Doctors shun

the far north

Even big bucks can’t keep physicians in places like Dease Lake

By ROD LINK YOU’D THINK $357 a day, all ex-

penses paid, would be enough to get a doctor to move to Dease Lake.

The problem is the provincial government is offering doctors $600 a day as fill-ins during the search for permament physicians.

It’s not surprising then that health care ad- ministrator Tom Wright can’t find anyone to take the job.

So the small Stikine Health Centre is using its small travel budget for recruiting trips down south instead of attending meet- ings up here to talk about health care gaps.

The centre is financed by the provincial government and has a budgel for two doctors. It’s been seven months since the last full time left.

That means it and the 3,000 people the centre serves have been relying on temporary fill-ins while searching high and low in hopes of find- ing permanent doctors.

“Sometimes we get them for a month at a time. One just left after three months. It's not suitable to the community because people have to keep explaining their situalion over and over again every time there’s a new doctor,” said Wright,

One of his problems is whal the health centre can pay a permanent physician.

These are salaried positions at $357 a day, or more than $90,000 a year. Unlike fee for service

physicians, they have no office or supplies over- head as all their medical needs are provided by the health centre.

“We have free housing and we provide a vehicle and flights in and out,’’ said Wright.

But while that might sound attractive, Wright ironically finds himself up against a provincial goverment program designed to help out com- munities the size of Dease Lake with physicians who'll stay several weeks or for a month and then leave.

This program pays $600 a day, substantially more than what Wright can afford.

Even with free housing, car,

flights in and out, and $357 a day |

(or $90,000 a year), communities like Dease Lake can’t keep a full- time doctor. government program offers them nearly double that money to come up for shorter stints.

“T can’t fault the program. They’ve been very . good with us. It’s just that we can’t compete,’’ he said of physicians who don’t mind coming to- Dease Lake or short term assignments but don?t want to stay full time.

Isolation, lack of back up and having to spend

CONDITION CRITICAL: Mills Memorial Hospi- tal's budget has been flatlining for years. Locals have long fought for recognition of the regional service the hospital pra- vides by way of an © increased budget. But so far those re- quests have gone unheeded by Vic- toria, despite stats that show the Ter- race haspital is ef- fectively serving the region. Patients are often shipped here from Prince Rupert and Kitimat on weekends and at other times

when there aren't enough specialists on hand in these hospitals to provide care,

That's because a:

sO much time on-call are among the reasons why Dease Lake can’t find replacements.

It's a similar story at the Stewart hospital which also receives money from the provincial government for two salaried doctors.

Although its been extremely lucky to have had one physician there since 1991, the haspital has had little luck in recuiting a second full time one since the position became vacant last year,

“We've had cight locums (doctors on temporary duty),”’ said hospital administrator Linda Hyde.

And there’s been times when the only doctor on duly has been the remaining full time one.

“When you're on call 24 hours a day and

, you’re the only doctor, it’s not much of a life,”

report

said Hyde.

It’s only the very lucky communities which come across doctors who want the kind of out- door lifestyle that can be offered in the north, she added.

Hyde and Wright from Dease Lake both there’s been little interest from physicians about moving to their communities as full time staffers.

Hyde said younger physicians tend to be worried about not having the experience to practice in more isolated places and being far away from specialists.

Stewart is expecting a doctor to arrive in May for four months who, they hope, will then agree lo slay on.

That doctor is in Uranium City in northern Saskatchewan and is now applying for registra- tion in B.C.

LINK BUDGET TO POPULATION

New formula could deliver regional health dollars

regional medical manpower deci-

A DIFFERENT WAY of setting hospital budgets might give them a break in providing regional ser- vices, says a hospilak official.

Hospitals now receive what are called global or baseline budgets determined by a formula created years ago and adjusted over time,

Bul as medical technology and services change, ithe way of determining spending doesn’t and that can causc problems, says Dr. David Poulin of the Thompson Regional Heatth Board in Kam- loops.

A better way of setting budgets is to look at the population of a hospi- tal’s coverage area and the services they require, he says.

“Population-based funding would be more reflective of the ser- vices a hospital provides,’’ said Poulin.

Up until recently | thal kind of

budgeting was hard to accomplish but the growth of modem informa- tion technology and data gathering makes it easier to determine what services people need and use, he continued,

Poulin did acknowledge that changing budgeting procedures would be complicated, likening it to changing the course of a large ship.

The problem of not getting money to provide specialized ser- vices to people outside Mills Memorial Hospital’s normal coverage area is al the heart of its

‘budget problems.

It isn’t recognized as providing regional specialty services so there’s no allowance made in the hospital’s budget.

The situation ts different with the Thompson Regicnal Health Board Which covers Kamloops and area.

In that area, Royal Inland Hospi- tal in Kamloops is recognized as a regional facility and so historically receives money for that, sald Poulin.

Feeding into Royal Inland are specialty cases from smailer, sur- rounding communities.

What helps, says Poulin, is the merger of Royal Inland and the five small hospitals in those com- munities into the Thompson Regional Health Board.

“We're able to shift our resources Where and as needed,"’ he said.

The northwest, on the other hand,

doesn’t have a regional health board.

Instead each community has its own community health council which runs iis own hospital so there’s no governing body to make

sions,

‘‘& regional health board can look at the bigger picture,’ said Poulin.

He added that regional health boards can deliver savings by com- bining on administration and other costs,

“Every dollar we save there is put into direct patient care,” said Poulin.

The northwest did have the be- ginnings of a regional health board as part of the provincial govern- ment’s ‘Closer to Home” decentralization effort of the early 1990s.

But that model was shelved in 1996, leaving the northwest with a collection of community health councils and no overall decision

‘ making body.

Liberals say locals must make decisions

A LIBERAL government wouldn't go as far as to force the regionalization of medical specialties to make northern health care more efficient.

But what it would do is

give regional health care

bodies the power to do that if it brought about the best use of the specialties, says a Liberal MLA.

Colin Hansen was one of two Liberal MLAs who met with local doctors last week.

Although they heard re- quests to group together medical specialiles so those specialists can support each

other and to spread out workloads, Hansen said it would be difficult for a government to do. “Obviously Terrace doc- tors would Iike to see that but there would be other communities with specialists that would be a difficult sell. They might get the feeling they’d be losing services,’* sald Hausen, Ironically, that feeling is close io that of Helmut Giesbrebct, Skeena NDP MLA and parliamentary secretary to health minister

_ Penny Priddy,

Giesbrecht has sald it

would be “political suicide” to take specialty services out of one com- munity and move them to another even if the move made sense. ; Hansen said the provincial government owes it to regions to do what’s best. ‘At least Iet regions make

the decisions by having - quallfied people in charge of .

the decisions,’’ said Hansen.

Hansen noted that there was to be a northwest regional health board but it was shelved in 1996 when the NDP re-tooled its “Closer to Home” health

‘called the

care management plan,

“Most of the decision making remains in Victoria and local health authorities have little control. It's not that regionalization is a bad idea, it’s fust that it isn’t being done,’’ said the MLA.

He also criticized what he “‘srowing politicization” of health care by saying the govern- ment has put ‘“‘political hacks” on community health care councils,

“These are people who are concemed about not making the government look bad,’’ Hansen added,

Colin Hansen

The Terrace Standard, Wednesday, April 29,1998 - AS i CORRESPONDENCE FOR THE TERRACE STANDARD

The Mail Bag

About the food bank

Dear Sir:

To set the record straight regarding the statement in the April 22, 1998 The Terrace Standard ‘Buck. helped found two important social institutions in Ter- race — The Food Bank of the Churches ....’’ The Food Bank of the Churches is an organization which I do not take credit for and 1] wish to clarify this error.

The food bank I was part of (January 1993 — June 1985) was one of the services of the Food for Thought soup kitchen, The churches’ food bank, according to my understanding, came to the needs of this com- munity after the Food for Thought soup kitchen closure. .

Thanks to the judges for the honour of selecting me one of the Volunteer of the Year winners. To all of the volunteers out there, each one of you is a winner. I be- lieve all volunteers fit this quote, ‘Much of the beauty af life is found in people who care.’’ Thank you.

Josephine (Jo) Buck, Terrace, B.C.

Story of Jane and Betty

Dear Sir:

I have been reading with interest the issue of our schools carrying condoms. It has set an interesting precedent and has toppled the walls of the shield around the concept of keeping the ills of the world secret — in this case pre-marital sex,

On one hand, we have Jane Doe, whose parents have worked hard in raising her right. Jane's parents edu- cated her about sex in a calm, unforceful manner when she was just entering a time in her life when she would be tempted by pre-marital sex. Jane is a strong-willed, confident girl, and her loving parents have shaped her personality and charisma about not only this subject but about many others throughout her life, ~

Jane has chosen not to have sex until she is certain that she will be able to face the possibility that she may get pregnant, not to mention that she may contract an STD. Jane is popular within the school she attends and there are maay others with the same concerned parents and who have chosen the same route in life.

On the other hand we have Belty Boop, whose parents have been disinterested in educating her about sex, Betty’s parents have raised her without discipline mostly throughout her short life, preferring only to ex- press their interest in their child’s behaviour when it af- fects them personally, such as the time when Betty stole the family car and totalled it on the way back home from a party.

They didn’t like the idea that Betty had been drinking and the fact that she was only 13, but what bothered them the most was that Betty had destroyed the only transportation that they could use to get lo and from the local bars. Sex? Well, Betty will do the right thing when the time comes,

Besides, they heard that the school Betty was attend- ing was installing condom machines in the girls’ bathrooms, so even if she screws up again (rotten kid, what are we going to do with her?) she’s covered (or rather, her partner will be),

Thus, two children from two completely different up- bringings ard with two completely different lifestyles

“have now the power to protect themselves from getting pregnant or contracting an STD. One does not need this protection, as she is not going to have sex anyway.

One definitely needs this protection, because she has been raised in ignorance and within no moral bound- aries. But the bread and butter of the situation is that both are faced with the issue of pre-marital sex every- day now, and all the education or concern that any parent can stipulate is useless since the striking reality of the necessity of a condom machine in our schools of all places has shattered any myth some of the more squeamish parents have tried telling their kids.

The condom machine reveals the cold, hard, facts of life. I'm not talking about the fact that one should be protected when having sex. I’m talking about how a condom machine has become the iast resort for the un- fortunate children who are like Betty, whose parents’ disgusting and pathetic attempt at raising their child has failed them so utterly that the school board has had to step in at taxpayers’ expense to protect these poor Bettys because their parents are too caught up in their own personal lives to care.

And Jane, the ‘“Good Kid’? She looks at the condom machine, knowing full well what its purpose is, and while laughing at the latest rumour of who was seen using it, is saying to herself, “Thank God I’m the smart ofe, Thank God for my parents. Because in this world, in this country, it’s really every man and woman for him or herself, and they can shove as much litera- ture and moral denunciations down my throat as they want to.’”

‘Nobody's going to tell me what to do, Pm my own person and I make my own decisions. With the help of those two great people whom God has lovingly made my parents, of course.” Then she goes looking for her best friend, Betty Boop.

Ted Sfikas, Terrace B.C.

Discussion was cordial

An open letter to: Barry Piersdorff Secretary-Treasurer School District 82

Dear Mr. Piersdorff: RE: Freedom of Information and Protection of Privacy Act

I received a copy of a letter dated April 2, 1998 from Ms. Sarah de Leeuw to the Trustees of School District 82. I noted an inaccuracy that I thought worthy of cor- rection.

I want to confirm that I did not instruct anyone, par- ticularly you, to carry out a course of action regarding release of information under the Freedom of Informa- tion and Protection of Privacy Act.

I would characterize our conversation as being a cor- dial and informative discussion of several sections of the Act. I am pleased that we had this opportunity to ' discuss the resolution of an issue.

Richard Collier, Director, Information and Privacy, Ministry of Education

The Terrace Standard welcomes letters to the editor, Our deadline is noon Friday for the following Wed- nesday’s issue. Our mailing address is 3210 Clinton St, Terrace, B.C, V8G 5R2, Our fax number is 250- 638-8432. We particularly welcome tetters via e-mail. Our e-mail address is standard @kermode.net