Verdun Hospital nurse unfairly fired after asking patient with expired health card to pay $500 deposit: arbitrator

An arbitrator has ruled an emergency room nurse unfairly lost his job at the Verdun Hospital after asking a patient in 2019 to pay a $500 deposit or face a possibly long wait to see a doctor.

According to the report, a man showed up at the hospital's emergency room with an expired health card. The triage nurse asked him to either renew it or put down a deposit; otherwise, he might be passed over and wait an extremely long time.

Dr. Paul Saba, a physician at Lachine Hospital, says it is common for uninsured people to be asked to pay first.

"If they don't have a Quebec medicare card, it's really haphazard ... each institution has its own policy," he said in an interview.

"If you're not breathing, nobody is looking at that, but if you have a problem like a fractured wrist, you're required to show some form of insurance."

The patient at Verdun Hospital left, only to come back later, needing emergency surgery. The nurse was later fired.

An arbitrator has overturned that, explaining that, doctors often arrange it so they don't have to care for patients without coverage and leave them in the waiting room so that the next shift’s colleague have to take them on. The problem then falls to the triage nurses, because they have to deal with everyone.

Dr. Saba says it's unethical and against Quebec's Good Samaritan laws to not treat a patient, and if they can't pay, hospitals end up paying the bill.

He says there should be a standardized system so it's clear when and how a patient should pay.

"The physician should not be bill collectors; they should be providing health care and not worried about being paid," Saba said.

And those ER fees also vary from hospital to hospital, but are usually over $1,000.

• Jewish General Hospital: $1,055.67
• MUHC: $1,129.47
• Lakeshore Hospital: $1,129.47
• St. Mary's Hospital: $1,129.47

The Centre-Sud health board responded to the case saying:

"The incident is regrettable and is not representative of how the Verdun Hospital deals with our users. Patients will receive care even if they do not put down a deposit."

Patients' rights advocate Paul Brunet says there are exceptions but uninsured patients should be paying.

"If you need urgent medical attention, you should be getting it. No matter where you're from, no matter what your status. We're talking about human life here," he said.

"To me, if a person who has no Canadian status that needs non-urgent medical attention they should be asked to pay."

Dr. Saba says Quebec should create standards so that patients aren't put in medical and financial distress.