Some ERs to shut down over the holidays as N.L. wraps up a year of health-care staffing shortages

Some emergency rooms in Newfoundland and Labrador will close over Christmas, marking a sour end to a year that saw staffing shortages across the health-care system.

In Bonavista, the emergency room — which serves more than 8,000 people living in the area — is scheduled to close until Thursday, reopen for two days, and then shut down again until Jan. 2.

On Thursday, Mayor John Norman said he fears the worst will happen.

"You're guaranteed to have some serious issues, and my fear is that something quite serious could happen; perhaps someone may die who could've otherwise been saved," he told CBC News.

Residents of Bonavista — and other rural communities — have been sounding the alarm as the regional health authorities struggle to recruit and retain health-care workers.

Earlier this year, Bonavista residents held marches, demanding better access to primary health care. Norman said residents are getting desperate.

"I'm accosted regarding health care," he said. "I have people knocking on my doors, screaming at me, crying at me: 'What are you gonna do?'"

Over 700 days of emergency room closures

Each time an emergency room closes due to a staffing shortage, the regional health authorities issue a press release with the date and time of the closures. According to data from those press releases, compiled by CBC News, 12 emergency rooms collectively closed for about 706 days in 2022.

The worst culprit is Whitbourne — that emergency room has been closed since June as Eastern Health attempts to fill two vacant positions.

The emergency room at the Dr. Y.K. Jeon Kittiwake Health Centre in New-Wes-Valley is in second place; it was scheduled to be closed for about 110 days in 2022. 

Some communities, like Lewisporte, have fared better; that emergency room was scheduled for just over a week of closures in 2022 — though this month, the closures became more frequent.

According to Lewisporte Mayor Krista Freake, nearly 4,000 people in Lewisporte and the surrounding communities rely on the emergency room, and the local medical clinic isn't currently taking walk-in appointments.

"It really does mean that there is no medical service for our residents," she said.

On Friday, just before this story was published, Central Health announced the emergency room in Lewisporte would close early on Christmas Eve and open on Boxing Day.

When the emergency room is closed, people in the area have to travel an extra 45 minutes to get care in Grand Falls-Windsor or Gander.

The emergency rooms in Harbour Breton, Baie Verte, Bell Island, Springdale, Fogo Island, New-Wes-Valley and St. Lawrence are also set to close over the holidays, according to the Central Health and Eastern Health websites.

The pressure is on

Dr. Desmond Whalen, chief of emergency medicine at Central Newfoundland Regional Health Centre in Grand Falls-Windsor, said diversion put extra pressure on already-busy emergency rooms in bigger centres.

"As long you're funnelling a higher volume of work into an area that was used to doing a certain volume, those pressures are going to exist," he said.

Sometimes the health authority is able to keep an emergency room open through virtual care, but Whalen said that isn't ideal.

"Our goal is to have in-person, on-site medical care for everybody within Central Health," he said.

Whalen, who's also the chair of Central Health's medical advisory committee, said the decision to close an emergency room largely comes down to human resources, including physicians, nurses and other health-care workers.

In a statement, an Eastern Health spokesperson said before closing an emergency room, the health authority exhausts every possible avenue to find coverage.

"We are committed to working with communities, physicians and staff to seek long-term solutions to these human resource challenges," said the spokesperson. "Temporarily closing an emergency department or implementing diversions is not an action we take lightly."

Turning the light off

The staffing shortages reflect a larger problem that health-care staff, management, politicians and patients continued to grapple with in 2022. 

Earlier this year, the Newfoundland and Labrador Medical Association said 125,000 people across the province don't have a primary doctor. Whalen said the problems in emergency care are a symptom of that provincewide shortage.

"As a province, there sort of needs to be a step back to say, 'What is the crux of the problem?'" he said. "We know it's that there's not enough investments put into primary care, and that's really where we've got to focus our efforts into recruiting."

Health Minister Tom Osborne said the health authorities have been working to fill shifts, but finding coverage over the holiday season is more difficult.

"We are going far and wide to try and find the healt-care professionals to fill the gaps in Newfoundland and Labrador. It is challenging because there are jurisdictions globally that have healthcare professional shortages, but we are going far and wide to fill those gaps," he said.

Whalen said as long as people can't access primary care, they'll keep turning to emergency rooms.

"One of the things that we're seeing right now is that one of the only access points that any patient in this province has is the emergency department. It is the only place that doesn't turn the light off at night," he said.

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