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Peter McKenna on Community Health Centers

November 7, 2018

One of the BC Rural Health Network’s community members, Salt Spring Island released two videos, interviewing Peter McKenna, Executive Director of the Rideau Community Health Services in Ontario, Canada.

With many thanks to the Salt Spring Island Community Health Society, and Peter McKenna.

https://youtu.be/jrnPyGPwdHw

https://youtu.be/JiTObivvgTI

Rural Coordination Centre features BC Rural Health Network

October 30, 2018
A delegation from the BC Rural Health Network posing with rural researchers at the 2018 BC Rural Health Research Conference which took place in Nelson, BC

A delegation from the BC Rural Health Network posing with rural researchers at the 2018 BC Rural Health Research Conference which took place in Nelson, BC

This grassroots organization may be young (it started up in December 2017) but has much wisdom to share.

The BC Rural Health Network is a collective of small communities working collaboratively to advocate for improved health service delivery in rural BC. 

The idea to create this group came after a presentation by the Princeton-based Support Our Health Care (SOHC) group at the BC Health Coalition Conference in 2017. SOHC presented a “how-to” workshop on organizing a Community Consultation on Health Care. 

The response to the presentation was overwhelmingly positive, and SOHC found itself being approached afterwards by other organizations who either had similar expertise to lend, or who wanted to draw on the hard-earned wisdom of SOHC and other seasoned rural BC community health care advocacy groups. A few weeks later, the BC Rural Health Network was formed with members from the communities of Ashcroft, Nelson, Sicamous, South Shuswap, Trail, and Princeton taking part.

Although the network is still establishing itself in a formal sense – terms of reference for the organization are in the process of being finalized – it has hit the ground running, organizing meetings with key stakeholders (including the Ministry of Health), connecting with other rural communities and adding to its membership, hosting conversations with rural physicians through the Divisions of Family Practice, and planning next steps. 

If your BC rural community is looking for information, support, or ideas about how to improve and sustain health care services, check out the BC Rural Health Network online or on Facebook. We’re all in this together.

Rural Coordination Centre of BC 

https://rccbc.ca

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Thunder Bay’s Rapid Access Clinic for hip, knee conditions cuts wait times from years to weeks

October 14, 2018

“This is the most modern arthroplastic program in the world,” says one of clinic’s 4 orthopedic surgeons

Orthopedic surgeon Dr. Dave Puskas (far left), Rapid Access Clinic program director Caroline Fanti (left), patient Laurie Horlick (centre) and orthopedic surgeon Dr. Travis Marion (right) stand in a treatment room at the innovative new clinic at the Thunder Bay Regional Health Sciences Centre. (Cathy Alex/CBC )

Orthopedic surgeon Dr. Dave Puskas (far left), Rapid Access Clinic program director Caroline Fanti (left), patient Laurie Horlick (centre) and orthopedic surgeon Dr. Travis Marion (right) stand in a treatment room at the innovative new clinic at the Thunder Bay Regional Health Sciences Centre. (Cathy Alex/CBC )

The new rapid access joint clinic at Thunder Bay Regional Health Sciences Centre is cutting wait tijmes for hip and knee replacements from years or months, to weeks or even days. 8:00

The Thunder Bay Regional Health Sciences Centre (TBRHSC) is leading the province with its Rapid Access Clinic, an innovative new central intake and assessment model for treating people with hip, knee and spine conditions, says Caroline Fanti, the program director.

“This is the most modern arthroplastic program in the world, it really is,” says Dr. Dave Puskas, one of the northwestern Ontario clinic’s four orthopedic surgeons, and the co-founder of the program with Fanti.

Patients are referred by their family doctor to the clinic, which then acts as a one-stop shop for consultations with orthopedic specialists and ultimately surgery if required.

Once enrolled in the program, the patient is assessed and then agrees to be cared for by the next available doctor from a pool of orthopedic surgeons, who also take turns working in Dryden, Fort Frances and Kenora.

‘More streamlined care for patients’

Putting aside the natural competitive instinct between surgeons was key to developing the program, said Puskas.

“We’re kind of territorial but my partners are very progressive and they listened to this as an idea and they chewed on it for awhile and it became acceptable, and we really have been able to provide more streamlined care for patients,” he said.

The program has cut the wait time for a consultation from nine months to just two to four weeks, with 90 per cent of surgeries being completed in less than six months, as opposed to two years.

‘I’m seeing people who need to see me’

“It means that I’m seeing people who need to see me, instead of me trying to pay attention to someone who really doesn’t need to see me, and I’m no longer dealing with the comment ‘What? I waited two years for you to tell me this!’ because they’ve already been in and seen someone who told them they were not an operative candidate”,  said Puskas, pointing to another unique aspect of the clinic.

The program also brings together physiotherapists and doctors in a much more collaborative environment.

“We don’t always trust each other’s diagnoses, so we had to go through a period of time where we really got on the same page and used evidence from the literature to guide how we would deal with each different thing”, he said.

That new respect is also translating into better service for patients, said Puskas, explaining he was able to see 30 patients in the fracture clinic, while his advanced practice therapist colleague cared for another 14, with the understanding he was always available if his expertise was required.

Quicker access means less pain, fewer painkillers

“So basically she was able to put 50 per cent more patients through and have them have the confidence that they had the attention of the surgeon if they’re needed.”

Quicker access to specialists and a shorter wait for surgery is having a dramatic effect on people’s quality of life, said Fanti, the program director.

“It reduces anxiety and stress. It’s decreased lost time off work and it’s also reduces the risk of narcotic dependence because you’re not using pain pills to manage your pain and it also reduces unnecessary tests ordered that may not impact your plan of care.”

Laurie Horlick, who was referred to the clinic in April 2018 and had her hip replaced in August, described her experience with the clinic as “amazing.”

‘I would do it again in a heartbeat’

“I talked to so many individuals and they were totally flabbergasted when I told them when my surgery was actually happening. They said ‘are you serious? people wait two years!'” said Horlick.

“If I had to, I would do it in again in a heartbeat.”

Fanti said they are planning to build on the success of their hip and knee replacement program and hope to soon include more back and spinal patients as well as people with shoulder, ankle and foot conditions.

As well, they also plan on making telehealth consultations available to people in their homes.

You can hear more about the Rapid Access Clinic from Dr. Dave Puskas and Laurie Horlick on CBC’s Superior Morning here.

Updates on the Brian Day case by the BC Health Coalition

October 14, 2018

We are at a turning point in the Cambie Case – the Plaintiffs (Cambie) will complete their part of the case by the end of this month. Starting in November, the other parties, including our intervenor group, will have their say. The Defense will start their case in January 2019.

Brian Day’s cross-examination:
Brian Day, CEO and President of Cambie Surgeries Inc., started this Charter Challenge back in 2006 after he learned his clinics were going to be audited by the BC Government. The audit was triggered by dozens of complaints by patients who complained they had been illegally overbilled at Cambie’s clinics.

Finally, last week, Brian Day took the stand and was cross-examined about his affidavits, his public statements and his business practices. His time on the stand was both confusing and illuminating at the same time, with Day contradicting himself repeatedly throughout the three days. For a more detailed description of his cross-examination, click here.

The provincial lawyer concluded his cross-examination by accusing Day of fraudulent billing activity at his private clinic, stating,
“I’m going to suggest, Dr. Day, that it’s quite remarkable that your physicians are prepared to accept a cheque, the basis for which they have not been told, over a period of years, with no documentation anywhere, nothing in writing explaining what the basis of that payment is, and I’m going to suggest that that is a very suggestive arrangement, a very unusual and a very suggestive arrangement…of the company’s awareness that what was going on was not legitimate, that it was, to…use your terminology, fraudulent.”

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The Case – what comes next:
Now, our lawyers are working with our two key experts before they take the stand to be cross-examined by Cambie’s lawyers: on November 26, Dr. Marie-Claude Premont (an expert on the impacts of the Chaoulli decision in Quebec) and on December 3, Dr. David Himmelstein (an expert on the relationship and links between the US and Canadian health care systems).

Then, in January, the BC Government, who are the Defendants in this action, will argue their case. Their case will conclude by April 2019, followed by Closing Statements by all parties later that spring. Finally, there will be the Judge’s ruling, which will come sometime in the months following the end of the trial.

Extra-billing and the injunction application:
Extra-billing is a key focus of the Cambie case – Brian Day is trying to make it possible for doctors to extra-bill (to charge patients unlimited amounts for any procedure).
In April, the government enacted legislation increasing the fines that doctors and clinics could receive if they extra-billed patients for services covered by MSP, along with other protections for patients.

In reaction to this move, Cambie applied for an injunction to stop the enforcement powers (or in other words, to be able to continue to extra-bill) until after a judgement is made on the entire Cambie trial – which could be another year. Judge Winteringham, who heard the injunction application, will make her decision within the month. In the meantime, the start date for the new patient protections is on hold.

Public health care matters and we appreciate that you are here with us fighting so that everyone gets the care they need, when they need it, where they need it, and not only if they can afford it.

Without your support, we would not have been able to continue to hold Brian Day and Cambie Surgeries to account, both in the courtroom and in the media.

We are working to ensure that not only Brian Day’s false promises (that two-tier health care will improve wait times) are debunked, but that the public knows what this case is really about: removing the protections that ensure patients can get care based on their need and not their ability to pay.

Terrie Hendrickson
Coordinator, BC Health Coalitionhttp://bchealthcoalition.nationbuilder.com/

Responses on Health Matters from Candidates for Princeton Municipal Office

October 5, 2018

Responses on Health Matters From Candidates for Princeton Municipal Office:  Warm appreciation to all.

The Responses below are printed with the content as received. No editing has been done. They are listed in alphabetical order under Candidate name.  The numbers correspond to the following questions:

  1. If you become mayor/councillor, where would you place the health care issue on your list of priorities for Princeton?
  2. In your opinion, what are the main health care issues for Princeton?
  3. What suggestions can you offer to improve our community’s health care model?
  4. Two of the social determinants of health are poverty and lack of housing. What is your position on this issue? Would you be in favour of establishing low income housing in Princeton?
  5. What is your view on the Ministry of Health initiative to establish Primary Care Networks (PCN) as a way to improve access to primary care in BC? What are your thoughts on the Community Health Centre and Patient Medical Home models and their role in the PCN initiative?

Candidates for Mayor

Frank Armitage:

1. Health Care is, and must remain a top priority for our Town Council

2. Ensuring we have the allotted number of Doctors  (6) in our  Community

3. Work with Interior Health and our Doctors (as we do) to insure a positive progressive relationship

4. Low Income Housing is managed by our Community Services Group and I am working with Executive Director Connie Howe for more Low Income Housing Units

5. These are good plans that are now being implemented in the Rural Communities. The Ministry of Health and Interior Health are working with the Doctors on these plans to increase the levels of Service available

Leona Guerster:

I believe Council should maintain an open and respectful dialogue with the Province in regards to Health Care. Healthcare is a priority. I would love to see our Hospital become more than just Primary Care, I lived here at the time when babies were delivered and operations including elective surgeries were performed. Municipalities, unfortunately, are not the governing or decision making bodies when it pertains to Healthcare.

Spencer Coyne:

1. Health care is high on my priority list. I would maintain the Town’s commitment to the Steering Committee, stay dedicated to maintaining our doctor numbers and start looking at ways to increase mental health and drug & alcohol resources for our community.

2.

1. Shortage of mental health workers

2. The opioid and drug problem in town

3. Maintaining service levels

3. There are two answers to this question. First I think communities need more direct input into what is needed in a local health care model. Secondly, I think we need to do more to increase and improve access to metal health. We also need more drug abuse assistance. We need outreach, counseling and maybe even a way to detox our residents at home and have more spots in a treatment centre once they are out of detox.

4.  I have talked to the housing manager for Princeton’s low income housing we have a waiting list for low income senior and family living units. I believe we need to lobby Victoria to build more units or find an alternative way to have more low income units built in Princeton. There is an old saying that “a chain is only as strong as its weakest link” if we consider this when we look at the community when we have vulnerable members of our community that cannot access basic necessities like housing we must ask ourselves how strong is our community.

Tackling poverty is a complex issue and is not something that you jump into without understanding it. In order for a true poverty strategy to be successful you must have mental health supports in place, you must have affordable housing in place and you must have support mechanisms to make sure that people do not fall through the cracks. We need to do more to support the local food bank and Princeton Crisis these two organizations are on the front lines along with social workers, school teachers and mental health workers we need to look at a collaborative approach to dealing with the overall issue of poverty. Read more »

Universal Pharmacare and Federalism

September 24, 2018

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Policy Options for Canada

COLLEEN M. FLOOD, BRYAN THOMAS, ASAD ALI MOTEN AND PATRICK FAFARD | SEPTEMBER 12, 2018

Canada is the only OECD country with universal health insurance that does not include coverage of prescription pharmaceuticals. Some provinces have taken steps to provide drug insurance coverage for the poor, the elderly and people facing catastrophic costs (there are some 70 drug funding programs across the country). However, access to essential medicines depends on factors such as age, medical condition, income and province of residence. It is estimated that approximately 20 percent of Canadians have no drug insurance.

A number of reports have recommended that Canada’s public health services be expanded to cover pharmaceuticals. This possibility is now under serious consideration, with the establishment by the federal government of the Advisory Council on the Implementation of National Pharmacare, led by Eric Hoskins (a former Ontario cabinet minister). The council is mandated to report by spring 2019.

This study explores options for universal pharmacare in the context of Canadian federalism. The authors define universal pharmacare as a system of insurance for important medicines that is progressively financed (i.e., contributions reflect users’ income) and has no access barriers due to costly copayments. Such a system would ensure access to important medications for millions of Canadians and improve the return on investment for the money spent on pharmaceuticals. However, there is very strong opposition to universal pharmacare from private insurers and pharmaceutical companies, which often argue for “filling the gaps” rather than comprehensive reform.

The authors outline two policy options that, based on their analysis, are feasible given the constitutional division of powers. The first would be for the provinces to delegate the power to administer drug insurance plans to a new arm’s-length agency funded by the federal government. An example of such an organization is Canadian Blood Services, which on behalf of the federal, provincial and territorial governments is responsible for the provision and management of a $500-million drug portfolio.

The second option would be for the federal government to adopt legislation similar to the Canada Health Act and provide an annual pharmacare transfer to the provinces and territories. This would give them flexibility in the design of their respective insurance systems, with federal contributions contingent on compliance with two critical criteria: (1) universal coverage should be provided for a basket of essential drugs, without copayments or deductibles; and (2) decisions over what to include in the basket should be made by an arm’s-length body (or bodies) that would negotiate with drug companies for the best prices.

The authors point out that, under either option, private insurers would not be eliminated. However, their business model would need to change to focus on brands of drugs not included in the universal public plan. Read more »

Vancouver health authority ends contract with private surgery centre over patient-pay issues

September 5, 2018

PAMELA FAYERMAN Updated: August 30, 2018

Vancouver Coastal Health is ending a contract with False Creek Healthcare Centre, and as of next week 115 surgeons and anesthesiologists with privileges at regional public hospitals won’t be able to use the operating rooms at the Vancouver clinic.

Dr. Dean Chittock

Dr. Dean Chittock

A memo to medical staff from a vice-president of Vancouver Coastal Health, Dr. Dean Chittock, said the health authority “made the decision to repatriate False Creek surgical activity back to the health authorities effective Tuesday, September 4, 2018.”

The change comes a month before new legislation comes into effect imposing harsh penalties on private clinics and physicians where medically necessary services are paid for directly by patients seeking faster treatment. Private clinics have gone to court seeking an injunction to block the bill that will be effective as of Oct. 1. There are dozens of private surgery clinics in B.C. which have always offered three streams of patient service — publicly funded (through health authority contracts), privately funded for expedited service and third-party treatment for agencies like WorkSafeBC and certain patients covered by federal government agencies.

For a few decades, health authorities have been contracting out day surgery cases to private clinics because of over-capacity problems causing long delays in non-emergency, non-urgent surgeries. Last year, Vancouver Coastal Health paid False Creek clinic $1.9 million for a range of operations or other treatments on patients who would otherwise have to wait many months or even years for procedures like hernia repairs. The year before, the private clinic received just under $1 million. In the past three years, Vancouver Coastal Health has contracted with the False Creek clinic for about 3,400 cases.

Read more »

A new physician for Princeton

September 1, 2018

Version 2

Dr. Marlin Samuels will be the newest member to the Cascade Medical team. Originally from Paarl in the Western Cape of South Africa, he completed his medical degree at the University of Stellenbosch. Dr. Samuels has experience in rural family medicine and emergency medicine with special interest in internal medicine and infectious disease. Dr. Samuels is an adventurer having worked onboard cruise ships prior to relocating to Canada. He was attracted to Princeton by the surrounding nature and abundance of outdoor activities in the area as well as Princeton’s reputation as an exceptionally kind, caring and welcoming community for new doctors. Dr. Samuels has recently completed the Spring intake of the Practice Ready Assessment Program of BC and will be providing a 3 year return of service in Princeton beginning in late August. We hope that you will warmly welcome Dr. Samuels to our community. 

To get on the waitlist for a family doctor, please stop in at Cascade Medical Centre and fill out our Request for Attachment form and return it to the clinic at your earliest convenience, you can also find a copy on our website at www.cascadeclinic.ca.

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Princeton Health Care Steering Committee Report

August 20, 2018

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July 27, 2018

Submitted by Edward Staples, Princeton Health Care Steering Committee

On Tuesday, July 17 , the Princeton Health Care Steering Committee (PHCSC) held its monthly meeting at Princeton General Hospital. The PHCSC was formed in 2013 to provide a mechanism for Interior Health, the Town of Princeton, the Regional District of Okanagan-Similkameen, Cascade Clinic, Princeton General Hospital, and community organizations to work together to support stable, sustainable and accessible health care in Princeton.

This month’s meeting was attended by representatives from the Town of Princeton, Area H (RDOS), Cascade Medical practitioners, Princeton General Hospital staff, Interior Health, BC Ambulance Services, Princeton and District Community Services, Princeton Family Services, RCMP, the Princeton community, and Support Our Health Care (SOHC). The meeting was chaired by Interior Health administrator, Susan Brown.

The following are communication points from the meeting:

  • Jim Bruce is the new Area H (RDOS) representative, replacing Sandra Lawlor who resigned her position on the committee; the Steering Committee thanks Lawlor for her contributions in support of the committee’s activities
  • Jim Bruce made a presentation on issues pertaining to the pharmaceutical needs of new people coming to Princeton (see attached); Dr. Van Der Heide will take the information forward to see about posting on the Cascade Clinic Website (www.cascadeclinic.ca)
  • Dr. Van Der Heide provided information on the waiting list for people wanting attachment to a practitioner; there is an application form available at Cascade Clinic
  • the Princeton Community Paramedicine program provides a bridge to health servicedelivery gaps in the community, identified in collaboration with our local primary care team. Our Community Paramedics have become an integral part of our community- based team of health service providers. People interested in accessing their services can contact the Princeton Home Health Nurse at 250-295-4442.
  • in response to queries from local residents about Princeton’s Alzheimer’s support group, the following information is provided:
    • support for Alzheimer’s caregivers is provided through the Caregiver Support Group run by Jennifer Clement, Home Health Social Worker
    • the group meets the 2nd and 4th Thursday of the month giving support for people providing home care to loved ones with declining abilities
    • no referral is necessary; to participate in the group, caregivers can contact Jennifer Clement by phoning 250-295-4464

• the BC Alzheimer’s Society in Penticton would like to start a separate Alzheimer’s support group in Princeton and is looking for volunteer help. If interested, local residents can contact Jennifer Clement at the number above

Letter to the Editor

July 30, 2018

Pharma

Letter to the Editor

Princeton Similkameen Spotlight

William L. Day

11 July 2018

The House Of Commons All-Party Standing Committee on Health has recently endorsed and recommended the implementation of a Canadian Pharmacare Program.

Many currently healthy people are not aware that prescription drugs are covered by our Canada health insurance only while the client is in hospital. Insurance outside the hospi- tal varies greatly among provinces and territories.

For example, the same out-of-hospital cancer treatment can cost you $0 in Nunavut; $3,000 in BC; $20,000 in PEI.

Currently, Canadians pay more for prescription medications than citizens in any other of the 29 wealthy OECD countries except Switzerland and the USA.

More than three million Canadians are under-insured or uninsured for prescription drugs outside approved hospitals.

Researchers have found that overall, 5.5 per cent of respondents across Canada reported they couldn’t take their medications as prescribed because of costs. In B.C., the proportion falling through such cracks in the health system was highest among all provinces and territories, at 8.11 per cent.

Unlike all other industrialized countries, neither the USA nor Canada have established a drug plan that would allow their national governments to negotiate drug prices on behalf of their entire population.

In summary, Canada remains the only industrialized country with universal health insur- ance but no national Pharmacare strategy for its citizens.

The Support Our Health Care Society (SOHC) of Princeton will be doing its best to acquaint Similkameen residents with our collective problem and opportunity. We will be providing information in Princeton at retail outlets and surveying our local public on the issue. We intend to inform our MPs and MLAs of our activities and findings. To date, they have been very receptive. Readers are encouraged to go to the government website to read the original complete document and join the discussion:
https://www.letstalkhealth.ca/pharmacare.

The power to engineer this change lies with us, with Ottawa and our collective Members of Parliament and MLAs. They are listening and waiting for us to signal our support for change.

The Time Has Come.

Yours respectfully,

Bill Day, Vice President, Support Our Health Care Society, Princeton BC

BECOME A MEMBER

To become a member of SOHC, please
email the secretary.
Annual membership is $2.
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SOHC Discussion Paper

Developing an Improved and Sustainable Health Care Model for Princeton, B.C
Support Our Health Care has released a discussion paper in order to get feedback from the community, politicians and professionals about the state of local healthcare and what the long term solutions should be.
Download PDF Here