With the number of available beds at the McGill University Health Centre (MUHC) dipping to an unforeseen 719 for a total of 14 weeks of the year, an oncology surgeon at the hospital predicts wait times for cancer surgery could double, and elective surgeries could face even longer delays.
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The bed closures, spelled out in a PowerPoint presentation to MUHC managers recently, amount to 10 weeks over the summer, two weeks over the Christmas/New Year's holidays and two weeks in the spring, for a total of 14 weeks.
MUHC staff left scrambling
Doctors at the hospital have been left reeling by the news and are scrambling to figure out how to provide patient care with a dramatic decrease in the number of available beds for what adds up to a quarter of the year.
"Instead of my cancer patients waiting for three weeks for surgery, they'll wait five or six weeks during the summer," one oncology surgeon said, under the condition of remaining anonymous.
"As a cancer surgeon, I get first pick of surgical days available — but it will still be fewer."
That surgeon said the bed cuts are certain to affect patients with less pressing conditions even more.
"Patients who have surgery that is required within three months, maybe that will be pushed to four or five months," the doctor said.
The seasonal bed closures affect all sites of the MUHC except for Lachine Hospital and will have an impact on general medicine, surgery, pediatrics and the Montreal Neurological Institute.
At heart of dispute: 2007 clinical plan
The full extent of the closures comes a week after the leak of a strongly worded letter sent to hospital staff in February from Ewa Sidorowicz, the MUHC's director of professional services and associate director general of medical affairs.
In that letter, Sidorowicz said a request for transitional funding to help in the year of the move to the new Glen site had been rejected by the Health Ministry – amounting in a $32-million "spending correction."
In that Feb. 10 letter, Sidorowicz said that "correction" would translate into cutting the number of beds across the network from 832 beds to 799.
Keep in mind that until January, 2016, the MUHC had 853 permanent beds.
However, a clinical plan signed between the hospital and the Health Ministry in 2007 required the MUHC to decrease that number to 832 beds.
Once these latest seasonal bed closures are factored in, the average number of available beds across the MUHC network is 779.
CBC obtained a copy of the 2007 clinical plan through Quebec's access to information laws.
In it, the MUHC says it plans to reduce the number of acute care beds to a total of 832, based on an "average occupancy rate" of 85 per cent.
'Imagine, a brand new hospital, $1.3 billion later ... and units closed even before they were ever used or inaugurated.' - Paul Brunet, patients' rights activist
The plan does not make clear that the MUHC's budget would be based on that "average occupancy," however, Mario Di Carlo, the co-chair of the MUHC central users' committee, says that's how the Health Ministry has chosen to interpret it.
"We know the patient is going to fall between the cracks," said Di Carlo."It's going to affect care."
"I don't understand how they expect to do this without any impact on patients."
With so many fewer beds, Di Carlo is worried that patients will be rushed out of the hospital or left in limbo because the network that was supposed to be set up in the community simply isn't there.
"The MUHC slogan is best care for life. So how are we going to do this in this kind of context? I don't know," said Di Carlo, adding that the users group is closely monitoring what's happening.
"We don't want any fatalities on our hands."
No comment from Gaétan Barrette
Health Minister Gaétan Barrette refused to take questions Tuesday, briskly walking past waiting reporters on his way to a caucus meeting.
A spokesperson for the minister simply referred CBC back to the 2007 clinical plan.
It is a recurring refrain: Despite outcries about fewer elective surgeries, an overburdened emergency room and a concern the MUHC will be unable to deal with a sudden influx of patients, Barrette has repeatedly referred disgruntled doctors back to that clinical plan.
"It always goes back to, 'We would like to stay as we were,'" Barrette said on Feb. 4. "Well, they signed. They agreed on something. And when you sign a paper, it has a value."
Paul Brunet, the chairman of the Quebec Council for the Protection of Patients, said the problem boils down to the MUHC's administration being stuck applying a plan that many people believe is outdated.
He said the bed cuts amount to a breach of service.
"Imagine, a brand new hospital, $1.3 billion later, and not having appropriate services – and units closed even before they were ever used or inaugurated," said Brunet.
Brunet said he would not be surprised if a senior MUHC administrator were to get the axe in the coming weeks.
He said Barrette is unlikely to tolerate weeks of leaked memos, which has put the Ministry of Health on the defensive.