B.C. Health Minister Colin Hansen says the system worked just the way it's supposed to when emergency patients at Royal Columbian Hospital in New Westminster ended up in a Tim Hortons next door to the ER.
Doctors had to set up temporary beds in the closed coffee shop Monday night between 11:15 p.m. PT and 12:45 a.m after the hospital was swamped by about 200 patients.
"It does happen from time to time that emergency rooms are under tremendous stress because of the number of patients presenting themselves on that day," Hansen said.
Hansen said it doesn't happen as frequently as it did 10 years ago, when he was the Liberal opposition's health critic.
"They had all the ambulances lined up outside waiting to unload passengers," he said. "Today we have protocols in place where the patients are brought inside, they're cared for, they get the attention of medical staff."
Fraser Health Authorty spokesman David Plug says the space inside the Tim Hortons is a "designated overflow area" to be used in extreme high-volume situations where the emergency room sees an unexpected surge.
Plug said about 100 patients checked into the emergency room, half the number later cited by Hansen.
The hospital has suffered from a shortage of beds and an overcrowded emergency room for several years. In May 2008 the hospital announced plans to build a temporary portable emergency room in the parking lot to ease overcrowding.
Plug says the hospital needs an expansion, but other facilities run by the Fraser Health Authority are first in line.
"We've built a new hospital in Abbotsford. We're working to build a new critical care tower at Surrey hospital at our regional hospital there, and Royal Columbian Hospital would then be next," he said.
But one emergency doctor at Royal Columbian disagrees. Dr. Sheldon Glazer said corridors and coffee shops are not adequate for patients.
"We can't appropriately examine someone in a hallway. We can't get them undressed. We can't do a thorough examination on a patient in a waiting room," said Glazer.
Treating people in makeshift conditions leads to mistakes and poor care, Glazer said, but it also points to a larger problem.
"There are not enough hospital beds in the system and the emergency room ends up being an overflow ward of the hospital, so that emergency patients, patients who have the acute problems, have to be seen in chairs, in hallways or now in a coffee shop," he said.
B.C. Nurses Union president Debra McPherson blames the health authority and the government for overcrowding.
"I don't know what it's going to take to get this government out of its coma of inaction, and for the Fraser Health Authority in particular to wake up and smell the coffee and finally admit that it has problems," said McPherson.
NDP health critic Adrian Dix has blamed what he calls the ill-conceived decision to shut down nearby St. Mary's Hospital in 2004 and underfunding for acute-care beds.