Documents show Quebec has known about problems at Lakeshore ER for years

The Quebec government was made aware of an array of problems at the Lakeshore General Hospital emergency room in Montreal's West Island prior to the pandemic but failed to move quickly to address them, documents show.

Government memos obtained by CBC News under access-to-information legislation offer details about how the health authority sought to upgrade the ER, which had been promised improvements in 2018.

In a memo the following year, in 2019, a top official at the province's Health Ministry acknowledged the ER space was inadequate — and situated within what was supposed to be a temporary expansion constructed in 1988.

"The physical layout of the emergency room does not correspond to current standards and is summed up by a general lack of space, problems with the functionality of the work environment which affect the quality of care and the safety of the clientele," then-assistant deputy minister Dr. Lucie Opatrny wrote in the memo.

Opatrny's memo, addressed to another assistant deputy minister, was written in response to a request by the regional health authority, the CIUSSS de l'Ouest-de-l'Île-de-Montréal, for an "expansion and refurbishment project."

The hospital has been the subject of complaints by patients and staff during the pandemic, with a recent report warning the ER is a "ticking time bomb."

This week, the union sent a letter to Health Minister Christian Dubé calling for more resources.

Long list of problems

In the document, Opatrny lists a number of issues at the ER that had been flagged by the CIUSSS, including: 

• insufficient space between beds (a problem staff has said still persists).

• a cramped triage area.

• lack of security and privacy in the isolation room for people experiencing mental health problems.

Opatrny also notes that some beds were not visible to supervising staff. 

Staff at the hospital say that issue has still not been addressed and that Emmanuel Maccarine, a woman found dead on the ER floor in 2021, was in a room difficult to monitor from afar.

Opatrny concludes the memo by saying several of the health authority's proposals need to be reconsidered, citing certain constraints of the building, and that her office would be open to working on an updated plan. 

Green light in 2018, then stalled

The plan to replace Lakeshore's ER has been mired in the "study phase" since 2018, when the Liberal government set aside $1.5 million for that purpose leading up to the provincial election. 

In June 2018, Gaétan Barrette, who was health minister at the time, sent a letter to the head of the health authority giving the go-ahead to study the project. 

It has not moved forward under the Coalition Avénir Québec government.  

Hélène Bergeron-Gamache, a spokesperson for the health authority, said the project was slowed by the pandemic and remains in the startup phase but that the ultimate goal is a new ER.

In the meantime, she said Lakeshore opened a two-storey modular building in 2020, which made it possible to add more beds and "enlarge the area of ​​the emergency room and … free up administrative spaces to dedicate them to clinical activities."

A spokesperson for Dubé did not respond to questions about a possible new ER, but said the government is aware of problems at Lakeshore and is working to improve the situation.