The independent analysis of the Vancouver Island Health Authority (VIHA, or Island Health) delivered by external consultants Ernst & Young two weeks ago concluded that an electronic health records system implemented at Nanaimo Regional General Hospital (NRGH) was “not properly planned or implemented.”

Consultants also found that the poorly functioning system, known as iHealth, was additionally challenged by “a general climate of distrust in the hospital.”

The Ernst & Young report reinforces the findings of another external analysis conducted by the Vector Group in early November that described the atmosphere at the Nanaimo hospital as “toxic,” an environment caused by management bullying its workers, retaliation and secrecy.

FURTHER READING: The Ernst & Young report

While those two analyses refer to NRGH specifically, north Island health care workers describe similar situations at the new Comox Valley and Campbell River hospitals.

After a two-month investigation involving multiple interviews with more than 30 different sources at both hospitals, Decafnation has found the facilities were not properly planned and that employees feel the concerns they raised during the process were ignored, and that decisions and information were kept secret. And they now fear retaliation for speaking out.

The purpose of Decafnation’s four-part series was to give these employees a voice in the hope that Island Health executives would start to listen to front-line workers and implement a genuine effort to mitigate the problems that can still be fixed.

And the public has a right to know that our communities didn’t get the hospitals we were promised.

FURTHER READING: The four-part series and other health care stories

Decafnation urges the B.C. Ministry of Health to conduct external studies at the two north Island hospitals similar those undertaken at Nanaimo, and to hold Island Health executives accountable.

The top executive of the region that includes the Nanaimo hospital no longer works for Island Health. Yet, all of the top executives involved in the planning of the two north Island hospitals remain in place.

FURTHER READING: Island Health exec sacked

And there’s more that needs to be done.

REVIEW ISLAND HEALTH — An external review should be done of Island Health itself. It’s clear that changes are needed at an organization where such mismanagement is allowed to occur.

RETURN TO LOCAL HOSPITAL DISTRICTS? —  An analysis of Island Health might find that a restructuring of regional health authorities could have prevented these problems. The former B.C. Government merged the province’s 52 local hospital districts into five regional health authorities. The Vancouver Island Health Authority is further broken down into five geographic areas. Geo 1, which includes our two new hospitals is massive, extending  from Courtenay to the whole north Island and portions of the mainland’s upper west coast.

The province used this same logic to break the large Comox Strathcona Regional District into two smaller jurisdictions, and it has improved local governance.

REVERSE THE P3 REQUIREMENT — The NDP government should reverse the trend toward building all major infrastructure projects in the province under public-private partnerships (P3). The new Cowichan Valley Hospital, which is now in the planning stages, should not be built as a public-private partnership.

Numerous studies have pointed out the dubious benefits of P3 facilities, some going so far as to say they are a bad deal for taxpayers.

FURTHER READING: P3’s double the cost of government borrowing; The hidden price of public-private partnerships

Many of the problems at the two north Island hospitals resulted from private companies pushing decisions during the planning process based on profitability, rather than what would best serve the community or health care workers.

PROPERLY FUND THE HOSPITALS — Planners badly misjudged the necessary capacity at both hospitals. As a result, both hospitals have been overcapacity since they opened and will never be adequate without further expansion. But the low morale among staff could be improved if Island Health properly staffed the hospitals based on reality.

Both north Island hospitals are incurring excessive overtime and most employees are stressed. That’s not a healthy or successful way to run any organization, public or private.

BUILD RESIDENTIAL BEDS ASAP — Island Health’s failure to assess the residential care requirement in the Comox Valley is epic. They don’t seem to know what to do. But those who work in the field of community Health Services know. The Comox Valley needs up to 200 new residential beds immediately.

It will take three years to get a new facility up and running. But with new funding right now, St. Joseph’s could reactivate its award-winning transitional care unit to accommodate the people who need that level of care but who are now taking up more expensive acute care beds at the Comox Valley Hospital. That would help to solve many issues surrounding overcapacity and understaffing.

COMMUNITY HEALTH SERVICES — Unpaid caregivers and those employed in home support programs need more funding. The Comox Valley needs more Adult Day Care programs and more respite beds.

At least a third of unpaid caregivers (usually family members) are in distress because the province isn’t supporting them with greater access to ADC programs and respite beds. They are burnt out, angry, and they deserve better for attending to their loved ones. Not to mention that unpaid caregivers save the province $3.5 billion per year.

SUPPORT ST. JOSEPH’S — The St. Joseph’s board of directors has an excellent vision to create a Dementia Village and campus of specific care for seniors on its former 17-acre hospital site. There should be no conflict between the Catholic-run facility and the Canadian Medical Assistance in Dying law, as 95 percent of patients currently in The Views (St. Joe’s residential care facility) suffer with dementia. And dementia patients don’t qualify for MAiD.

—

Taking these actions will move health care in the Comox Valley and Campbell River in a positive direction, and diminish the human toll on workers and patients that bad planning has created.

Those responsible for planning the hospitals that fell short of their promises and the community’s expectations should be disciplined.

And the provincial government must reverse policies from former governments that have fostered these problems.

It’s too late (or too early) to renovate our new hospitals, but swiftly addressing these issues will make the best of our given situation and support dedicated health care workers who continue to act professionally and provide the best patient experiences possible.