A report by Quebec's Health Commissioner finds the province has the longest emergency room wait times in the western world.

Robert Salois, whose term of office is approaching its end, prepared the report. His job was eliminated as part of provincial budget cuts.

Salois found 35% of Quebecers wait more than five hours to see a doctor in the ER.

In 2015 about 45% of all ER visits, 1.5 million, were longer than the maximum time recommended by the Ministry of Health.

In Ontario, only 15% of patients wait that long.

The length of time spent in ERs in Quebec is also very long: an average of nine hours per visit, more than double the four hours recommended by international guidelines.

One significant cause of lengthy delays was the need to see a specialist, which created an average wait time of eight hours.

The report drew fire from the opposition parties in the National Assembly.

"We should change our license plates from 'I remember,' to 'I'm waiting,'" said Coalition Avenir Quebec health critic Francois Paradis.

However, a spokesperson for Health Minister Gaetan Barrette said things are improving, citing last year's wait times as being the lowest in 10 years, a statistic they said would continue to drop as Quebec hospitals hire more nurse-practitioners.

Salois said there are ways to change this, and singled out two anglophone-run hospitals as having the shortest average wait times.

St. Mary's and the Jewish General have average wait times of under two hours.

Salois said those hospitals have several philosophies in common that should be adopted by all hospitals in Quebec.

Those include: 

  • upper management making ER care a priority
  • strong leadership from the chief doctor
  • doctors and nurses collaborating
  • a culture focused on patient care

Salois found one problem was that 90% of hospitals could adjust the number of nurses working depending on patients, but that only 25% of them could adjust the number of doctors working. 

He said that is a problem because the majority of ER patients need to see a doctor.

Another problem is that 60 per cent of ER patients are not emergency cases and should go to a clinic instead.

"We have had an increase in volume at the MUHC since the move to the Glenn site," said Greg Clark, the ER director at the Royal Victoria Hospital. "That being said, it's kind of expected. Who wouldn't want to come to a brand-new, shiny hospital?"

To prepare the report Salois queried hospitals across the province and visited the five ERs with the shortest wait times. 

Forty percent of ER visits are for urgent cases, while 60% are for less urgent matters.

One out of ten patients leaves an ER without ever seeing a doctor, although in some hospitals that rises to one patient out of three.