Table sectorielle de l'hôpital de LaSalle

Table sectorielle de l'hôpital de LaSalle

February 27, 2007 14:19 ET

Alarm Sounded by the Doctors of Lasalle Hospital

LASALLE, QUEBEC--(CCNMatthews - Feb. 27, 2007) - We have become aware of the contents of the report submitted by Dr Abraham Fuks to minister Couillard concerning the reorganization of the medical services at Lachine and Lasalle hospitals. This report was commissioned by minister Couillard to evaluate a reorganization plan already adopted by the board of directors of the CSSS, last autumn.

We are in complete disagreement with the conclusions of Dr Fuks' report and wish to alert the population and concerned elected officials as to the serious risks posed to the health services of the area if all the recommendations were to be followed.

We wish to point out the following problems with the manner in which the report was produced as well as the contents.

Procedural problems

It was clear to all the doctors from LaSalle who met with Dr Fuks that his opinion had already been formed and the report's main conclusions had already been decided before the consultations even began. The purpose of the meetings therefore seemed to be an attempt to pressure the doctors to subscribe to a political compromise. They appeared to have little to do with addressing the health care needs of the population and more to do with appeasing a small but vocal minority within the Lachine community.

Contrary to what had been suggested, Dr Fuks did not meet with all medical personnel concerned. The executive committee of the CPDP, who by law is the hospital authority mandated to assure the quality of medical care, was never consulted. How is it possible to evaluate the organization of medical services for the region without even consulting the very committee whose mandate is the surveillance of quality of care? He should have taken into account the serious reservations that this committee held as to the quality and security of medical services currently being delivered by the Lachine hospital. Dr Fuks also did not meet with the duly elected board of directors of the "CSSS de Dorval-Lachine-LaSalle" who had previously adopted the administration's reorganization plan, the very plan which was the object of Dr Fuks review. While Dr Fuks stated that he met with representatives from the RUIS McGill, he failed to mention that these same representatives had previously enthusiastically endorsed the administration's reorganization plan.

Problems with the contents of the report - Unrealistic recommendations

Dr Fuks recommendations, though they follow a political or electoral logic, are simply unrealistic. To realize them, one would first need to recruit dozens of new doctors, generalists and specialists. Where would one find such doctors? They simply don't exist. It is precisely because of the shortage of medical personnel that the reorganization plan was proposed in the first place.

The administration's plan revolved around centralizing the intensive care and hospitalization services for both LaSalle and Lachine on one site, making it possible to consolidate the medical teams necessary to assure 24/7 on call services. As LaSalle hospital is the largest of the two sites, in terms of equipment and number of doctors, and has the most modern installations, as well as an obstetrical unit, it was the logical choice for that purpose. This plan, while calling for eventual increases in certain medical departments, could have been implemented with the existing medical staff, and was not dependant on the immediate and totally unrealistic recruitment of non-existent doctors for its initial phases.

In compensation for the transfer of those services to LaSalle, the plan proposed that Lachine get all future development including dialysis, oncology, magnetic resonance, nuclear medicine and a host of sub-specialty clinics (heart failure, chronic pulmonary disease, etc). This seemed to be a fair trade and a win-win situation for the citizens of Lachine and of LaSalle. In particular, the residents of Lachine would have not only been assured of safe hospitalization and intensive care services on their territory (LaSalle-Lachine-Dorval), but the plan would have given long term stability to those services by securing a critical mass of doctors on one site. In addition, the residents of Lachine would have acquired new services like dialysis and oncology, for which they currently need to go downtown. This plan, the only viable one, the only one that made sense in terms of providing the largest possible range of medical services on the Lachine-LaSalle territory, was unfortunately rejected by some residents of Lachine for understandably emotional reasons.

What does Dr Fuks propose?

Nothing less than maintaining hospitalization and emergency services on both sites, which is simply not feasible with the current number of doctors, though some would like to lead us to believe otherwise.

Not only are Dr Fuk's recommendations unrealistic, they are also incredibly unjust. All the new investment would now go to Lachine, none to LaSalle, without Lachine giving up anything. Where is the fairness in that?

Alarm sounded by the LaSalle doctors

The administration's reorganization plan of the medical services on the LaSalle-Lachine Dorval territory was proposed over a year ago. After critical review added improvements to the plan, it was supported by the LaSalle doctors, who constitute the majority of doctors of the CSSS. It was also supported by a majority of doctors from both the Lachine and LaSalle CLSCs, as well as by a number of Lachine doctors who privately confess to being unable to say so publicly due to peer pressure. The plan has been enthusiastically supported by the RUIS hospitals. It has the best interest of public health at heart.

Unfortunately, for political reasons, realization of the plan has been held up. A few media-savvy doctors have succeeded in scaring the citizens of Lachine, who wrongly think their hospital is closing, which was never suggested in the plan. Politicians have stepped in for electoral reasons. The lot would want us to believe that medical services would be in peril if the administration's plan was adopted, whereas it is the opposite that is true.

At LaSalle Hospital, though medical personnel is stretched to the limit, all first line services are currently offered. If we were to lose any doctors however, this would lead to a loss in quality of care.

As for Lachine hospital, it is imperative that it be known that:

- The hospital is unable to assure continuous coverage in anaesthesia. Specifically, on numerous days every month there is no anaesthetist on call in the hospital.

- There have also been interruptions in coverage in internal medicine, with no general internist on call on several occasions.

- There has been no microbiologist for over a year now.

- Two radiologists have resigned within the last year and it has only been possible to provide uninterrupted service thanks to cross-coverage provided by the radiologists at LaSalle hospital.

- One of four surgeons has resigned and another has withdrawn from the call schedule.

- The plastic surgeons have withdrawn their services.

It seems clear to us that the Lachine hospital is in a very precarious position and is unable to fulfill its current mission alone.

If Dr. Fuks' recommendations were to be implemented as is, there would be no choice but to reduce services at the LaSalle hospital in order provide the necessary support to maintain even basic services at Lachine hospital.

We are therefore alerting the population and elected officials of LaSalle to the imminent and serious danger facing their hospital. If logic and the interests of public health do not prevail, and the recommendations of Dr. Fuks' report are implemented as is, then the elected officials of LaSalle will have to answer to the population for any deterioration of health services that may result. They will have only themselves to blame for their own inaction. Their counterparts in Lachine will have succeeded, through their own media campaign, in imposing a solution that, despite the appearance of "saving" the Lachine hospital, actually only consolidates the deterioration of medical services being offered at the hospital while ultimately causing the same problems at the LaSalle hospital.



Source:
Dr Francis Engel
Head Of the OBGYN Department of LaSalle Hospital
President of the table sectorielle LaSalle Hospital

And

Dr Francois Langlais
Vice President of the table sectorielle LaSalle Hospital

Dr Henry Lapin
Head of Department Of Specialized Medecine Of LaSalle Hospital

Dre Catherine Duong
Head of Department Family Medecine of the LaSalle Hospital

Dre Nicole Latortue
Head of Department of Anesthesia of the LaSalle Hospital

Dre Mathangi Ramani
Head of Department of Radiology of the LaSalle Hospital

Dre Marie Jolivet
Head of Department of Medical Biology of the LaSalle Hospital

Dr Emile Badro
Head of Department of Surgery of the LaSalle Hospital

Dre Marie-Eve Nadeau
Chief of General Surgery of LaSalle Hospital
& Member of the Table sectorielle of the LaSalle Hospital

Dre Nadine Lahoud
Chief of Internal Medecine of the LaSalle Hospital

Dr Tony Assouline
Chief of Emergency of LaSalle Hospital

Dr Duncan Schellenberg
Chief of Intensive Care of the LaSalle Hospital
Member of the Table sectorielle of the LaSalle Hospital

Dre Chantale Giard
Member of the Table sectorielle of the LaSalle Hospital

Dre Julie Choquet
Chief of Medical Wards of the LaSalle Hospital

Dr Vitiya Pou
Chief of Geriatrics and of long term care of the LaSalle Hospital


Contact Information

  • Dr Francis Engel
    Head Of the OBGYN Department of LaSalle Hospital
    President of the table sectorielle LaSalle Hospital
    514-367-3337