Letter signed by 45 doctors declares emergency at Prince County Hospital

Critical and acute care services at Summerside's Prince County Hospital are facing an emergency that requires swift and drastic action, according to a letter signed by a group of doctors who work in and with P.E.I.'s second largest hospital.

The East Prince Medical Staff Association declared the emergency in an open letter released on Thursday and signed by 45 doctors. The declaration was unanimously endorsed by the association on Jan. 11, according to the letter.

"Our challenges include the ongoing lack of capacity for local internal medicine and critical care, and the impending loss of 24/7 in-house respiratory therapy coverage," the letter said.

"We write this letter as physician leaders with 17 months of experience of decreased critical care capacity at PCH; over that time, our staff have struggled to continue to provide essential care in a safe fashion in the face of crippling human resource gaps."

On Thursday, Health P.E.I. announced that the PCH would begin accepting fewer critical-care patients due to a lack of staff in the progressive-care unit starting in late January.

The progressive-care unit opened last spring as a replacement for the hospital's intensive-care unit, which was closed due to a shortage of internal medicine specialists. Patients who require intensive care are currently being transferred to Charlottetown's Queen Elizabeth Hospital.

Earlier this week, the health authority had said it was considering either cutting services or temporarily shutting down the progressive-care unit to deal with the staffing shortage.

Dr. Steven MacNeill, who has been an emergency physician at PCH since 2004, sent the letter to CBC News in an email.

"The members of the PCH Medical Staff Association ... have been more and more concerned about the crisis and have endorsed the decision to write a letter to the public to better inform them of the situation," he wrote in the email.

"We felt it was important, as patient advocates, that we explain the significant pressures our hospital is currently facing, our fears of what this deterioration in critical care capacity will lead to, and how it may affect the care we can provide to them."

Health P.E.I. said Friday morning it had no further information to report, but a spokesperson did say in an interview on Thursday that rebuilding the progressive care unit at the PCH was a priority.

Province-wide trouble feared

The East Prince Medical Staff Association warns the problems at the Prince County Hospital threaten to spread across the entire provincial health system.

"Centralizing all critical care services to QEH and relying on transfer of our sickest patients poses a challenge that invites poor patient outcomes," the letter reads.

"Our colleagues at QEH face their own pressures, so timely acceptance and transfer of all critically ill or at risk patients is an unrealistic expectation. Increased transfer demands will strain an already overburdened EMS system ... We as a medical staff have growing concerns about equal access to health care across the Island, especially for our more vulnerable populations.

"Loss of critical and acute care capacity for the western half of this province cannot be a safe or acceptable strategy."

The letter calls on health officials to come up with an urgent response, including a sustained and concrete action plan, to deal with the challenges facing the province's health-care system.

A failure to plan and recruit

The root cause of the problems plaguing the system, according to the letter, is a shortage of physicians, respiratory therapists and nurses, and the staff that remain are struggling with burnout and overwhelming on-call demands, risking further loss of doctors.

"Nearly one year after PCH lost two internal medicine physicians, on the heels of three long-planned retirements, we are exposed to an ongoing crisis which impacts every department at the hospital," the letter said.

"Our group is dismayed that despite our health leadership acknowledging these staffing shortages, there have been few tangible actions visible to us. There has been failure to effectively plan and recruit physicians for retirements and known gaps in coverage."

The association said it has revitalized a physician recruitment committee that is available to partner with Health P.E.I. in helping to boost recruitment efforts. It expressed a hopefulness that with the right support and partnership from healthcare and provincial leaders, challenges at the hospital can be overcome.