Inside the Lakeshore ER, a hospital in dire need of staff and space

On its busiest days, the Lakeshore General Hospital emergency room is so stretched for space that patients on gurneys line not just every hallway, but even the narrow passageway in front of the nursing station. 

"You can imagine that's not a great place for a sick patient," said Dr. Tim Heeley-Ray, the hospital's chief ER co-ordinator, on a rare tour of the ward at the only hospital in Montreal's West Island. 

It's unusually quiet on this particular morning, but throughout the pandemic, the Lakeshore's ER has rarely been below 100 per cent capacity. It's not uncommon for the ER to exceed 200 per cent. 

"When it gets there, it's hard to provide good care for anyone," Heeley-Ray said. "I just hope people know that it hurts us almost as much as them when they don't get quality care."

Asked to sum up what it felt like in the ER at the Lakeshore during the pandemic, Heeley-Ray chose these words: "difficult, challenging, understaffed and too small."

Emergency rooms traditionally bear the brunt of a failing health-care network: when there are long wait times and patients remain on stretchers in the hallways for days, it's a clear sign there are problems elsewhere in the system.

 "We often say that ERs are the tip of the iceberg. So it's just what people see; what shows," said Dr. Judy Morris, head of the Quebec Association of Emergency Physicians. 

"When there's lack of beds, lack of personnel across the health-care network — primary care, specialized care, operating rooms, long-term care, CHSLDs — if there's not enough capacity in those settings, it's going to show up in ER, because it is essentially the only door that's always open 24/7 for the patients that seek care and cannot get it elsewhere."

In the Quebec election campaign, fixing the health-care system ranks second only to the environment as the top issue among those who have taken part in CBC's Vote Compass. 

The parties have made a wide range of promises to improve services that would lighten the burden on ERs, from improved access to primary care to more home care for seniors. 

Heeley-Ray acknowledges the problems plaguing his hospital aren't unique, but rather part of a broader failure in the health-care system.

"I think you could talk to people who have positions like mine at any Quebec emergency, and the rhetoric will be the same. We have the same comments, concerns, questions about how to fix things."

But he added, "I think ours are particularly severe, and our statistics prove it. We're frequently in the most over-capacity."

The Lakeshore General Hospital, built in 1965, has been a subject of controversy throughout the pandemic, despite innovative efforts to control the spread of the virus.