CELPIP Reading Part 4 Practice Test: Overnight ER Closure in Marlow Falls Debate

Marlow Falls Hospital has staffed its emergency department around the clock for over sixty years. The regional health authority now proposes closing it nightly from 8 p.m. to 8 a.m. for a twelve-month trial, diverting overnight patients to Halstead General, a 45-minute drive away. The prospect, open to public comment until May 15 with a final decision due in June, has polarized a population of about 6,000, many of whom live on farms well outside town.

Corinne Bélanger, vice-president of rural services, attributes the proposal to staffing, not finances. Three of seven emergency physicians have departed within eighteen months, and the remaining four cover a schedule normally requiring twice that number. Already the department shuts on a few hours’ notice whenever someone falls ill. “A fixed timetable is safer, because patients could at least plan,” she reasons. Only about four patients arrive nightly, she adds, and any savings would finance recruitment.

Dr. Samuel Achterberg, one of the remaining four, admits the schedule is unsustainable, having worked over seventy hours last week. Still, nightly averages strike him as treacherous. “Arithmetic is no comfort to whichever of those four is having a heart attack.” Instead of locked doors, he advocates an overnight nurse on site, with a physician accessible by video link and prepared to attend the gravest cases, an arrangement reportedly successful at several small hospitals elsewhere.

Paramedic Luis Ferreira, representing regional ambulance crews, professes no objection in principle but identifies a dangerous omission. Marlow Falls has only two ambulances, and each round trip to Halstead occupies one for close to two hours. He wants one thing first: “Put a third vehicle here before anyone locks a door.”

Wendy Gaudet, a trucking operator for twenty years, finds no conditions acceptable. Her drivers and the sawmill’s night shift are precisely those likeliest to need care after dark, and winter can shut the Halstead highway for hours. The trial’s promised twelve-month limit draws only a dry laugh from her. “What young physician would settle beside half a hospital?” she asks.

A lifelong Marlow Falls resident, I cannot support this plan as written. The authority keeps saying “trial,” but I suspect 6. Choose…Halstead will soon be swampedrecruits will arrive soonthe sawmill will end night shiftsthe doors will stay locked. Ms. Bélanger’s observation that only 7. Choose…a few patients arrive overnightfour physicians remaintwo ambulances serve the communitya few hours’ notice is given is offered as though it settled the matter. It doesn’t.

Averages conceal 8. Choose…the hours doctors workthe distant farmsthe life-threatening casesthe trips paramedics make. The plan would also 9. Choose…overload Halstead’s emergency staffstrip the area of coverturn paramedics into night nursesraise ambulance charges for distant farmers, a risk nobody has explained away. We live well outside town, so the drive alone already frightens us, and winter makes it worse. My neighbours feel much the same, whatever they think of the authority’s figures.

Our exhausted doctors are blameless, and something must change, but the authority should first 10. Choose…station a third ambulance locallyrecruit the three missing doctorsstudy the sawmill’s injury recordstest a night nurse and video doctor. If it succeeded elsewhere, why not here?