A System Too Big to Fail

And it's still failing:

Hundreds of thousands of sick and injured Canadians are spending up to two days or longer parked on hard stretchers or plastic chairs in the country’s swamped emergency departments, waiting for a scarce bed to open upstairs, and these delays can be deadly.

New data show that, in 2024-2025, one in 10 emergency patients — 1.5 million people — spent more than 14 hours in emergency.

Of the 16.1 million ER visits reported in total, 1.8 million people needed to be admitted to hospital.

While half waited less than five hours for a bed after the decision was made to admit them, one in 10, or 180,000 people, languished 48 hours or more in emergency before they were moved to a ward bed or the operating room.

Studies have shown that for every 82 people waiting more than six to eight hours to be transferred to a bed, one additional death will occur, meaning that “for those 180,000 patients waiting more than two days for an inpatient bed, we could expect 2,195 attributable deaths,” said Ottawa emergency physician Dr. Michael Herman.

“This is not just inconvenient for patients, this is lethal.”

The new report from the Canadian Institute for Health Information validates “what we’ve been saying on the frontline for years now,” said Herman, a director on the Canadian Association of Emergency Physicians’ board of directors.

People are landing in emergency sicker, many with multiple underlying health problems in addition to whatever brought them to hospital, and staying longer.

Two-thirds are being triaged as “high acuity,” meaning with conditions that are either life-threatening, such as cardiac arrest, or require rapid medical attention (severe chest pains, signs of sepsis, severely abnormal vital signs) —  shooting down the “zombie myth that refuses to die” that waits times are being driven up by people with minor complaints, Herman said.

“The data clearly show that’s not true. We’re seeing a decrease in our low acuity patients and yet wait times are still going up.”

According to CIHI, severe, unstable cases have increased from 59 to 66 per cent of all emergency visits, or 1.7 million more visits since the pre-COVID year of 2018-2019.

Across Canada, ER wait times are intensifying in overcrowded, short-staffed hospitals big and small, urban and rural. Stretchers and beds aren’t keeping pace with growing demand, creating backlogs and growing wait times and more frustrated people are leaving before being seen by a doctor.

In 2024-25, 7.7 per cent of emergency visits — 1.2 million — involved someone leaving without being assessed by a doctor, according to the report.

Pre-pandemic, it was 5.4 per cent, or roughly 800,000 visits.

People aged 55 and older face the longest waits for a hospital bed. Unlike younger people, they can’t simply be moved into the first available bed. They often need to be in a specialized unit or isolation bed for infections like pneumonia.

Emergency departments are witnessing historic levels of boarding, a risky and humiliating practice of holding admitted patients on stretchers in loud, crowded, chaotic hallways or any available makeshift space.

The longer people, especially older people, stay in emerge when they’re admitted, the worse their outcomes, Herman said. ERs are set up for “brief, episodic care and high turnover,” he said. They aren’t resourced to provide the level of care the way an inpatient ward is, increasing the risk of deterioration and delirium.

The report highlights that the emergency crisis is largely outside emergency’s control. It’s a decades-old, inflow-outflow problem.

 

 

No Country For Anyone

One never has to answer for anything if one simply denies things:

It is a tragedy in its own right that Ilana Gritzewsky, a liberated Israeli hostage whom Hamas abused sexually, had to confront the United Nations expert on violence against women, according to Hillel Neuer, executive director of UN Watch.

“It’s absolutely horrible that this should have to be the case,” Neuer told JNS on Wednesday, the day after Gritzewsky appeared before the U.N. Human Rights Council to address Reem Alsalem, special rapporteur on violence against women and girls.

“It’s absolutely absurd and tragic that there are U.N. experts who are supposed to care about the rights of women, especially to combat sexual violence, and she’s one of the world’s major deniers of sexual violence against Israeli women,” Neuer said.

The United Nations considers special rapporteurs to be independent “experts,” whom it is loath to censure even when they make offensive comments. Francesca Albanese, a U.N. adviser on what the global body calls the “occupied Palestinian territories,” has a long history of antisemitic comments. The United Nations has told JNS often that it doesn’t tell its advisers what to say, or not say.

A Jordanian national who has held the unpaid, U.N. advisory role since 2021, Alsalem has denied survivor accounts of Hamas sexual violence on and after Oct. 7 repeatedly. She has said that “no independent investigation found that rape took place on Oct. 7.”

“She’s made some rather horrible statements that have either doubted or denied the violence against Israeli women, and in general against Israel as a whole,” Neuer told JNS.

Since Oct. 7, Alsalem has not met with a single survivor of the Hamas-led attacks, according to Neuer. That could change after Gritzewsky’s testimony, he said.

The special rapporteur stated on Tuesday that “if any other survivor of Oct. 7 is ready to finally meet with me, I am always ready to meet,” he told JNS.

“She claimed that she always was willing to meet with Israeli victims, but Israel never got back to her,” Neuer said. “So she said if Ilana and any other survivor wants to meet with her, they could do so anytime.”

Gritzewsky is willing to meet with Alsalem, Neuer said.

JNS sought comment from Alsalem about whether and when she would meet with Gritzewsky and if Gritzewsky’s testimony would prompt her to update or revisit her past reporting and public statements about sexual violence on and after Oct. 7.

Gritzewsky, who appeared before the Human Rights Council on Tuesday as part of an event organized by UN Watch, recounted the sexual abuse she endured in Gaza after terrorists kidnapped her from her home in Kibbutz Nir Oz.

“I woke up half-naked with seven terrorists standing over me, not knowing what happened to me in those lost moments,” she told Alsalem. “I went through days of pain and horror in captivity and even now, the feeling of being powerless and violated still lingers. I came back with a broken hip, a broken jaw and a shattered soul.”

“When I and other Israeli women begged not to be raped, why were you silent?” Gritzewsky demanded. “Please look at me. Do you believe us now? Will you apologize?”

Video footage, in which Alsalem appeared to sit without visible reaction as Gritzewsky delivered her testimony, spread widely on social media. Neuer told JNS that the U.N. adviser was “stone-faced.”

“It’s not inconsistent with her positions until now,” he said.

 

Reem Alsalem is a b!#ch.

 

 

 

Some People Are "Special"

But never accountable:

First Nations schools operated by Indigenous Services Minister Mandy Gull-Masty’s department have failed an audit for the second time in five years. Records show the federal system spends 29 percent more per capita than the national average yet has the highest dropout rate in Canada: “There has not been measurable improvement over time.”

** 

Cabinet should adopt as a principle the validity of “Indigenous laws,” says a Canadian Human Rights Commission report. “Indigenous ways of life and Indigenous laws are not seen as valid as Canadian law,” wrote the Commission.

 

Alright! Stone Age law!

** 

So, nothing has changed:

But even this unusually restrained Canadian judge has a track record of embracing identity politics in law, including levying a mandatory pronoun policy on Manitoba lawyers and seeking to make Canada a “tri-jural” system in which Indigenous practices are treated as co-equal with Canadian civil and criminal law.

In 2021, Joyal made Manitoba one of the first provinces requiring lawyers to employ pronouns while introducing themselves or a client to a court.

“At the beginning of any in-person or virtual proceeding when parties or counsel are introducing themselves, their client, a witness, or another person, they should provide the judge or justice with each person’s name, title (e.g. ‘Mr./Ms./Mx./Counsel Jones’) and the correct pronouns to be used in the proceeding,” reads a 2021 order signed by Joyal.

The order further states that if a lawyer refuses to specify the pronouns of themselves or a client, “they will be prompted by the court clerk to provide this information.”

In Joyal’s submitted questionnaire to the body tasked with reviewing new Supreme Court justices, he cited this measure as proof of his “considerable” efforts to “promote gender equality and a broader diversity of peoples in our justice system and in our courts.”

“Under my leadership and that of the other Manitoba chiefs, we were amongst the first courts to formalize a gender inclusive pronoun policy for all court proceedings and practice,” he wrote.

But it’s on the issue of Indigenous reconciliation where Joyal has been explicit in the view that the Canadian court system should accord special treatment to Indigenous people, and “make space” for Indigenous legal norms to overrule Canadian ones.

Starting in 2019, Joyal oversaw the introduction of Indigenous cultural practices into Manitoba courtrooms, including Métis jig dances and smudging, the burning of herbs to create a purifying smoke.

In a podcast interview last year with the Canadian Bar Association, Joyal acknowledged this as an “asymmetrical” policy, as no other Manitoba litigants had special dispensation to perform cultural rituals in the courtroom.

But he justified their continuance as “unique and special and deserving of an asymmetrical approach when it comes to Indigenous law and traditions.”

In that same interview, Joyal said Canadian courts must “make space for Indigenous law and legal orders,” and not let “liberal neutrality” get in the way.

 “If we are moving, as I believe we are and should, to a tri-jural system, it’s not fair, and it’s not rational to try to compare so literally and so symmetrically the arguments about liberal neutrality with respect to what we owe our Indigenous community,” he said.

In a 2024 speech, Joyal told a meeting of First Nations leaders at Manitoba’s Building Safer Communities conference that courts were not acknowledging the “lived realities” of Indigenous people, and called for their powers to be increasingly devolved to First Nations communities.

“Many would argue the courts are not using the discretionary powers to apply a greater sensibility and understanding of the lived realities of Indigenous Manitobans, and I think that is a fair statement,” he said.

In that same speech, Joyal would outline the province’s outsized rates of Indigenous incarceration, framing them not as a downstream effect of higher criminality, but as the result of system failure and a lack of trust between First Nations people and the legal system.

“The solutions really lie with a greater assumption of control and jurisdiction in your communities,” he said, while urging courts to incorporate a “greater appreciation and use of Indigenous legal orders, legal practices in communities, and legal knowledge.”

 

Are there legal orders to stop murders?

Asking for a friend.