As the Newfoundland and Labrador government scrambles to fill shortages of health-care professionals across the province, three emergency rooms in Eastern Health have had trouble just staying open.
Since July 1, according to Eastern Health, the emergency room in Bonavista has had just over a week of closures, while the emergency room in St. Lawrence has had more than two weeks of closures. The emergency room in Whitbourne has been closed since June and is scheduled to remain closed until at least Monday.
On Thursday afternoon, Eastern Health provided CBC News with a statement showing that altogether, the three emergency rooms have been scheduled for 79 days of closures since June 27.
Bonavista Mayor John Norman said the uncertainty surrounding emergency services and acute care at the Bonavista Peninsula Health Centre, which serves about 8,000 residents, has been an "ongoing nightmare."
"It's very unfortunate because we've lost, of course, continuity of care over the past two years. Even if we do have ER coverage, it's basically a new doctor every day or two," Norman told CBC News on Wednesday.
Since the last emergency room closure ended on Aug. 3, Norman said, Eastern Health has managed to re-establish chemotherapy, dialysis, acute care and emergency services at the Bonavista hospital. However, he's wondering how long the regional health authority will be able to use temporary doctors — locums — to cover off services.
"How many of those locums that are covering days now in August are going to say, 'Yes, I will return and do future call shifts in October, November, December'?" he asked.
When the emergency room is open, Norman said, it's often inundated with patients who have come to the hospital out of desperation because they can't access a family physician or nurse practitioner.
The province has made some strides toward physician recruitment; most recently, Premier Andrew Furey announced five new spots in the Memorial University family medicine program for Canadian graduates of international medical programs.
In a statement Thursday afternoon, an Eastern Health spokesperson said the regional health authority is working to recruit physicians for the emergency rooms in Bonavista, St. Lawrence and Whitbourne.
"Physician recruitment is a team approach led by the physician recruiter, who is the primary point of contact, targeting medical students, residents, and practising physicians for all areas within the region," said the spokesperson.
The statement said Eastern Health works within physician compensation parameters set by the provincial government, and works with individuals to offer incentives like housing, relocation and flexible schedules.
An hour and a half away
Bonavista is about 110 kilometres, an hour and a half drive, from the nearest emergency room, in Clarenville. Norman said the wait could be even longer if there are no ambulances available.
"Yes, this is a problem across the province," he said. "But there are not many places that have over 8,000 people that are over an hour away from the next nearest hospital that are seeing no emergency services."
Jade Way, a small business owner in Bonavista, is part of a cohort of residents protesting the emergency room closures. When the emergency room closed for the first time, she said, residents panicked.
"People thought we were losing our hospital," she said.
The hospital isn't closing, but Way said residents are also concerned the emergency room closures could deter potential tourists.
"They could fall and roll their ankle. They could do anything, really, and expect to go to our emergency room. And then they're like, 'Oh, they don't have one,'" she said.
Way said residents are willing to go above and beyond for any physicians who want to come to the community.
"Bonavista would totally welcome them with open arms," she said.
Trans-Canada health care
St. Lawrence Mayor Kevin Pittman said the town has been told the emergency room at the U.S. Memorial Health Centre will been closed off and on for at least the next two weeks.
Pittman said the temporary closures have led to worries that emergency room services in the town will shut down for good.
"Everything at this point is a fear. Our residents are afraid that that's going to happen. Our residents in nearby communities are afraid this is going to happen," he said.
St. Lawrence, a community of about 1,200, isn't too far from the nearest hospital in Burin — about a 25-minute drive — but Pittman said the distance isn't the main problem.
Like other rural Newfoundland communities, the town has a large population of seniors, some of whom don't drive. Pittman said the town has only one ambulance on call, which means a possible hours-long wait if it's unavailable. Pittman said diversion to the hospital in Burin also places more strain on staff there, increasing wait times for everyone.
Pittman said Eastern Health has assured him it's working on recruiting staff for the hospital in St. Lawrence and the Burin Peninsula as a whole, but as staff shortages get worse, he's worried smaller facilities may be on the chopping block.
"Some time down the road, we're going to have what I'm going to call Trans-Canada health care. If you're not living on the Trans-Canada [Highway], you are second class."