When fog settles in, our vision is limited | George Le Masurier photo
The Week: VIHA and province disrespect our hospital board, medical staff and the public
As a retired journalist who has seen the health care system from up close on both sides of the Canada-US border, I can tell you that we are fortunate to live here.
It’s true we don’t have a Mayo Clinic or a John Hopkins University, and there aren’t storefronts offering MRIs on every street corner (only a slight exaggeration). But we have our fair share of brilliant and competent people providing us with health care, from brain surgeons right through to admitting clerks.
I have retired friends in the Puget Sound who pay $1,000 per month for comparable health insurance that used to cost BC residents just $75 a month, and is now free. For their inflated cost, my American friends get little more than better access to technology and procedures, although that can be critical in certain situations.
I say this to put my next sentence in context.
Many of those who work in the healthcare field on Vancouver Island — the doctors, nurses, laboratory workers, kitchen workers in hospitals, receptionists and more — believe that the Vancouver Island Health Authority is poorly managed. Employee surveys at Nanaimo General and the two North Island Hospitals in 2017/2018 bear this out.
And sadly, with a few exceptions, our elected officials and our mainstream Island media have let them off the hook.
VIHA, or Island Health if you prefer, is a secretive organization whose top decision-makers appear out of touch with the people they are supposed to serve. It’s an organization that could not properly plan and build new hospitals in Campbell River and the Comox Valley; planning flaws that after two years still have not been fully corrected.
How else can you describe the VIHA executives that have imposed reductions of pathology services north of the Malahat, especially on the North Island? Or, how they have dealt with the public that has explained the harm that these changes have made to patient care? We have lost critical onsite clinical pathologists’ services in Campbell River, and soon, if VIHA gets its way, in the Comox Valley, too.
The centralization of clinical pathology interpretation and diagnosis in Victoria is a disservice to north Islanders. Next on the block might be medical imaging. After that, who knows?
DECISIONS MADE IN ISOLATION
VIHA hatched this plan to shut down certain laboratory services at our hospitals without prior consultation with our doctors, our lab staff or even our elected officials at the Comox Strathcona Regional Hospital District. Consulting the public, of course, would never cross their minds.
North Island medical professionals, such as Dr. Aref Tabarsi, a Campbell River general pathologist, learned of this centralization plan through an out-of-the-blue phone call. “Don’t do this work any more, send it to doctors in Victoria.”
This change has created potential life-threatening situations and, at the very least, has added unnecessary stress to people already suffering through longer wait times, increased uncertainty and delays in treatment. North Island doctors are concerned that people will die as a direct result of not having clinical pathologists’ services onsite in the Valley and Campbell River.
And here’s another problem: our elected hospital board directors have no say at all about operations at our hospitals. The extent of their job, it appears, is to ask taxpayers to pony up 40 percent of the capital costs for projects proposed by VIHA.
To their credit, hospital board directors wrote a letter to the VIHA board chair and BC Health Minister Adrian Dix asking them to restore the lab services VIHA has grabbed for Victoria. That would, in turn, free up funds for hiring a needed third general pathologist for the Campbell River Hospital.
That was last spring. To date there has been no response to their letter from Health Minister Dix and directors who asked to meet with him at the UBCM Convention were rebuffed. VIHA did respond with a presentation notable for its flawed graphs, inaccurate information and a confusing explanation that did not address the board’s concerns.
Now, the board is struggling with how to respond to this treatment and whether they even can advocate for the citizens of the North Island. It’s a problem foisted upon them by VIHA, which has neglected public sentiment and deflected its accountability.
HOSPITAL BOARD MUST ADVOCATE
The public has naturally turned to the one and only group of regionally accountable individuals available, the regional hospital board.
It was the hospital board that committed North Island taxpayers to pay for 40 percent of what we all assumed were two complete hospitals. We expected they would come with fully-functioning laboratories suitable for community hospitals, which we already had at the old Campbell River Hospital and at St. Joseph’s.
Now we have hospitals with diminished laboratory services, and who knows what further reductions are yet to come. This is not what we were promised when our hospital board committed us to a $267 million debt.
How is it possible that our elected local officials who sit on the Comox Strathcona Hospital Board are reduced to nothing more than a conduit through which VIHA extracts capital funding from local taxpayers with the blessing of a provincial government that thinks it cannot be held to account?
We elected the hospital board directors. It’s shameful that the province takes our money and treats them with such disrespect.
Can the board accept this role, standing idly by rather than rising up to advocate for North Island patients? Isn’t it right that, at the very least, they demand to have the services we paid expected? And that they continue to demand it until full hospital services are restored?
Their advocacy is important and can be powerful. And it’s their obligation to us, the constituents who are paying the bill.
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The whole government’s think that the “globalization” of everything is the way to go…Me personally I do not agree with it. I don’t want to be controlled by some rich organization who is interested in only money not mankind. This is just a small step in their plan, to contain us in urban areas, stipe our rights and just produce for them like the slaves of history. God help us if we don’t start and stand up for ourselves soon.
I keep getting dropped from Decafnation’s mailing list. Have I unknowingly been bad? I promise to reform, though not conform, if you put me back on the mailing list.
In recent years, I perceive an increased general trend in mental health toward centralization of services in the urban centers. This is accompanied by increased specialization, and it is echoed and supported by a regulatory system that works against the generalist, at least in the case of the College of Psychologists. There is a mistrust in this organization toward the generalist mental health practitioner in rural or semi-rural practice, and a profound lack of understanding and appreciation of what is possible when we build capacity, empower and support health care where people live.
Rare conditions need big hospitals where one can see a clinician who has seen your particular condition before. Diagnosis sometimes benefits from centralized hubs of experienced people.
But even diagnosis can be improved when the clinicians include and demonstrate respect for the local context of a person’s life. And for follow-up and care, it is absolutely imparative that local people be the front line. Tele-mental health is not the answer, nor is pulling people out of their community to receive treatment.
In my training as a psychologist 30 years ago in Burnaby, I was stunned by the easy repetition of bigoted stereotypes of rural people. My instructors were baffled that I would want to practice in a rural area, and they had absolutely no knowledge to pass along to me about the special challenges or joys or perspectives that this would entail. Having recently gone through an investigation of my practice by the College of Psychologists, I can say that this attitude has become institutionalized. People who have never lived outside the urban centers do not believe that professional and competent treatment is possible outside of urban centers, do not believe that there is anything about living outside of the urban centers that they need to learn about, and are stunned at the thought that working outside of the urban center is a specialty in its own right. Without this understanding, they can only see the care offered in Campbell River or the Comox Valley as sub-standard (because the city is the standard). The answer, with this mindset, is to pull expertise out of our communities rather than build it here.
As tele-health has developed, this indifference, even disdain for rural care has deepened.
VIHA and the Health Professions Board need to hear that when they pull services out of our communities, or when they fail to apportion our fair share of the health care budget to our communities, it’s a justice issue, a health care quality issue, an economic issue, a human issue. We have expertise, and we can build context-appropriate expertise when we are given the tools to do so.
Just a small example: Why not ask how Warm Autoimmune Hemolytic Anemia can be diagnosed with out local labs?. The blood needs to be tested WARM not put in an ice box and shipped to Victoria for 3 hours. We were fortunate to be allied with a medical center in the US. We watched as the phlebotomist took the blood sample, put it under her armpit and ran it to the lab. Voila! One of our friends near Campbell River couldn’t get a diagnosis to his odd symptoms. I mentioned to the Doc to look at my husbands records and compare them to our friend. Our friend was sent to Victoria where they could process his blood sample properly. He was diagnosed and treated effectively and is a healthy contributing active older gentleman.
Medicine is not a practice anymore. It is a business.
Love this statement “ VIHA extracts capital funding from local taxpayers with the blessing of a provincial government that thinks it cannot be held to account?” There is no accountability on the part of VIHA. There is no accountability on the part of the BC Government.
If you are concerned about the care you received at the hospital you can complain to Patient Quality Care Office. They state: “When you make a care quality complaint we work with you to resolve it.” I made a complaint. Started it on Nov 5, 2018. (No, that is not a typo – 2018) It still isn’t resolved. They told me it is. I told them it wasn’t. Now we are at the court stage.
If you don’t like PQCO resolution you can contact a BC government office called Patient Care Quality Review Board. But you must finish with PQCO first, then proceed to the BC Government Review Board. When you contact them, they admit they are back logged. They also state that they can review, respond with recommendations, but they have no authority to make any change at the hospital level as their Review Board is only advisory. Why are we taxpayers shelling out money to have a BC Government Board when VIHA doesn’t have to follow any of the recommendations? My comment was, I am sure those recommendations go right to the shredder.
So I guess the Comox Strathcona Hospital Board is classed the same as the Patient Care Quality Review Board. They can consult but then VIHA does whatever they want anyway.
Listen to the AUTHORITY and do what you’re told. We, you, no longer have any voice! We are governed like children. We are over powered by Bureaucracy ! Time to make a change. Decentralize government and return to local governance. Disband the so called Health Authority and other control groups. CRD, Island Trust, …..?
Anyone who thinks our medical is now free is very naive, nothing is free, most all premiums will now be collected by the EHT)Employer Health Tax, so added cost to the running a business, guess who is going to pay for that ,the consumers with increased cost of goods and an increase in municipal taxes to cover the cost.
VIHA is a good example of an organization put in place by government to act as a buffer between it and the public and/or as a means of privatizing public services. It is given way too much autonomy and the government can easily say “Well, we have this organization tasked to manage heath care on Vancouver Island. We don’t want to interfere in how it does its job.” It’s obvious the board of VIHA is hamstrung and has failed in its governance responsibility to direct staff with policy that is in the interests of the whole population of Vancouver Island. Like you write in your article, George, we do have a fairly sound basic health care system and the fact is we have to fight to keep it. VIHA, like any organization, has its own survival and prosperity as its primary goal whatever it says in its promotional material.
I was diagnosed three months ago with multiple myeloma, bone marrow cancer. It’s incurable but treatable. I have an oncologist, but he’s in Victoria at the Cancer Centre. He’s great, and I can reach him when I need to but for us in the Comox Valley, the oncology team here is crucial. One major concern I have is with pathology services. I had a bone marrow biopsy a couple of months ago performed by a pathologist here, Dr. Bellamy. It’s great that we can have this done here for two reasons. One is that if I had to travel to Victoria to have this procedure done it would cost the system a lot of money for travel, accommodation, etcetera, but two, the stress of driving to Victoria while already very ill is bordering on inhumane. Of course, one of the effects of concentrating health services in Victoria is a downloading of costs on patients and making the VIHA financial statements look better. VIHA is all about VIHA but VIHA is all about the senior management and its stranglehold on the organization. The fact that VIHA can sign a deal with a private corporation of Victoria pathologists which aims to monopolize services for the whole island is appalling to say the least and flies in the face of public interest. Enough for now.
Thanks, George, this important coverage and commentary! Our communities very much need our municipal elected officials to step up and advocate for improvements in our healthcare system. Decisions about solutions for affordable housing, homelessness, mental health and addictions, transition care, urgent and primary care, seniors care including homecare, daycare and long term care all affect demand on our limited hospital acute care beds and the quality of healthcare and life of our citizens. For example, in June (non flu season), the Comox Valley hospital average monthly capacity was 122% with 58 of the 147 acute care beds occupied by persons who did not require hospitalization but had nowhere safe to go. Most are waiting for a care bed to become available. A review of news stories and the websites for other hospital boards around the province show that other communities have benefited from this kind of advocacy and yet our hospital board is struggling with whether or not it should be involved in advocacy because it’s about operations and Island Health is responsible for healthcare operations!?! It is deeply concerning that a number of our hospital board members have little to no awareness about the overcapacity problems at our hospital and show little interest in finding out more let alone come to the meetings informed and prepared. If they can’t or won’t step up to do more for us than show up, rubber stamp expenditures and vote themselves a pay raise for their meeting attendance then they really should stop wasting tax payer dollars on so many meetings and stop fanning expectations for those in our community who really care, that they will actually do something…
Our decling hospital care hurts me where it counts. My husband and i worked in and retired from St Joseph’s Hospital after our 30 plus year careers.
Seriously i have been watching, with dismay, our valley health care since VIHA took over. This shameful beauracy is at its most crass now. “Follow the money” Should not be the our health care’s mission statement. Who, exactly, decided to take away the pathology services? Could it be a member of the VIHA administration who is involved with the Lab in Victoria? Is this a conflict of interest which compromises health care on the North Island ? This information must be available through the Freedom of information act.
I do hope that our elected representatives are keeping appraised of this situation and advocating for us.
Rolande, you can read our three-part series on the removal of certain pathology services here.
As a retired Medical Laboratory Technologist, I cannot emphasize how accurate and well explained George Le Masurier’s series of articles about VIHA’s decisions to reduce laboratory services on the North Island will negatively impact North Island patients. Shipping specimens long distances always has a more negative impact on specimen integrity, turn around time for results and patient service vs. having the work done in-house. The North Island was previously already well served by General Pathologists, and now the North Island has a partially functioning hospital that no longer serves its needs and a health authority that seems deaf to the patients it is supposed to serve. There is no longer a Medical Technologist at the Campbell River Hospital, only one Laboratory Assistant, and if that Assistant is sick or on holiday, the C.R. Lab must shut down altogether. North Island patients deserve better service for the taxes they pay. VIHA is reducing medical services to the North Island to 3rd world country levels. People should be outraged and demand restoration of laboratory services to the North Island. What medical services will VIHA remove next?
Very well said…the BC Liberals are 100% responsible for creating this mess but I really hope the NDP can and will fix it! VIHA heads really need gone…
Excellent article! Clearly, the hospital district board members who are our councillors, area directors, and mayors, must advocate for their constituents if they hope to get re-elected or move on to senior government. We need our elected officials to fight for us!
And why do we have fewer beds for mental health patients with the New Hospital? The number of beds was inadequate before! When these patients are in crisis they need help now not to be put on a waiting list!
Not only did they remove 7 beds from St. Joe’s to the new hospital, they also completely removed mental health care beds from the Campbell River hospital. I don’t know what their rationale (money?) was for that, especially in light of the opioid crisis.