N.S. opposition leaders call for plan to address rural emergency department closures

Opposition leaders in Nova Scotia are calling on Premier Tim Houston’s PC government to come up with a better plan to address ongoing closures of emergency departments in hospitals, and particularly rural hospitals, across the province.

The death of a patient at the Soldiers Memorial Hospital in Middleton, Nova Scotia last week is sparking renewed calls improving emergency health-care policies.

This comes after an admitted patient went into cardiac arrest last week at the Soldiers Memorial Hospital late in the evening when the emergency department was closed and there was no doctor on site.

Health staff called 911 and volunteer firefighters responded along with EHS paramedics, who performed chest compressions. The patient did not survive.

Middleton deputy fire chief Scott Veinot, said in a letter to the town council that the doctor on-call the evening when the patient died was more than 30 minutes away in Kentville.

Veinot said they received the 911 dispatch call late Thursday night and firefighters arrived at the hospital around 11:00 pm and were informed there was no doctor on duty.

“I find this very concerning to know that not only is our emergency department failing our community, now our inpatients are at risk with no doctor coverage on the medical floor,” wrote Veinot.

“Is this a new normal for Soldiers Memorial Hospital?”

The deputy fire chief closed his letter by pleading with his local government to work with the province to come up with a better health-care plan.

“We want to know what happened and what the health authority’s plan is to address this issue going forward,” said Veinot in the letter.

Nova Scotia Health said the patient's death was reviewed internally all procedures were followed, and no further review was necessary.

Opposition leaders say the community deserves better.

“The point that I think the community has been making for months now is they don’t have the same access to health care as people in other parts of the province and that’s fundamentally unfair and something the government needs to fix,” said Nova Scotia NDP leader Claudia Chender.

Zach Churchill, leader of the Nova Scotia Liberal party, said the situation is a tragedy and more needs to be done to staff emergency departments in rural communities.

“The plan can’t be when you have someone in the hospital to call the volunteer fire department to come in and give them health care services,” said Churchill. “That’s not a plan. We need to have doctors in rural Nova Scotia and we need to have our emergency rooms open.”

Dr. Colin Audain, an anesthesiologist and the new president of Doctors Nova Scotia, said each hospital has its own protocols in place as to when a call to 911 needs to happen, and said it’s not unusual for the ER to call 911.

“It doesn’t happen everyday,” Audain said. “But I can imagine a dozen scenarios and I’ve seen a half dozen scenarios myself where that has happened.”

Staffing is a big issue in Nova Scotia’s health system and Audain says doctor shortages are an issue right across the country and beyond.

“There is no doubt that access to care is an issue,” said Audain. “And there are going to be instances where emergency departments don’t have enough staff to stay open during the hours they would like.”

Audain said it’s also not uncommon for on-call physicians to not be on site at the hospital and believes it’s unrealistic to assume all on-call doctors could be in house during all on-call hours.

“Most on-call doctors, at least in the central zone, are not in-house,” said Audain. “But certainly they would be there if something acute happened.”

"I’ve worked with doctors on call on the phone for 31 years and that’s part of how we access, and not every hospital has a physician on site but they do have a physician available,” said Nova Scotia’s Health and Wellness minister Michelle Thompson.

In a statement to CTV News, Emergency Health Services (EHS), who provides paramedic services in Nova Scotia, said they are ready to respond anywhere when a call for emergency comes in.

“In time-sensitive medical emergencies, EHS Operations has responded to 911 calls at hospitals when care is required,” said EHS in the statement.

Deputy fire chief Veinot confirmed this was the first time members of the Middleton volunteer fire department responded to a 911 call from inside the hospital, but policy dictates that the fire department is mandated to attend all cardiac arrest calls.