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Bittersweet announcement - A new 600-bed hospital for the Outaouais

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Added: Wed, 10/21/2020 - 12:56pm
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Allyson Beauregard

OUTAOUAIS – On October 14, Christian Dubé, Quebec’s Minister of Health and Social Services, and Mathieu Lacombe, Minister responsible for the Outaouais, announced the Coalition Avenir Quebec (CAQ) is moving forward with its election promise to build a new hospital in the Outaouais.
“For too long, the Outaouais has been dealing with major health issues, particularly because of our geographical position …We are laying a new stone to give nursing staff a desire to work here and telling Outaouais residents they will finally have the infrastructure they deserve,” said Lacombe.
The new hospital will be university affiliated and include 600 beds, bringing together several specialties. Dubé says this will promote interdisciplinary work, staff retention and attraction, efficiency and more specialized care for the Centre intégré de santé et de services sociaux de l'Outaouais (CISSSO). It will require a massive
reorganization of the entire region's health services, resulting in the net addition of 240 beds.
The next step is to complete the “clinical plan and begin the scoping study” to estimate the costs and timelines of the project, which are expected to be available within about 18 months.
A location has not been identified, but it will be in an urban area. The CAQ originally said during the election that the hospital would be built within five years (by 2023), but Pontiac MNA André Fortin said the government has confirmed
it won’t see the light of day for “many years.”
The government says the new hospital’s aim is to respond to a marked increase in health needs in the region over the next few years, due in particular to forecasted population growth of 14% between now and 2036 and the aging of the population.
Wrong focus?
Many people have criticized the project, claiming a new hospital isn’t needed and will only exacerbate current staff shortage issues. Some worry the massive reorganization of health services will close or take services away from existing hospitals.
Fortin says a new hospital is a good long-term goal, but there are many unanswered questions and problems that need to be addressed in the short-term that have so far been ignored.
“Everyone wants more modern infrastructure and additional beds will obviously be needed. But, the [announcement] still raises many questions about the cost, location, timing and services offered (or removed from existing hospitals),” he explained.
Fortin reiterated that labour shortages remain the number one issue in the short and long-term. “Due to a lack of nurses, surgeries are cancelled, critical care is undermined and obstetrics in Shawville is still closed. Unfortunately, the Minister of Health did not have an answer to this pressing issue,” he added.
Fortin advocates for increasing Québec nurses’ wages equal to Ontario, which are much higher, in order to prevent the exodus of nurses – especially in
border regions. The MRC Pontiac submitted a request to the government for a
pilot project in which the Pontiac would equalize nurses’ wages; Warden Jane Toller is hoping for an answer in November.
Toller said she can’t see the new hospital taking away from the Pontiac Community Hospital (PCH) and if any closures or reduction of services are part of the plan, the MRC has been grossly mislead. “[Our hospital depends on specialists coming from the city], so we need the Gatineau health system to be strong too,” she said.    
Équité Outaouais, which brings together Outaouais residents concerned about inequities in health services, education and social justice, applauds the project. They see it as a way to curb the exodus of youth going to study elsewhere and hopefully enable the Outaouais to obtain funding and health resources equivalent to other similar regions in Quebec. However, the group worries about a lack of
personnel.
“CISSSO is already understaffed. With this addition of beds, how will [it improve]? It will be a real challenge to have sufficient professional staff. This is the time to improve working conditions to promote retention by improving [employee] satisfaction,” said Patrick Guay, president of the Syndicat des professionnelles en soins de l'Outaouais.
Is it needed?
Dr. Ruth Vander Stelt, a doctor at the PCH, says she has nothing against
a big, new hospital, but she questions whether it is needed.
“I haven’t seen any data or evidence proving the Outaouais lacks capacity. On the other hand, I’ve seen consistent evidence of problems with throughput – the rate at which patients move through the hospital - during my 26 years of practice in the region,” she told the Journal, noting people often have to stay in hospital longer than needed because of administrative delays (ex: waiting to see a specialist or for certain tests).  
“Our health care system suffers from an incredible amount of bottlenecks and we have no plan or system to deal with them. There are many things we can do to improve flow without increasing capacity. Once we address the flow, with the goal that no one stays in the system any longer that clinically necessary,
we will quickly discover if and where we need more capacity. There’s no point building a hospital around administrative delays,” she added, giving the analogy
of a clogged sink.
“Imagine, a clogged kitchen sink containing water about to overflow. Instead of completely removing the clog, we could buy a bigger sink.
This would initially appear to improve the situation, but without removing the clog, the water will still overflow eventually, and the resulting mess will be much bigger.”
Dr. Vander Stelt believes there is danger in store for the Pontiac region, which is being “increasingly drained of resources in favour of the urban conglomeration”.
“Our patients will make up part of the water in the clogged sink of the new hospital and no longer be cared for close to home,” she said. Vander Stelt worries the
new hospital is the grand finale of the gradual removal of services from the PCH, which could justify its closure because of a lack of services.
Focusing on each patient’s needs and working to reduce administrative delays is the most reasonable and cheaper option, she claims. 
But the doctor can see some benefits of the new hospital: “it may unify certain urban sectors that currently seem to spend great amounts of time and energy coordinating care amongst themselves,” she concluded.