We, the undersigned people of Canada, wish to draw your attention to an urgent issue that affects the health and well-being of our fellow citizens and the overall healthcare system in our country. We urge the Canadian provincial and territorial Ministers of Health to take immediate action to address the critical issues of long wait times, overcrowding and closures and the associated harms across our nation's emergency departments.

Emergency Departments (ED) are a vital component of our healthcare system, the front door to our healthcare system, providing essential care to those in dire need. However, the ongoing issues of long wait times, overcrowding and closures have far-reaching consequences, endangering patients’ lives and compromising the quality of care they receive. We believe that it is the government's responsibility, at all levels, to ensure that people living in Canada have timely access to quality healthcare services, and the current state of our emergency departments is unacceptable – for both those receiving and providing care.

The harms associated with long wait times, overcrowding and closures in our emergency departments include:

1.     Delayed care: Patients experiencing life-threatening conditions such as heart attacks, strokes, or severe injuries often face delayed treatment, leading to worsened health outcomes

2.     Patient safety and excess deaths: ED overcrowding and long wait times may be causing excess deaths potentially leading to an estimated 8000-15000 Canadian patients dying unnecessarily per year as a direct result of hospital overcrowding.

3.     Increased patient, family & caregiver suffering: Extended wait times, overcrowding and ER closures cause unnecessary suffering, anxiety, and discomfort for patients, families and their caregivers exacerbating the stress of their medical emergencies.

4.     Workforce wellbeing: Overcrowded EDs place immense pressure on our healthcare professionals, leading to burnout, decreased job satisfaction, and potentially compromising the quality of care they can provide.

5.     Resource Allocation Challenges: ED overcrowding strains healthcare resources, diverting valuable resources away from other essential medical services and elective procedures, leading to a ripple effect throughout the healthcare system.

6.     Economic Burden: Inefficient use of healthcare resources results in higher healthcare costs for the government and taxpayers, as well as lost productivity due to patients' extended hospital stays and recovery times.

Universal health care is not free. We as Canadian taxpayers pay for it through a variety of ways in the taxes we pay to the government. The Government is accountable to us as taxpayers when using these funds to allow for safe, timely, quality and accessible care.

To address these critical issues, we respectfully request the following immediate action steps proposed by the Canadian Association of Emergency Physicians (CAEP):

·      Continued bidirectional communication between CAEP and provincial health systems regarding the crisis.

·      Increase hospital bed capacity to match the demands of the population and enhance inpatient flow.

·      Implement effective patient flow management strategies within hospitals to reduce bottlenecks.

·      Enhance support for primary care services and expand access to community-based healthcare resources.

·      Facilitate seamless communication and collaboration between EDs, hospital administration and primary care providers

We believe that by taking these steps as a minimum, the Canadian provincial and territorial Ministers of Health can start alleviating the suffering of countless patients, improve the working conditions for our healthcare professionals, and ensure the long-term sustainability of our healthcare system.

We, the undersigned, urge you as provincial and territorial Ministers of Health, to prioritize this pressing issue and take decisive action, improve transparency and accountability to address the crisis of wait times, overcrowding and ED closures in our Canadian emergency departments. The health and well-being of our fellow people depend on your commitment to acting promptly.

References

1. Canadian Association of Emergency Physicians: Official Statement Regarding ED Closures and Crowding Across Canada (Sept 5, 2023)

2. Waiting to Die: The hidden pandemic of ED crowding and excess mortality – Canadian Journal of Emergency Medicine (CJEM) (Worrall, J, Atkinson, P)