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Emergency rooms: A Swedish hospital shows that long waits need not be the norm

Montreal, October 17, 2017 – Quebec’s Health Minister recently gave an ultimatum to the province’s hospitals such that emergency room stays could no longer exceed 24 hours. To solve our wait time problem, our politicians should instead take inspiration from the operation of Saint Göran, a Swedish hospital run by a private company, accessible to all and funded by the government at lower cost than public hospitals, as explained in an Economic Note published today by the MEI.

“Interminable emergency room stays, which are frequent in Quebec, are anecdotal at Saint Göran. Only 1% of its patients spend more than eight hours in emergency. In Quebec, that’s the proportion of patients who spend 48 hours or more in emergency! One patient in fifteen spends more than 24 hours in emergency here, and waiting seven or eight hours has become commonplace in our large hospitals,” points out Patrick Déry, Public Policy Analyst and author of the publication. “Quebec is light years away from Saint Göran’s level of efficiency.”

What is this hospital’s secret? The business model of Capio, the publicly traded company that runs Saint Göran, is simple: to provide patients with quality care and to do so efficiently in order to generate profits.

The case of Saint Göran illustrates the application of basic economic principles. Instead of concentrating decisions within a provincial department that is assumed to be omniscient, responsibility is entrusted to hospital administrators, who in turn leave decisional latitude in the hands of department heads and employees. Also, everything is measured, including the degree of patient satisfaction. “These indicators show that Saint Göran employees are happier at work than the employees of comparable public hospitals in Sweden, and their staff turnover rate is lower,” explains Patrick Déry.

While our hospitals have failed for years to significantly reduce wait times, the performance of this Swedish hospital should inspire decision-makers within our health care system. The government could thus decide, as the Stockholm County Council did, to entrust the administration of a hospital to a private operator, all while maintaining public funding as we know it.

“The idea is not to see Saint Göran as a miracle solution, or the only model. The fact is that we have failed for decades to resolve the problem of emergency room wait times, and there is no good reason to forgo the contribution of the competitive sector in the provision of hospital care. Most industrialized countries benefit from its involvement, with better results than Canada,” says Patrick Déry.

“According to a tenacious myth in Quebec that is maintained by many commentators, politicians and, unfortunately, too many doctors, making more room for the competitive sector in the provision of care would threaten access and quality, and would happen at the expense of patients. The experience of Saint Göran shows that this is simply not the case,” concludes Jasmin Guénette, Vice President of the MEI.

The Economic Note entitled “Saint Göran: A Competitive Hospital in a Universal System” was prepared by Patrick Déry, Editor and Public Policy Analyst at the MEI. This publication is available on our website.

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The Montreal Economic Institute is an independent, non-partisan, not-for-profit research and educational organization. Through its studies and its conferences, the MEI stimulates debate on public policies in Quebec and across Canada by proposing wealth-creating reforms based on market mechanisms.

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Interview requests: Pascale Déry, Vice President, Communications and Development, MEI / Tel.: 514-273-0969 ext. 2233 / Cell.: 514-502-6757 / Email: pdery@iedm.org

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