who are used to top-notch medical care; and tell them they must go to Kentville, is second class service.”
Linda Haven, a former employee of Soldiers Memorial Hospital, says when she came to Middleton in 1974, the province had one of the best health care systems in the country.
These days she feels that rural health care is less efficient and less available to its citizens than health care in the more populated areas.
Over the past dozen years, Haven says she’s seen the SMH be downgraded from a facility with 105 acute care beds, 20 doctors on staff, a busy lab, a 24/7 emergency department, two busy operating rooms, an intensive care unit, and maternity ward into a band aid station.
“When our own doctors covered the emergency room, there was never one shift left uncovered,” said Haven. “Now that we have ‘emergency room doctors,’ we can’t depend upon coverage and we pay the same taxes as those who do have emergency services available 24/7.”
She thinks a big part of this ongoing problem could be solved if doctors were paid the same hourly rate to cover emergency departments. Given that the hourly rate is about $50 more per hour in the larger hospitals, there is no incentive to work in the smaller centres.
Marc Britney, a town councillor who heads the newly formed committee looking into the emergency department closures, says his group has been busy getting different perspectives about the problem.
“It seems that everyone we talk to has a slightly different opinion,” he said. “This is a very complex issue.”
One of the problems is the two-tiered pay scale for emergency room doctors, he said. Other factors are centered in people’s perception and expectations of physicians.
In the past the doctors lived and worked in the community and were dedicated above and beyond office hours. The new generation of doctors factor in quality of life issues and are looking for a better work/life balance when they decide where to start a practice, he said.
One way of addressing this is to step up efforts to better promote the community and encourage physicians to adopt Middleton as their family’s new hometown.
“When it works, it’s a tremendous service,” he said. “All in all, it’s a good system, but seeing the ‘closed’ signs is a real concern.”
Britney added that the committee has met with Annapolis Valley Health and is hopeful that it can soon meet with the Department of Health and Wellness and work towards a better solution.