Emergency physicians at Surrey Memorial Hospital say urgent action is needed to address the worsening conditions for patients and health-care workers in the emergency department. 

"The deteriorating conditions in our ED are unequivocally leading to substandard care," reads a letter to Dr. Victoria Lee, CEO of Fraser Health. "These conditions create an increasingly toxic work environment that discourages emergency physicians from showing up to work." 

"This, in turn, creates a vicious cycle, as growing staffing deficits make it impossible to meet the demands of a growing patient population. Ultimately, this leads to further decline in patient care, which exacerbates the already negative environment in which we work." 

The physicians who penned the letter urged Lee to visit the emergency room, observe the "deteriorating conditions, and engage with patients whose lives are directly affected by these shortcomings."

The letter dated Sept. 16, 2024 expressed appreciation for a town hall held in the summer of 2023 but noted there has been little followup since then. 

In June 2023, the Ministry of Health met with Fraser Health and health-care workers in Surrey. During this meeting, the province identified short-term, long-term, and medium-term strategies to improve care at Surrey Memorial Hospital. 

Part of these actions included hiring more health-care providers. At a press conference in July 2024, B.C. Minister of Health Adrian Dix noted that since July 2023, 414 new job positions at Surrey Memorial Hospital and in Surrey communities have been posted. Of those, 293 new positions have been filled by health-care providers, including 23 of 27 pediatric emergency positions. Four associate physicians, two nurse practitioners specializing in internal medicine, and four internists were also hired. 

"Despite assurances from the Minister of Health that 'everything and the kitchen sink' is being thrown at the staffing problem, we have yet to see any practical solutions," states the letter. 

Staffing has not kept up with the increase in patient volume, the letter notes. Patient volumes has increased from 30 per cent since 2021 and staffing has only increased by eight per cent. 

The staffing issue is not just facing physicians alone. In August, a nurse from Surrey Memorial Hospital sounded the alarm about conditions that they say make work unsafe. 

The individual, who requested anonymity for fear of retribution from their employer, told the Now-Leader about the immense pressure they are under as ICU nurses are being assigned 鈥� otherwise known as redeployed 鈥� to the emergency room to cover as the ER is short-staffed. 

The nurse said more than 15 emergency room nurses had left Surrey Memorial Hospital for jobs at other hospitals in the region. 

The doctors' letter notes that the emergency department has seen a 30 percent increase in volume over the past four years. According to Becker's Hospital Review, it is now the busiest emergency room department in Canada and the third busiest in North America. 

Emergency room physicians continue to do their part and provide high-quality care despite challenging conditions, the letter says.

The letter notes the disparity in care between health care in Vancouver and Surrey, which leads to "an uneven allocation of resources and corresponding disparity in quality of care." 

At Vancouver General Hospital, physicians spend an average of 44 minutes per patient, compared to Surrey Memorial, where they spend only 16 minutes. 

ER physicians at Surrey Memorial Hospital are also paid less per patient than those in Vancouver Coastal.

"New physicians are gravitating toward better-paying and less stressful positions, leaving Surrey Memorial increasingly vulnerable to staffing shortages," the letter states. 

95 per cent of 'Code Orange' calls declined 

A code orange is called when physicians identify a situation that pushes the department "beyond a safe level to maintain quality of care."  

"Despite the in-house physician determining that Code Orange criteria had been met, 24 out of 25 requests were denied. To our knowledge, only one was granted temporarily," reads the letter. 

A spokesperson for Fraser Health confirmed they had received the letter. 

"We acknowledge the concerns raised in the recent correspondence received from the emergency physicians of Surrey Memorial Hospital. We are in the process of thoroughly reviewing the letter and the issues outlined within. We understand the seriousness of these concerns, and we will be responding directly to the physicians involved to address them comprehensively." 

Elenore Sturko, MLA for Surrey South and Conservative Party of B.C. candidate for Surrey-Cloverdale, expressed her outrage. 

鈥淭he doctors are asking, 鈥榃hy do conditions continue to deteriorate?鈥� while David Eby pretends everything is fine. This is not just mismanagement; it鈥檚 a complete betrayal of our health-care professionals and patients,鈥� stated Sturko in a Conservative Party of B.C. news release Tuesday (Sept. 17). 

Premier David Eby, Adrian Dix, Minister of Health and Ravi Kahlon, Minister of Housing, were in Surrey on Tuesday (Sept. 17) at the site of the new Surrey hospital. 

Eby announced while at the site in Cloverdale, that the province is using land owned by the Fraser Health Authority to build rental homes prioritized for nurses and health-care workers and their families. It would be funded through the government's B.C. Builds program.

In reaction to the letter, Eby said the Province is addressing the challenges that doctors at Surrey Memorial Hospital face, including building a second hospital in Surrey. The new hospital in Cloverdale, which is set to open in 2030, will have 168 beds and a cancer centre that can perform about 100,000 cancer treatments per year.

"We have big challenges, there's no question," Eby said. "The biggest challenge is around the recruitment and retention healthcare workers."

"There's more than 100 new doctors at Surrey Memorial Hospital. I know we're headed in the right direction, and I also know those emergency room doctors are under huge pressure. There's significant demand, Surrey is growing so quickly."

Minister of Health Adrian Dix stated that progress continues to be made at Surrey Memorial Hospital.  

Dix noted that Surrey Memorial Hospital has 476 net new staff. Dix acknowledged that the emergency room at Surrey Memorial is under significant pressure and that they will continue to recruit health care workers. 

"We got to continue to work with our healthcare workers, do what we've been doing, which is adding doctors, adding nurses, adding healthcare professionals, adding internists, adding long term care, which we're doing in Surrey as well, to address these issues and to continue to move forward," Dix said. 

鈥� With files from Malin Jordan & Lauren Collins