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Fewer Doctor Visits Approved for Rural, Isolated Towns

Mayors fret about shipping out patients.

By Ethan Ribalkin, 27 Sep 2006, TheTyee.ca

Doctor

Have stethoscope, will travel?

A lot of small towns in B.C. rely on the care of visiting family doctors and specialists. It's the only alternative to flying or busing people miles to medical centres. But this year the B.C. government has lowered the number of approved doctor visits to rural and isolated communities, according to a Health Ministry report obtained by The Tyee.

The move has angered small-town officials. But B.C. Health Minister George Abbott says the numbers are being misinterpreted, and merely reflect a more realistic picture of the actual health needs in those towns.

The Northern Isolation Travel Assistance Outreach Program (NITAOP) compensates visiting specialists and family doctors for travel time and travel-related costs.

Although the funding for this program has increased to $2.05 million for 2006/07, up from $1.95 million in 2005/06, of the 664 requested doctor and specialist visits, 385 have been approved, according to the NITAOP status report.

"I think saying you're spending more money and giving less service does not best serve the community," said Adrian Dix, NDP health critic and MLA for Vancouver-Kingsway.

"It means rather than having someone come to your community, you go on a wait-list for Vancouver, Burnaby or Surrey," he said. "Obviously, the more people on waiting lists, the worse it is for everybody."

'We're in bad shape'

According to B.C. Health Minister George Abbott, the changes in approved doctor visits were made because more visits have been requested in the past than the amount that have been used.

"What the planning allocation is based on is the number of actual visits that were made year after year," Abbott said.

"If community X had utilized 50 in 2004, 50 in 2005, it is probably not a bad planning assumption to think they will use about 50 in 2006 as well," Abbott said, adding that the number of actual visits has increased from 2044 to 2369.

According to the status report, dated June 1 of this year, Hazelton, Smithers and Terrace will see the biggest gaps between requested and approved visits.

In Hazelton, of the 103 doctor visits requested, 52 have been approved. That is an overall gap of 49.5 per cent and includes a shortfall of $38,390.

"We're in bad shape," said Alice Maitland, mayor of Hazelton.

"Even if (patients) don't have to fly to the Lower Mainland, they have to travel to Smithers, 50 miles, or Terrace, 100 miles," Maitland said. "Those are the two airports, so you're going to have to go there first."

Maitland said that her community is very poor and has yet to recover from when the Repap Corporation closed its mill in Hazelton. Over 100 workers lost their jobs.

Many other companies went under after the mill closed. As a result, people in the community cannot afford to fly to the Lower Mainland for health care, she said.

According to Maitland, Gordon Campbell's government almost closed down Hazelton's hospital last year, leaving the hospital with only two beds for a community of approximately 6,000 people.

'We're back to travelling'

For Smithers, of the 108 doctor visits requested, 70 have been approved. That is an overall gap of 35 per cent and includes a shortfall $49,945, according to the status report.

"We're one of 14 communities that have been hit," said Marilyn Stewart, a councillor in Smithers and chair of the Smithers Health Watch.

Stewart said that when an obstetrician visited Smithers six times last year, the doctor saw upwards of 100 people per visit, for a total of 600.

"We're back to where we were before, back to travelling," said Stewart.

"If they are putting more money into the program, then why does Smithers have a shortfall?" she said. "It doesn't make any sense to me.

"The reason we're so disturbed by it is because it wasn't a well thought-out plan," Stewart said. "It was done across the board."

Abbott said that the changes were made based on the changes in medical resources in the north, noting that specialists have increased from 89 to 96, and general practitioners have increased from 219 to 257.

"The allocation is not made in a static environment," Abbott said, adding that a new program has been introduced that takes patients to hospitals on buses.

Stewart, however, said the buses are not the best solution.

"The bus comes once a week and once a week might not be enough," Stewart said. "Not everybody gets paid sick leave. It does cause some hardship for the people."

Thousands of trips

Stewart and Maitland both voiced their concerns about patients from their communities who have been discharged from the hospital without a way home.

"People have been flown in hospital clothes, with no day clothes, money or credit cards," Maitland said. "And then they have to pay their own way home again."

Meanwhile, having surgery away from home might not be the best option, Stewart said, adding that she is worried about patients driving in the winter.

"If you're having surgery, you're having it in a strange place, not in your own community," she said. "It's that other part of healing...people can't come and visit."

According to Tracy Morton, chief of staff for the Queen Charlotte Islands General Hospital, 3,000 trips leave the island each year for medical care, out of population of 5,000.

For the Queen Charlottes, of the 40 doctor visits requested, 27 have been approved. That is an overall gap of 32.5 per cent. Morton said this means 600 more off-island trips will occur for patients.

"This isn't a good choice because it is affecting the people most vulnerable," Morton said, adding that it costs $600 to fly to Vancouver, plus the cost of transportation and hotels once there.

"We haven't been able to recruit an ear, nose and throat specialist for five years," he said.

Meanwhile, Margaret MacDiarmid, president of the B.C. Medical Association, said that patient care cannot be comprised.

"People need to know that they have some access (to health care)," MacDiarmid said. "I'm sure the government would share that concern."

Ethan Ribalkin is a freelance journalist in Vancouver.

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20  Comments:

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  • Grumpy

    5 years ago

    Comments on "Fewer Doctor Visits Approved for Rural, Isolat

    They don't call it the hurtlands for nothing! In an age where small towns are getting smaller and the Lower Mainland's population is getting larger, the provincial government is just encouraging more people to flee rural BC.

    A sad policy, from a sad government, who care more about an expensive, one time event (2010) than the future of BC!

  • DenisB

    5 years ago

    a community with no health care will die. leaving no witnesses to the rape and piledge of the land and its resources. This is a deliberate strategy to allow for unlimited resource developement .

  • mcdull

    5 years ago

    Yes less operating rooms less beds more Administration from Health Authorities who only do the bidding of their political Masters. Listened to that humanitarian Christy Clark as a guest host on NW about the hospital to be built between Courtney and Campbell River at a net loss of service but cost more money against the wishes of the people. VIHA doesn't care.

  • Bailey

    5 years ago

    It's not just the sick who are being abused by this government. They're currently promoting a foster parent type scheme for the disabled.

    It seems to be something like this, though as usual it's difficult to get them to admit to the specifics in detail.

    Unqualified and poorly trained people will be recruited to 'adopt' adults with developmental disabilities for money. Very little money at that. The Californian 'consultant' they're trotting around to promote this says $9 to $11 an hour.

    For this pittance they will be expected to provide room and board and all services, including policing their own behaviour, since the social workers were pulled out of service a few months ago.

    So the clients, once placed in this way, will be 100% in the hands of these service providers. 24 hours a day, seven days a week, without the option.

    If they aren't able to operate a telephone, which most are not, they won't even be able to call a cop.

    Sounds like a Liberal plan to me. All these refusals to provide public services by these conservative governments are of a single pattern. The people properly pay their taxes to pay for these things, then the government raises their own pay, reduces their own workload, and keeps the money.

    Or gives it in great whacks to their 'contributors' to build things we already built.

  • Realist

    5 years ago

    Who pays for these trips to hospitals and doctors? What pot of money does the airfare for patients care from small communities to urban centers? Why it comes out of the very budget that the Liberals claim is unsustainable! What a Shock to realize that this is yet another ploy to increase the financial pressure on the health budget and make it appear unsustainable. What is the cost comparion between flying in a doctor to see a hundred people verses flying a hundred people to the doctor? These con artist we have in Victoria are so arrogant they don't even attempt to cover up their poor reasoning for doing this. The only thing I can think is that the liberasl must have collectively had their consciences removed so they can pull this $hit on us and still sleep at night. Then again why worry about your actions when the AVERAGE CITIZEN JUST ALLOWS THEM TO GET AWAY WITH IT!!!! These guys and gals are poor excuses for human beings if you ask me.

  • DPL

    5 years ago

    Abbott talks a lot, waves his arms around a lot and it's always not true what others are saying. Next thing we will be hearing is that its the tax payers fault they live some were outside a local bus stop from the Vancouver General or get sick after 4 PM Mon. to Friday. A long time ago I was in the Canadian Military. It was fairly common to line up a bunch for certain tests. In came the doctor doing the tests. Everyone got the tests and he went back to somewhere else. Fast and efficient simply ain't words in the vocabulary of the Provincial Health experts. My God, I've been waiting for a very long time for a steroid injection here in the little town of Victoria. So silly me, I ask if nobody can get it done here, come up with a name in the lower mainland and somehow I'll get there. Blank expressions all round. We don't do things that way. What a strange way to fix peoples problems. Wait for them to go private seems to be the name of the game. So far no one has suggested going to some religious guy for a hands on cure

  • Realist

    5 years ago

    Don't forget the new motto of Health Canada as presented by our "new Government":
    TIME HEALS ALL WOUNDS.

  • alive

    5 years ago

    yep, some pretty bad schemes are developing, but remember the ministers in charge do not get a bonus, unless they can cut more costs!
    They have no incentive to do the best job, only the one that can save money right now, and fuk the future!

  • kurt

    5 years ago

    Small towns in Ontario recruit GPs by offering to set up their practice, complete with offices and clerical/nursing staff paid for by the village. For those fresh out of med school, saddled with onerous student loans, it is often quite attractive.

  • snert

    5 years ago

    Yup! It makes sense to get more people to travel just to save a few bucks on doctors visits. Not very green though. Just gobbles up the gas.

  • DPL

    5 years ago

    The VIHA announced today a 300 million dollar hospital, not in Campbell River or Comox but somewhere in between. They were a bit vague on how much money they will be putting intoteh old hopsitals in those two places. have to run it by Gordo first. wonder how many doctors will be travelling between the three places.. Hey maybe Gordo will give them bus passes

  • RickW

    5 years ago

    snert:

    Quote:
    Yup! It makes sense to get more people to travel just to save a few bucks on doctors visits. Not very green though. Just gobbles up the gas.

    That's the "advantage" of many budgets....fuel for transportation naturally enough doesn't belong in healthcare. Yer fuel is integral to getting patioents to whare they must go....
    Good point, snert!

  • RickW

    5 years ago

    PS If medical education is subsidized by government to the tune of some 80%, why aren't new doctors, et al, required to service in remote locations?

  • srfl

    5 years ago

    IRPbc has been used to offer an opportunity for students from various health professional programs, not just medical students, to find out what it is like to work in rural/remote B.C.
    I'm not sure of the success rate in having them relocate to these remote locations, when they are through their training.
    The mention by Kurt of how the small towns in Ontario attract GP's sounds like a good way to do it.
    On the other hand if new doctors are forced in some way to serve in remote locations and absolutely hate it, there is no positive for the doctor or the people he ends up treating.

  • DJT

    5 years ago

    Bailey:
    It's refreshing to hear someone standing up for the developementally disabled, a population that too often is forgotten. I have worked (as a public servant) with these folks for 24 years. It is an absolute shame how this government has treated them. The sad thing is that most people dont care. I could tell ya' some stories, but I digress from the story.

  • Bailey

    5 years ago

    Thanks. It seems to be a pattern of abusive behaviour that just squats in the souls of these ideologues. It's a near certainty that you will be abused by them once you've shown them weakness.

    The sick are abused because they are unable to defend themselves due to their illness, and the healthy can be lied to so they won't stand up for them.

    The elders can be abused because they've already been discarded and who listens to old people?

    The developmentally disabled can be abused because of the way others look away from them in embarrassed fear, and because they can't speak for themselves.

    The damaged and mentally ill can be abused because they're bereft. No money, no homes, no voices, no power.

    Everybody who safely can be abused by these cowardly Liberal bullies is abused by them. But they still keep the money we pay for the services we used to offer these groups, don't they?

    If anybody can point to any powerless or even vulnerable group in our society who ISN'T being abused, I'd be interested to hear about it.

  • RickW

    5 years ago

    srfl:

    Quote:
    On the other hand if new doctors are forced in some way to serve in remote locations and absolutely hate it, there is no positive for the doctor or the people he ends up treating.

    But they don't hesitate to take the public money for their education...............
    TANSTAAFL! (but of course, for some there is.....)

    I think all post-secondary education recipients should expect to do some government service, if their education is being subsidized. If they don't want to meet this obligation (in lieu of massive student loans), then pay for an education entirely out of their own pockets, or find a patron, or win bursaries.........all that......

  • Fiat lux

    5 years ago

    I was too busy in the past few weeks to read these stories, but they're nothing new.

    One of the main efforts of the neocon ideology and neoclassical economic theory is the depopulation of the rural areas and jamming everybody into shoebox apartments in huge cities, where they have to rely on big business for every bite they eat and for every service. Then the land is given to the multinational mafia for total exploitation with skeleton crews.

    This is called "free centerprise competitiveness".

    Our school district #27, is losing about 300 students every year and we've lost the Cariboo-Chilcotin electoral district for the lack of voters.

    This is no accident, but well executed plan and this medical mess is part of it.

    Ed Deak, Big Lake.

  • anne cameron

    5 years ago

    The history of Vancouver Island is rife with similar programmes of depopulation. I'd hazard that's true of the entire coast. Time and again people have been encouraged to homestead, or to move to small places where suddenly the government is helping fund some work. Used to be logging and sawmills. People would move, get settled in, start to carve a life for themselves and......one by one the services would be chopped until, inevitably, people had to move on looking for work...Ed's right, it isn't an accident. The temporary booms lasted as long as there was huge profit to be made from cutting old growth. When the cream began to run out so did the arstles.

    The "crisis" has been manufactured, and this whole uproar from Mz Taylor and our esteemed divorced drunk is part of a plan to make things seem so bad we swallow the shite sandwich and they get to bring in yank-style province wide privatization of health care.

    Look at the absolute mess that is our ambulance service! Towns without any coverage for days and weeks at a time. I don't believe a mess like that can happen without a concerted effort to force it to happen.

    And while we're all worrying about whether or not we'll have a doctor on Tuesdays and Thursdays we might neglect to find the time to protest the huge "cost over run" of the Olympic cow cack.

    If any of us were as slapdash and silly with our household budget as this pack of suits is with the provincial budget we'd be a province of people filing for bankruptcy. Which we very well might wind up being, anyway!

    Great to read you Ed Deak!

  • RickW

    5 years ago

    Think maybe it was Joey who gave the impetus to this form of "progress" when he called for the closure of the outports in Newfoundland...........?

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