NDP'S MUCH-LAUDED CLINICS AILING BADLY
Primary care networks were set up to relieve emergency wards; they aren't
While the billion-dollar provincial museum makeover was a major embarrassment for the New Democrats during the legislature session just ended, they also had to explain big holes in their reforms of primary health care.
Health Minister Adrian Dix has made much of primary care networks — medical practitioners linked by an administrative network to provide team-based care — and urgent and primary care centres: bricks and mortar facilities to supplement walkin clinics and emergency wards within a given community.
Dix has repeatedly cited the combination as the future of primary care and as a substitute for the growing shortage of family doctors.
The credibility of those reforms took a major hit in mid-may when the Opposition obtained the Health Ministry's figures on actual staffing within the primary care networks and the urgent and primary care centres.
Up to that point, there had been anecdotal reports about networks faltering for lack of doctors and clinics with discouraging waiting lists and reduced operating hours.
But the Health Ministry had been dragging its feet in responding to media requests for actual staffing levels and now its reasons were evident.
The Richmond primary care network, open for three years and funded for 32 fulltime physicians, reported only one physician.
The Nanaimo urgent and primary care centre, one of the first, and announced by the New Democrats in a 2019 byelection campaign, was funded for 16.83 full-time equivalent positions. Actual staffing: 5.73.
And so on. Ironically, at one point this week, Premier John Horgan declared “you can't provide health care in a stack of press releases.”
Yet the government files overflow with promises on urgent and primary care centres. Some were announced several times. None of those news releases came with a caveat that “actual results may differ from our claims.” Increasingly, medical practitioners were speaking out about the credibility gap around the centres.
“There's this false narrative that's being presented that (the centres) are going to somehow take the pressure off the emergency department,” said Jeffrey Eppler, an emergency room doctor at Kelowna General Hospital. “That's a convenient narrative for administrators and ministries of health, but is really largely untrue.”
Granted, the urgent and primary care centres are extremely busy. But they are not providing a solution to the problem they are intended to solve, according to Eppler.
“There's some very, very excellent doctors and nurses that work at (the centres), providing good care,” he told Gloria Macarenko during a lengthy interview on CBC'S On the Coast. “To present it as a solution to our health care ills, I think, is simplistic and actually dishonest on the part of administrators and governments.”
Peter Gladstone, a cardiologist based in the provincial capital, noted the government had spent $100 million on the centres and none were fully staffed, and few were providing continuing care.
“They basically provide walk-in care, at two to three times the cost of a family doctor,” he told Cindy Harnett of the Victoria Times Colonist.
“You could put a (centre) on every street corner, but they'll be of less use than a Tim Hortons unless they've got doctors in them — qualified doctors providing longterm comprehensive care.”
The anecdotal evidence continued piling up as well.
Brett Mineer, host of the morning show on CHNL radio in Kamloops, reported his wife's experience this week in trying to get a prescription for antibiotics.
Not available through a virtual network and there was an all-day wait at the emergency room at Royal Inland hospital, which is heavily overloaded. So, she called the Kamloops urgent and primary care centre, which opened three years ago. The centre “told us the best they could do is an appointment on June 13,” two weeks hence, Mineer reported on social media.
This did not sound much like the commitment to “urgent” care, reflected in the title of the facility.
In defence, Dix continued to insist that this was all part of the plan. The centres are staffed at 53 per cent, close to the Health Ministry target of 55 per cent.
“We're on track,” he assured Gregor Craigie on CBC'S On the Island this week.
Pressed, he and the premier blamed the pandemic with significant numbers of health-care workers booking off sick.
The New Democrats blame COVID-19 for their troubles when it suits them, yet trumpet their success in managing the pandemic through a propensity for taking premature victory laps.
For instance, this week Dix brushed off the UBC study that documented how B.C. has led Canada in excess deaths during the pandemic.
On the contrary, said the health minister, “If you look at the numbers, they're pretty clear we have the lowest mortality rate due to COVID-19 of any equivalent jurisdiction in North America. Overall, the response in B.C. at every level has been the best in Canada.”
So say the numbers he controls.
But the UBC study on excess deaths is just the latest evidence of the need for an independent inquiry into B.C.'S handling of the pandemic.
The week ended with the government still under fire over urgent and primary care, and a telling comment from B.C. Liberal MLA Peter Milobar.
He noted that the clinics have acquired a nickname, a play on the initials UPCC.
“Within the health-care system right now, they're calling then `oopsies' because they're not working.”
One thing to have people angry and disappointed with the health-care reforms.
But when they start laughing, it is time to revisit some assumptions.
The Richmond primary care network, open for three years and funded for 32 full-time physicians, reported only one physician.