P.E.I.'s health-care system 'backed up and overburdened,' consultant says in report
System ‘treading water’ and population growth adding to strain, says Health P.E.I. CEO
A report commissioned to assess how ready P.E.I.'s health-care system is to support a new medical school at the University of Prince Edward Island also lays out how the province is struggling to meet the current needs of Island residents.
According to the Spindle report, the province's health-care system is "backed up and overburdened" and care is "more reactive than preventative."
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The consulting firm Spindle Strategy is conducting a three-phase review to assess what capacity P.E.I. has to integrate medical students — whose training would occur in the field as well as the classroom — under the direction of doctors working within the province's health-care system.
UPEI is building a new faculty of medicine, and plans to start offering a new joint degree with Memorial University in 2025.
The first phase of the Spindle report was delivered to UPEI and Health P.E.I. officials in October. It has not been released but CBC News received a copy through a freedom of information request.
Illnesses undiagnosed, untreated
The report paints a picture of a system that's not meeting the needs of residents, with long wait times and a growing number of people struggling to access primary care leading to worsening health outcomes.
The Spindle report says patients are being admitted to hospital "with more advanced illnesses that have gone untreated or not been identified at earlier stages" because they don't have access to a family doctor or nurse practitioner, and because of other issues with accessing care since the start of the COVID-19 pandemic.
Spindle's assessment was based on a snapshot of the system conducted over the summer of 2023.
At the time there were 30,571 Islanders on the province's patient registry waiting to be assigned a primary-care provider, representing 18 per cent of the population.
Spindle said that number is "likely to be under-reported as many individuals, especially those from more vulnerable communities who do not have a primary-care physician, are not registered."
As of Dec. 3, the number of doctorless Islanders stood at 35,145, or 20 per cent of the population.
According to the CEO of Health P.E.I., the report confirms what he's been saying for some time now: The health-care system is in no state to be able to support a medical school without further restricting access for Islanders.
"Our system is basically treading water," Dr. Michael Gardam said Monday, just days before leaving his position as head of the province's health authority.
"Add on increased immigration, add on retirement — because we have a lot of older doctors — and add on a medical school and you start to see the demands that our system is going to face," he said.
"It's a lot."
Growing population adding to strain
Gardam said the province's population and patient registry are growing "completely parallel with each other."
He said he gets emails almost daily from Canadians who are considering moving to the Island, "and they'll say, 'I'm getting active cancer treatment. Can I be attached to a hematologist when I arrive?'"
Gardam said the only answer he can give in these situations is "no."
"If you're being treated at Princess Margaret Hospital in Toronto right now, my advice would be stay at Princess Margaret Hospital. We don't have the ability to absorb all the people and get you the access you need. And I think it would be inappropriate to suggest otherwise."
PCH noted for lack of staff
Spindle identified Prince County Hospital in Summerside as having one of the "biggest gaps" in terms of physician staffing, with "50 to 60 vacant health-care positions (whose workload is currently being carried by 31 physicians)."
Due to a shortage of internal medicine specialists, the intensive care unit at PCH was temporarily closed in May, channelling all the patients who would have been treated there to the province's only remaining unit in Charlottetown.
Health P.E.I. provided information showing that as of Nov. 30, the PCH had 88 vacant positions, representing 15 per cent of its workforce — but those numbers do not include physicians.
According to the Spindle report, as of late August, Prince Edward Island was operating with two-thirds of its total complement of internal medicine specialists, 79 per cent of its complement of family doctors and less than 60 per cent of anesthesiologists it should have, with all four full-time equivalent positions for anesthesiologists in Summerside vacant.
Overall as of Aug. 29, the province had 54.75 vacancies among 292.55 approved full-time equivalent positions for doctors of all disciplines — meaning almost one in five positions was vacant.
Among the wait times Spindle listed as being conspicuously long were those for:
- Non-urgent gynecology: four years
- Neurology and orthopedics: two years
- CAT scans: 99 weeks
- Hip replacements: 601 days
- Knee replacements: 605 days
- Cataract surgery: 568 days
Wait times for CAT scans have improved considerably since earlier this year, but otherwise Gardam said the situation outlined by Spindle remains largely unchanged.
Last week, CBC News asked the Department of Health and Wellness for an interview to talk about the Spindle report, at the same time seeking an interview with Premier Dennis King.
The department responded with a written statement saying the provincial government "is committed to addressing the challenges identified" in the Spindle report, and "is working with Health P.E.I. to adequately prepare the system so medical learners and all health-care practitioners are supported as we prepare to train physicians in PEI."