in aris

Part IT
by Tod Strachan

‘The Royal Commission on
Health Care and Costs visited

Terrace on Sept. 5 and from that.

came a regional concept of pos-
sible health care changes in our
part of the province. It will likely
be some time, however, before we
see any changes... if changes are
made at all.

The Royal Commission on
Health Care and Costs was estab-
lished by the provincial govern-
ment last March as an independent
investigative body free to make
recommendations for the improve-
ment of our health care system
with no interference from the
province. Under its mandate, the
commission is to study the present
health care system and its struc-
ture, management, funding and
underlying policy.

In addition, they are to look at

requirements for professional per-
sonnel, prescription drug programs,
the use of advanced technology
and the promotion of good health.
But their duties don’t stop there —
they have also been asked to take
their investigation one step further
and look at factors beyond the
present health care system; for
example, the promotion of good
health as a method of reducing
health care costs. -

Sitting on the commission are the
chairman, Justice Peter Seaton who
has been a trial judge with the
Supreme Court of B.C. and since
1977 a judge on the B.C, Court of
Appeal; Marguerite Ford, a direc-
tor of the Vancouver Board of
Trade and until recently the execu-
tive director of the Alzheimer's
Society of B.C.; Robert Evans, a
health research scientist at UBC,
Kenneth Fyke; a former deputy
minister of health in Saskatchewan
and the current president of the
Greater Victoria Hospital Society;

and David Sinclair, a recently

retired senior partner of a major
national accounting firm.

But what are the primary health
care concerns in the northwest?
The commission heard 17 oral
presentations in Smithers on Sept.
4 and thesé covered everything
from the election of hospital
trustees to capital funding prob-
lems and difficulties in finding
staff. Also covered were medica-
tion and costs, the cost of travel to
Vancouver specialists, quality
versus quantity of care and the
need for extra billing services for
the mentally handicapped.

There were around the same
number of presentations in Prince
Rupert and the concems were
similar. Manpower recruitment and
retention, the current funding sys-
tem (particularly the way in which
it penalizes rehabilitation prog-
rams), the cost of. visiting special~
ists in the south, the need for
public health programs and prom-
otion, and something a little dif-
ferent — elected versus appointed
hospital boards. .

And there were few differences
in Terrace. Ruth Hallock repre-
sented the City of Terrace and
talked about the regional nature of
health-care services offered here as
well as the impact of drug and
alcohol abuse on northem com-
munities and the need for a detox
centre in Terrace. Hallock referred
to alcohol and drug abuse as our
number one health concern and
said the cost of abuse — debilitat-
ing accidents, beatings and fetal
alcohol syndrome — could be seen
in the faces of our children. And
how all of this is preventable with
a little help from the province.

- A possible solution was offered
by Marguerite Ford, but on her
own admission, its something that
might be difficult to achieve.
Limiting the number of liquor
outlets and their hours of operation
might help, she suggested, but it

would. have to be a reasonable
compromise. "I think there would
be a tremendous outcry if we
closed the bars and boarded up the
liquor stores," she admitted.

A presentation by Dr. David
Bowering, medical health officer
for the Skeena Health Unit,
expressed the problem of substance
abuse in the north in a slightly
different way. Life in the north is
different. Rather than large urban
centres, there are widely dis-
tributed small, one-industry towns
which in general have a much
younger population than is found
in the south.

The net result of these dif-
ferences: A frontier attitude where
people take greater risks than in
other parts of the province. There-
fore, there is a greater tisk of
dying if you live in the north,
regardless of your age. Infant
mortality, for example, is higher
than in any other part of the pro-

The problem is compounded by
the fact there are twice as many
teenage mothers on a per capita
basis and in general they have
greater difficulty raising their
young than older women do. This
provides a unique pattern that
tends to keep our frontier attitude
alive, And in addition, the problem
of conflicting value systems
between Native and white com-
munities is much more pro-
nounced. a |

A solution, says Bowering, is far
from simple. We need more medi-

cal specialists and more general |

practitioners. Often, medical per-
sonnel who chose to work in the
north find the demand for medical
treatment far exceeds the scope of
their medical training. Not because
they are improperly trained, but
because the distribution of exper-
tise doesn’t necessarily match the
needs of individual communities.

We need training institutions in|

the north. We need resources for
prevention. We need to find a way
to attract medical personnel to the
‘north. David Sinclair agreed.
Medical expertise in the north is

often as widespread as the com- .

munities that are served, and he
noted that the commission had

Terrace nurse Sonja Willits Is this year’s recipient of the Nora Langley bursary, giving her $300
to help finish her Bachelor of Science in nursing studies. The bursary, prasented by Terrace
Registered Nurses of B.C. chapter president Ellen Bentham, honours the memory of Nora Langley,

a Terrace public health nurse who was killed In a car accident in 1977.

TSS Tak ie .

crgrageily ot pec im A nk orc : eben ab enae chewy wry pgm agp tee a pepe tc uae co eee MBAs
hat TRA A RON SEP Ee seer Rear ache Ce oe im aking asinine OPT RT ge EA EET SUE APT a GD AB

‘Terrace Review — Wednesday, September 19, 1990. A9

ky place: the North —

been told in Smithers a day earlier
that perhaps our present system for
remuneration — fee for service —
is not appropriate in northern com-
munities.

Other presentations came from
Marie Hildebrandt, regional re-

 habilitation officer for the Cana-

dian Paraplegic Association, who

told the commission more atten-

dants are needed in the north and
a second wheelchair should be
covered by MSP. And Lou Gair
who emphasized the need for

’ supportive housing in Terrace and

a fair solution to the cost of travel
for medical reasons. In both cases,
Gair suggested, there is a very
simple solution. "I understand
Lotto B.C. is giving out
$10,000,000 in prize money next
month," he stated in a written
submission. "A better use of this
money could be made for Medical
Care for the Citizens of B.C."

There was input from the Native
Community. The Nisga’a Valley
Health Centre shares the same
concems as everyone in the north;
a lack of funding, physicians, and
manpower in general: And Ker-
mode Friendship Centre executive
director Sadie Parnell told the
commission that there is a need for
health care workers in Native
communities and a need in Native
communities to make health care
decisions on behalf of Native
people.

Particularly frustrating, said
Parnell, is watching people who
have fallen through the cracks of
society and not having the funding

or people to help or educate them.
We need fully trained Native
health care workers, she said;
people have died because they are
not aware of preventative measures
or don’t know how to deal with
diseases such as diabetes. She
added that there are a lot of young
people interested in medical
careers in the Native community
but they don’t have the educatio

prerequisites. -

"Bridging" programs, she sug-
gested, would help but they don’t
exist.

A presentation from Northwest
Community College was offered
by nursing coordinator Joanne
Thomson. ‘Thomson offered sug-
gestions on how basic nursing
education can be adapted to
address the special needs of the
north, talked about the accessibility
of health education in the north,
described the lack of transcultural
care, and discussed the problem of
the retention of nurses during their
education.

A presentation made on behalf of
the District of Kitimat added to the
list of staffing complaints. Kitimat
still doesn’t have an orthopaedic
surgeon, they are in need of a
psychiatric social worker, and ~
there is a shortage of nurses. And
one of the biggest complaints in
the north; travel to the south.

hearing in Terrace, see next
_ week’s Terrace Review

TERA HE AP SERED

SOMETIMES WE DON'T APPRECIATE WHAT WE HAVE IN TERRACE

UNTIL WE SEE iT THROUGH THE EYES OF OUR VISITORS. THE MA-

JESTIC MOUNTAINS, THE BEAUTIFUL RIVERS... AND THE WARMTH

OF THE CITIZENS. JEFF BECK IS A WELDER AT JOHNNY'S WELDING.

HE CAME HERE ON HOLIDAYS FROM CASTELGAR A YEAR AGO. .
- AND STAYED! JEFF AND HIS FAMILY ENJOY THE EASY ACCESS TO

FISHING, HUNTING AND CAMPING SPOTS — AND HE KNOWS
~ HOW MUCH A WARM WELCOME MEANS!

HAMBER OF OME E

WITH ASSISTANCE FROM THE CITY OF TERRACE