Hospital cuts hurt patients The Terrace and Area Health Council is more concerned with balancing the hospital’s budget than taking responsibility for people’s health, doctors Say. : -By ALEX HAMILTON DOCTORS WANT the health council to send the health ministry a deficit operating budget to save the services on which patients depend. "By sending in a balanced budget, the hospital is telling the minister everything is okay up here,’’ said Dr, Erica Buck, family _ physician. The health council bas reduced hospital services to send the government a proposed balanced budget plan in hopes of getting about $300,000 in additional money for overextended hospital departments. Buck said by doing this, administrators are sending the wrong message to Victoria, She doubts the government will reward Mills for balancing its deficit budget. .“They’re not going to give us money,’ She said, ‘‘We’re in danger of losing what we have. It’s not safe.’” ; Buck said the Terrace and Area Com- munity Health Council’s proposed 1999- 2000 hospital budget involves cost saving measures that directly affect hospital ser- vices and patients. And those budget culs make working at the hospital stressful, she said, ‘*We want to provide the best care for our patients, but they’ve [health council] made it harder for us to do that,’’ she said, But Larisa Tarwick, chair of the Terrace and Area Community Health Council, said hospital services and patients won't be af- fected by the cuts to balance the budget. “People come first and health care comes first,’ Tarwick said, , ‘Every year when we've gore over- budget we’ve continued to serve the region. We don’t shut the door, when we've got beds we use them.’’ Tarwick said the health council expects the ministry will give Mills $360,000 in financial aid when the budget is announced this week, She is confident the money will come be- cause the provincial government has promised to make health care its number one priority. She said the extra money will go back to hospital departments that have’ been troubled by cost overruns like the intensive care unit, the surgical ward and the nursery. Doctors are angered that services have al- ready been cut back so drastically to save money. They say it’s difficult for them to provide patients with adequate care, Doctors say the CHC has forgotten that its role is to provide medical care io the communily. They worry that administrators sec their only role as satisfying the ministry and balancing the budget “‘All their decisions are made from a’ financial basis,’’ said Dr. Michael Kenyon, internal medicine specialist. Doctors want the health council to slop running the hospital as a business because from a business standpoint it’s more cost effective not to serve patients, Kenyon said the CHC either needs to stand up to ihe ministry and refuse to balance the budget or admit to the public that services have been cut to save money, ‘'They need to tell the public that they’ve screwed up, that the province is bankrupt and that standards are going to drop,”’ Kenyon said. , Doctors criticize Mill's budget Doctors outline how budget cuts have affected Mills Memorial Hospital and how the proposed 1999-00 budget plan will further affect services to patients. DOCTORS say there are a number of examples where hospital services have been cut or are proposed to be cut in order to save money. “We have all seen, the. standards of care in tie hos-. pital fall considerably over. the past year or so,” said | Dr, Paul Warbeck, who has been practising in Terrace for five years. Dr. Lani Almas, an ob- stetrician practising in Ter- race. since 1980, said the hospital has cut so many services that conditions are unsafe, Last Christmas Almas said there = weren’t = enough matemity nurses available to take care of her patients. “I had to tell my patients’ families to sleep in [the hospital] over Christmas to look after them,’’ she said. “There wasn’t enough nurs- ' ing staff.” Warbeck said last week there weren’t enough nurses to help ane of his palliative care patients. When he complained that his patient wasn’t being fed properly, his grievance went unnoticed, What he was forced to do was artange for a hospice volunteer to feed that palient his meals, 4 ON £ ’ Dr. Paul Warbeck ‘I had to get outsiders doing work because the hos- pital won't staff wards for their needs,’’ Warbeck said. is so small that when a nurse is away because he or she is sick, it’s often hard to find a replacement. ‘Nurses are running to keep’ up,’’ Warbeck said. “That's not safe to do over ‘the longterm.” Obstetric Care Doctors say one of the . hospital’s biggest cost saving measures in the pro- posed budget plan will af- fect obstetrics. The budget plan states that as of Apzll 1, locum support _ their slack. is discontinued. That means whenever one of the hospital’s two ob- stetricians/gynecologists takes a holiday and a locum (a doctor. from another hos- bar pital) is needed 't0 fill in, the’! Ioeum’s | airfare” Wout Be’. covered 'by the fiospital.’” * Locums are needed when one doctor goes away be- cause the workload becomes too great for the remaining doctor to cover the other’s workload for a month. “Tt's too much to expect one obstetrician to be on call 24 hours a day seven days a week for one month,’’ said obstetrician Dr. Lani Almas. Not even a superhuman can do that, she said. This summer when Almas and the other obstetrician, Dr. Sheila Watson, take hol- idays therc won't be a locum coming to take up Almas said there was a locum who was willing to fill in, but because the hos- pital won’t pay his fight or accommodation fees, he refuses to comic. The hospital also won't pay locums to be on call, ‘It’s not attractive to - come here,”’ Alinas said, The problem with not hav- _ing a locum, she said, is when there is only one ob- sletrician on duty while the other is on holiday, baby deliveries become prob- lematic. Almas said she can’t pos- sibly be available 24 hours a day seven days a week for a a, month to cover emergency caesarean births. Family doctors can da deliveries but not caesareans, Almas said she will be telling GPs (general prac- litioners) this summer to send their high risk pregnan- cies to deliver elsewhere, She said GPs can decide whether or not they want to He said the pool of nurses | - send their low risk pregnan- cies out for deliveries, She added that many .} women might not want to - deliver al Mills knowing the “tisk they take in not having " caesarean coverage. Acute Care Services are definitely ‘being cut in acute care, ac- . cording to Dr. Erica Buck, family physician. Last week she had two patients in her office who she needed to admit to the hospital, But when she tried to ad- “mit them, she was denied because the 25 bed average the hospital can afford to provide were full, ‘I’m constantly being told I can’t admit people,’ she said. ‘Where am I supposed “to send thom? What am “‘suppased to’ do :—- nurse ' them at home??? What she does, she said, is send her patients to the emergency care ward, regardless. ‘*They may have to wait in- emergency all night [before a bed frees up} but I have to send them some- where,”’ she said, In a letter to one of the doctors, statistician Allan Thompson stated Mills should be run- ning 50 beds (including the psych ward, acute care unit and the intensive care unit) to supply the demand. The problem is, the hospi- tal is only breaking even providing 38 acute care, psych and ICU beds, Doctors say more beds are needed and required since 38 beds are incompatible with good health care in the community, “*There’s no chance in hell to limit the number of [acute care beds] to 25 because the needs of the community for medical care exceed that,’ said Dr. Warbeck. Larisa Tarwick, chair of the CHC, agreed the number | of beds is low. "We think it should be in a higher range,’’ she said. She said she hopes the ministry will account for that and provide the hospital with more money. The problem with provid- ing only 25 acute care beds, said Dr. Linton, family physician, is if there is a flu epidemic, patients wil] have to either go to Kitimat or Prince Rupert or wait until the hospital discharges patients to make room for new ones, According to dactors, once the hospital reaches its 25 bed maximum, it will cancel elective surgery to make sure no more beds are taken up. Radiology » Dr, Linton said the radiol- ogy ward will be affected by budget cuts because over- time been ellminated, He explained that normal- ly doctors stay after hours to get an urgent ultra sound ” done for patients, Now, however, if a patient needs an ultra sound right health ministry . away, doctors can’t do it after hours. Instead, they will have to Tearrange wait lists and bump a palient whose al- ready scheduled in order to fit urgent patients into regu Under ‘(he — proposed budget, there also won't be any replacements for lost CT scanner days due to Statutory holidays and en- forced days off. Dr. Greg Linton This angers doctors since the CT scanner, which the community paid for, is a valuable tool which saves lives, A CT is used to help image people’s chest, ab- domen and head to diagnose diseases like cancer, Pediatrics The pediatric ward ~ has been essentially been climinated to save money, shid Dr, Michael Kenyon, When a child is admitted, he or she is placed in the pediatric playroom, which is located next to palliative care. This is problematic since children in the playroom are noisy and may disrupt pal- liative care patients and theiz families. In the hospital’s proposed budget, one on one nursing care in pediatrics is climinated. That means if a baby is born who needs one to one nurse care, they will only be looked after until they are well enough to be trans- ferred to a hospital in Van- couver, “As soon as they can be transferred, they’re out,”’ said Dr. Linton, “We have the nurses available to provide for that but the hospital won't fund _ a nurse for that.’’ He said families shouldn’t have to fly to Vancouver when there’s someone to look after them here. He added that it’s ir- responsible for taxpayers to have to subsidize air am- bulance fees (about $6000) for patients to be flown to the Lower Mainland. - : ‘And when patients are dis- lar-X-ray hours," bus dei ‘charged: ‘from chospitals down’ south, they have to in- cur all the casts to return home, To save money, the hospi- tal also won't accept patients from Kitimat or Prince Rupert who are in need of a pediatrician (a higher level of care). Those people will have to go ta down south for help. Intensive Care A month ago the hospital tried to reduce the number of intensive care unit beds from four to the budgeted number of three, said Dr. Michael Kenyon. But when a patient with a serious medical emergency was admilted at 4 o’clock one moming, Kenyon had to break out the fourth bed from the closet because the other three beds were oc- cupied. He said he doesn’t under- stand how administrators could altempt to get rid of an ICU bed. *'That fourth bed is full all the time — mosily of the time with out of town patients,’ he said. He explained that Ternice has the only [ICU unit in the region, but it’s not getting the funding to reflect that, Kenyon said taking away an ICU bed to save money is obstructing medicine. ’ "To be honest, the admin- istration would rather you died,’ said Dr, Michael Kenyon. “It would save them a fortunc."” He said he can’t refuse patients because il’s his job to take care of people. “The budget can't be a concern when it comes to patient care,’’ Kenyon said, Surgery Doctors have been asked to cut back on surgery time to stop beds from filling up. Dr. Kenyon said that means cither paticnts must go elsewhere for an opera- tion or join a waiting list. He said making patients wait in some cases creates the need emergency surgery, which involves overtime. That only increases costs ‘which reinforces the need to cul more surgery time to save money. The Terrace Standard, Wednesday, May 12, 1999 - A5 CORRESPONDENCE FOR THE TERRACE STANDARD ‘Ot The Mail Bag He’s not warm and fuzzy Dear Sir: Wonderful picture of Fred Glover in your April 21 paper (‘NDP isn’t ali that bad,’ letter to the editor). 1 could slill see his eyes through his rose coloured glasses. No covertps by the NDP, Fred? Ever heard of BingoGate, HydroGate, CasinoGate, PacificatGate? We have a government that spends money like drunken sailors, billions more in debt, hundreds of mil- lions yearly in interest payments alone. As far as your happiness with the labour code and fair wage policy, you should ty to run a smail business under those guidelines, There is not much of a balance when the laws are written by a political party filled with union organizers and academics with zero busi- ness experience, I just don’t feel all warm and fuzzy like Fred does towards the NDP whenever ! look ata paystib and sce what it cost us in taxes for these folks to run our pro- vince. Doug Yeast, Terrace, B.C. (received via email) Could we be next? Dear Sir: Our society must take a good hard look at itself. Parents are the first line involving the children. They should and must know what our children are doing. The yardstick my wife and ] used when raising our eight children was ‘Respect people and their proper- > A couple of weeks back, while my wife was out walking our dog, she happened to be at a bus stop while children were getting off. As the last child was . getting off, the other children began yelling, “Come on Fatso, hurry up.’’ Now where did these children learn to use such hurtful words against one of their school- mates. A couple of years ago, one of my sons (who was over 35 years of age) after swimming in the city pool went into the workout room for some exercise, taking a cas- Sette tape with him so he could listen to music at the same time, ‘ After a few minutes three teenage boys came in and immediately told my son, “‘Take your tape out of the machine, we want to listen to our own music,’’ Sounds kind of scary doesn’t it. In more ways than one. We must also count on our teachers, I recall years ago children remarking the teacher gives most of the attention to the so-called teacher’s pet. This may sound trivial but to some but to a small child it might just be a big thing, Business and industry must play their part as well and ensure that they are operating in a fair manner. It brings to mind, words in a song, where a man is waiting with great anticipation an opportunity for promotion, Finally, the day of reckoning arrived and the person who was called was the Boss’s brother. We all know that this sort of thing is pretty well typical. Maybe it’s time to start caring about the feelings of others, If we don’t, we may just pay the ultimate price. woh ras ; J.-A. Nabess, Terrace, B.C. Don’t cut music, band Dear Sir: I played in the school band every year, from Grade six until I graduated from Caledonia in 1994 and I still play music to this day. Throughout my school years, the only classes I consistently looked forward to were those where music was the focus. I always came back from my music classes feeling energized and focused. I have never pursued a career in music, nor have I studied il intensely, but I couldn’t imagine a life without music, Despite an overwhelming cry of protest from the community this time last year, the wise men and women of the board still saw fit to decimate Kindergar- ten and Grade six and seven music. This year the list of casualties has grown to include all elementary band, senior jazz band, and senior choir. Children wanting to play an instrument in band will now have to wait to Grade 8 to do so, that is if they don’t lose interest after two years with no music at all, High school students wanting to receive official credit for instruction in jazz and choral music will now have to wait for university, if they ever get that far. The skill level of students entering Grade 8 band will be virtually nil, and as a consequence, all high school ‘music wil] suffer. As ] understand it, Wayne Desharnals, the expert sent , here by the education ministry, made a prioritized list of recommendations for balancing the budget. One of those recommendations was that a certain high-level administrative position be eliminated. This recommendation was given higher priority than cuts to music, and yet it was not even considered by the board. J would like to know why. Valiant efforts by union president Frank Rowe resulted in education minister Paul Ramsey making a possible last-minute allowance: for the board to balance . the budget over three years, instead of onc. The budget advisory committee endorsed this sig- nificant develapment that could have resulted in music programs being spared further starvation. Yet the board mindlessly ignored the advisory committee’s recom- mendation on this matter, and passed the budget without even considering this option. Shame. One of the main reasons my family came to Terrace was because of its reputation throughout the northwest as a musical oasis, We weren’! disappointed but I fear that many others will be in ycars to come if matters aren't set straight and music programs aren’t reinstated, The board members of School District 82 have failed to make the tough decisions that needed to be made in order to save our vital music programs. [ would urge the people of Terrace to judge them appropriately, should they run for reelection, Aaron Hill, Terrace, B.C. About letters THE TERRACE Standard welcomes letters to the editor. Our deadline is noon Fridays; noon Thursdays on a long weekend, You can write us at 3210 Clinton St, Terrace, B.C. V8G 5R2, Our fax number is 250- 638-8432 or you can email us at standard@kermode.net . Letters must be signed and must have a phone num- ber.