New Brunswick’s auditor general is raising major concerns about the province’s emergency departments in a report that highlights excessive wait times and a lack of strategy to improve the situation.
“We’re talking about people’s lives — be it at different triage levels but at high triage levels — people’s lives and potential deaths here,” said Paul Martin.
“It’s concerning when it’s people’s lives at stake.“
The report examined ER visits between April 1, 2020 and Dec. 31, 2024. Of the nearly 1.5 million visits during that time, 66 per cent did not meet the Canadian Triage and Acuity Scale (CTAS) timeline targets from triage to physician assessment.
The target states Level 1 patients, who are the most urgent priority and require resuscitation, should be seen immediately. The audit found of the 6,557 visits triaged at Level 1, 44 per cent were not seen by a physician within the target. In fact, 77 patients waited more than two hours after triage, and 11 patients waited more than 24 hours.
Level 5 patients, who are the lowest priority and cases deemed non-urgent, have a target of being seen by a physician within two hours. These patients may have minor lacerations or sprains.
Over the course of the audit, 29 per cent of these patients were not seen within the CTAS target time frame. The report found 967 Level 5 patients waited more than 12 hours, with 57 of those patients waiting over 72 hours.
The report found 2,199 patients were pronounced deceased after arriving at the ER during the audit period. They examined 1,287 of those cases and found 43 per cent of them were not seen within the CTAS target times.
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The audit also uncovered 249,158 patients who left the emergency department altogether without being seen by a doctor.
“We have a trend, we have an issue here with emergency rooms being in excessive capacity, people in hallways, offices, and in closets waiting for service. Doctors potentially being available at times where there’s not a treatment room to put people in,” said Martin.
“We’re looking for the Department of Health, for them to have a strategy and targets, and what is it they’re going to invest in, what changes are they going to make. And it provides (an) opportunity to hold them accountable for the things they’re doing (to fix) the problem.”
Martin made 11 recommendations in his report, including that the Department of Health develop a “comprehensive strategy” to address ER needs, outcomes, timelines and resources.
The audit also recommended the province review data on patients who died after arriving at the ER to “evaluate risks and opportunities in developing strategies to improve results.”
Health minister responds
Health Minister John Dornan said the province has accepted all of the auditor general’s recommendations, calling it “quite a good report,” however points out some of the data may be skewed because statistics were “mischaracterized or mislabeled.”
“There’s no way a Level 1 patient waits more than 10 minutes at the most. And that would only be because if someone else demands similar levels of care,” said Dornan.
He went on to say the Liberal government has already initiated many of the recommendations in the report since coming into power in October 2024.
“We are holding ourselves and our emergency departments more accountable. We’re looking at shortening the wait times that exist at the time of that report, and I think we’re making progress,” he said.
Dornan, who was a practicing doctor, regional chief of staff at the Saint John Regional Hospital and the former head of the Horizon Health Network, said the province won’t meet any of the CTAS targets in the short term.
“We will not meet any of those targets completely. I will guarantee you that. But we had to move towards those targets,” he said.
“You know, every surgical group, every medical group has optimal targets. Very few places around the country meet all those targets dead on. So our goal is to move on those targets to get closer to what the Canadian standards suggest.”
‘No real action’
The auditing period mostly took place during the Blaine Higgs PC government, although the auditor general also raised concerns about the Liberal government’s accountability framework.
PC MLA Tammy Scott-Wallace, who is chair of the public accounts committee, acknowledged emergency wait times has been a “challenge.”
“It was a challenge of the previous government, it was a challenge of the government before that. I think we’ve heard references to this being a challenge over many, many years, and we’re still in it,” she said.
But Green Party Leader David Coon said it’s an unacceptable trend that’s gone on for too long.
“The most disturbing thing is that we continue to see no real action to solve the problems in our emergency department, that the health department has no plan,” he said.
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