Friday, November 2, 2012

Designed to fail - REPLAY

From March 2011, in my humble opinion, this article is worth repeating:

Overcrowding at Royal Columbian hospital led to shutting down microwaves in the on-site Tim Hortons doughnut shop. Emergency physicians were not worried about ovens jamming the medical equipment, they needed the space. They got it. So now, all those people complaining about giant salaries and cushy end of contract rewards for hospital bureaucrats should eat their words. How many other regions were smart enough to double purpose fast food facilities?

Multi tasking Minister of Everything Colin Hansen - no braver-man than he - flagged this as a good day,
"Patient care was appropriate. People's needs were met in an appropriate way. It was not a normal day. It was a very, very, unusual day."
EP Dr. Adam Lund was not quite so happy,
"Last night's circumstance was in no way an anomaly. We, on a daily basis much of the time and certainly multiple times per week, are in the situation where we are overcrowded, where we have double parked stretchers in the hallway, where we have people in inappropriate care spaces.  ... As these things become institutionalized, we complain, we complain, nobody hears, nothing changes and then, we do what we can, which is to take care of the patient in front of us."
A five year old article from the Vancouver Sun proves Hansen's dishonesty and the accuracy of Dr. Lund's statements. In April 2006, emergency officials at Royal Columbian Hospital issued a report that said ER overcrowding was killing patients:
"Significant, documented morbidity, mortality and complaints have occurred," states the report on congestion in the emergency department submitted to the Fraser Health Authority. . .

Morbidity refers to a patient's condition deteriorating as a result of having to wait; mortality refers to death.

The document, titled Royal Columbian Hospital Patient Flow Redevelopment, further states that the ability of the hospital "to respond to patients with trauma injuries, in "life-and-limb-threatening scenarios is severely compromised."
It is important to remember that the hospital's overcrowding was fully predictable. Even a middle school student in 2001 could have examined population trends and extrapolated the demand growth sure to result at Fraser Valley hospitals. How did Colin Hansen prepare? In 2004, as Health Services Minister, he closed St. Mary's Hospital in New Westminster, telling British Columbians it was done with the best interests of patients and a healthy system in mind.

In April 2006, a majority of Vancouver General Hospital's 24 emergency doctors released an open letter, stating:
"We . . . feel obligated to publicly declare our non-confidence in the ability of the . . . department to provide safe, timely and appropriate emergency medical care."
That month, RCH's nine ER physicians wrote The Sun stating in part:
"We are writing to support our colleagues at Vancouver General Hospital in their efforts to bring awareness of the deleterious effects of emergency department overcrowding to the public."
In 2006, Dr. Sheldon Glazer had little faith the system would respond appropriately, saying that politicians and health bureaucrats should be ashamed for their many failures. Dr. Glazer is still speaking out this week about the same problems at RCH. Five years ago he said,
"It is difficult to pass the pleading faces of patients and their families and feel helpless to ease their suffering or give appropriate care. I feel like I'm trying to swim with my hands and feet tied.

"Emergency patients are assessed and treated on ambulance stretchers in hallways. They wait interminably long hours for care, often resulting in poorer outcomes, or worse . . . .

"Patients have lost any sense of privacy or respect."

"Interventions and laboratory investigations are often missed or not done. Suspected cardiac patents wait for hours in chairs until their lab results come back, all the while at risk for sudden death."
Colin Hansen, who will soon retire with a pension worth millions, is a shameful minister of the crown. He behaves like a psychopath, smiling while families cope with unnecessary funerals because he values a stadium roof over hospitals able to meet today's needs, or even the needs of five years ago. He chirps blithely that the system worked,
". . . just the way it is supposed to. . . It does happen from time to time that emergency rooms are under tremendous stress because of the number of patients presenting themselves on that day,"
As the doughnut shop story unfolded, Global TV was quick to redirect the discussion. Ted Chernecki reported Tuesday that the Canadian medical system,
"was already ranked one of the worst in the world when it comes to bang for your buck. Are we simply throwing more good money after bad?"
A 2009 article from the Harvard Business Review has a much different story:
"The Canadian healthcare system delivers life returns more than three times greater than those of the American healthcare system."

Global has a particular story to convey in partnership with the Liberal government and multi-national companies that lust after the profitable business of medical services in British Columbia. Just as Liberals designed BC Rail to fail (read the linked article for evidence) so it could be sold to friends, they are designing the healthcare system to fail so it too can be privatized.

Whenever a story of healthcare crisis surfaces, Global's infomercialists are quick to show stock footage from Dr. Brian Day, operator of the largest private surgical center in BC.  Day says,
"Right now we are looking at bankrupting the system, bankrupting the economy. Clearly that can't happen."
His solution, privatize the public healthcare system. If a person cannot afford a knee or hip replacement, let them do without. In fact, if you deny medical treatment to all poor people, we could afford to cut corporate income taxes yet further. Charles Dickens wrote these words about Ebenzer Scrooge being told of needy people outside the prisons and poorhouses,
"If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population. Besides -- excuse me -- I don't know that.''

"But you might know it," observed the gentleman.

"It's not my business," Scrooge returned. "It's enough for a man to understand his own business, and not to interfere with other people's. Mine occupies me constantly. Good afternoon, gentlemen!"
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14 comments:

  1. Thank you for your review and commentary on this issue. As an Emergency Physician, and one of the team members involved in the "Tim Horton's Decision", I would be very pleased to help you and your readers to fully understand the "lived experience" for patients and staff members working in your ER's on the front line.

    Your support around this issue is appreciated.

    Thank you,


    Adam Lund
    Emergency Physician, Academic Director
    Royal Columbian & Eagle Ridge Hospitals
    Clinical Assistant Professor, Department of Emergency Medicine, UBC

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  2. Thank you Dr. Lund. Quality people at the front line of healthcare allows our system to work as well as it does.

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  3. Whatever the issue, the sacrifice is always made so big business can lower taxes. We should all be running around with warm fuzzy feelings that the head honchos and investors in our big corps have such large and healthy wallets. The province is falling apart yet the same idgits talk on and on about how we cannot possibly let the NDP in. The NDP are the only party that want to make our systems better. And they will too by raising taxes on those same healthy and wealthy corporations. As it should be.

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  4. Another accomplishment that can be chalked up to the disgraced former premier, Gordon Campbell - along with some of his other accomplishments like the corrupt BC Rail sale, the privatization of BC Ferries, dismantling of BC Hydro and the absolutely not needed IPP projects.

    Yes siree - Canada's crime and corruption capital of British Columbia, where government Casino's launder money for the criminals and get away with it !

    Thank you

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  5. Why is it that private clinics/hospitals are allowed ANY funds from public healthcare? If they want private medicine, and their patients want to be treated by them - then patients must be made to pay 100% of ALL costs for their care in said private institution.

    As I see it, it's doctors like Day and his ilk that are helping to bankrupt our system, they're not only allowed to do it - they are seemingly encouraged to do it. Nothing like having your nostrils stuck in two troughs is there?! But, I keep forgetting they're in it for their patients - it has nothing whatsoever to do with money. Silly me.

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  6. Terrible conditions for patients and the front line workers at RCH.

    Health Regions across this Province are top heavy with highly paid executives -- a substantial drain of monies that could/should be directed for patient care, facilities, doctors, nurses and staff.

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  7. Norm, I hadn't seen that diagram before, the one that shows:
    - Announce target
    - Make no plan
    - Do nothing
    - Fail ....
    - Announce target
    - Make... ad infinitum

    It perfectly captures the BC government's PR-driven reign of abuse of its citizens, and how it has managed to fool so many people for so long.

    I wonder when, or if, the 90,000 BC Liberal members who are purported to exist in this province, will understand how their future and their children's future has been decimated by the Campbell-Harper slash and burn practices?

    Ninety thousand people actually paid money to belong to this party – the elite, sure, I can see them as members because they get to dip into the public's pocket all the time. But rank and file ordinary folk? People who can figure out how to balance their cheque books and are 'responsible' citizens, paying to belong to this rape&pillage political party?? I just don't get it. What cool-aid have they been imbibing?

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  8. I think that a contract breaking would help the health care system greatly. Do you know of any other job where you can serve for 6 years and get a full pension.

    http://thetyee.ca/Views/2007/05/18/PensionGrab/

    Let me see, isn't the magic number somewhere between 30 and 35 years for us normal saps?
    6 years people for doing what? look at the number of days worked in 2011. How many people in jobs could get away with not visibly doing any work save for 14 days and get paid in full.

    From 2007 http://thetyee.ca/Views/2007/02/09/NiceGig/

    And we, the public shout, 'all politicians are crooked . . .' and so they get away with it. Shame us all for being so complicit in this sham.

    Shame on us for not making sure that the people that we put in place to take care of our provincial ( and federal business) are not crooks.

    To Dr. Lund and all the other ER Docs, and all family DOcs. THANK YOU.

    If you want to see a little hospital that can, one that the Liberals were not able to completely destroy (they however, made a terrible mess), take a look at Delta Hospital in Ladner. But it is only with the community support that little ER room is so great.

    This little hospital was and example of how a working hospital works, with a great ER, and IC unit, operating rooms, . . . then along came the Lying AHs Liberals.

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  9. All this political talk is just noise. Both the NDP and the Liberals have closed beds in this province in their attempt to control costs. The real problem is that Canadian politicians of all stripes have failed to take bold steps to reform the entire system. There are better ways of delivering health care as evidenced by systems in Europe, Australia and many other parts of the world. Our politicians have not been honest with us. That refers to politicians on both sides of the house.

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  10. Thanks Norm.

    I've said the same thing for years everytime someone states that "we" have to have a conversation about healthcare in this country.

    It is nothing more than an attempt to engineer a transition to a private system.

    If they really want to save money, getting rid of the upper echelon of managers in the health authorities would be a good place to start and start funding healthcare the way it should be, adequately.

    And of course, people should stop watching Global. Don't tell them you're going to stop watching, just stop watching.

    ReplyDelete
  11. Thanks Norm, a very good reminder (and excellent diagram too).

    Sometimes it's too easy to forget how far we've slipped in the past 12 years.

    I had even forgotten about the $1+ billion in annual tax cuts that the Liberals announced out of the blue in 2001 because the provincial books were in such good shape. (So $12+ billion in lost revenues).

    Of course, only months later, the Liberals then announced (thanks to the findings of their hired gun economic panel) that actually BC had enormous "structural deficits". This manufactured crisis then "justified" massive program and staff cuts and continuous, destabilizing re-organization (and which continue to this day).

    Another interesting tactic has been the use of what the British call QUANGOs. Over the past 12 years, many former government functions have been spun off into these "black-box" independent organizations. These organizations receive little public scrutiny, no public accountability and are stuffed with Liberal partisans as both directors and executives. There are no single mothers or community activists or even labour representatives on board. And no questions in the Legislature either.

    As an example, can anybody explain what the BC Safety Authority does? How many staff they have? and what role they played/play with respect to the recent sawmill explosions?

    Nothing like a confusing, chaotic provincial structure with QUANGOS coming and going (as funding expires) to further dis-engage citizens from how our province is governed.

    And thank you for being an independent voice. Your blog is a favourite part of my day and an inspiration to British Columbians who care.

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  12. "...it does happen from time to time that emergency rooms are under tremendous stress..."

    Clearly Mr. Hansen is/was just as disonnected from the workings of the Health Ministry as with every other one he is/was in charge of. I know it sounds cliche, but how can the senior members of this government and their appointed bureaucrats sleep at night? I speak not only of outright lies they publish, but of the salaries they make. Norm, you have done many articles recently on the out of this world (quite literally) salaries.... all the way from deputy ministers down to "on-site" administrators. My significant other is an RN. Every day she comes home she speaks of what a crazy place the ER's are. She is starting to stop by after her regular shift just to give a few minutes of help to her co-workers. Waste and incompetence at the administrative level is a daily occurence, never mind higher up in the Ministry. I have challenged Mr. Hansen to follow me to one of his "small Run of River" operations, stay to see the lake drain out and then explain himself. The above comment prompts me to challenge him to go to work for a day with my significant other, then explain himself. "Lying" is a very strong word, I am open to any other description. The fact he is "no longer in charge" does not take away from the groundwork he laid. Statements like this lead to irreversible decisions with subsequent dismantling of systems originally put in place for the good of the public. People like Hansen need to be responsible for their actions in government even after they are gone....if we are paying them pensions we have every right to stay on their backs.

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  13. Great post Norm.
    It truly has been a dark decade for not only acute care in our province but residential care as well. Wages for many frontline workers are still lower than they were in 2001 after their contract was broken in the early days of this government. Managements' ranks have swelled to disproportionate levels. Residents' costs in long term care facilities have increased while staffing levels have been cut. Food and housekeeping standards have dropped and respect for residents' quality of living has been diminished by a management structure that has continually become further disconnected from the final days of their lives.
    Unfortunately the many problems with health care don't register with the public until they need it.

    Keep up your great work, thanks for your efforts

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  14. My deceased,UK born, father-in-law used to tell me that when he practised as a doctor, starting in the late forties and thru the early fifties, there was always a large percentage of billings that were never paid. In Canada he vigorously opposed the arrival of medicare but ironically, his billings were generally paid 100%.
    Brian Day and his cohorts should not be allowed a foot in each camp, public/private. Let them go entirely private, using private infrastructure that they themselves have to build. Let them have a few complicated cases, toss in a few lawsuits and let's see how far they get...remember, they shall have no access to publicly financed facilities. Private means private.
    I support the hard working medical personel that work long and hard in our (less than perfect) public system.As for the political and administrative overseers, not so much.
    Norm, many thanks for your own hard work and sensible, intelligent analysis of this and all the other real issues passed over by MSM.
    Mark B

    ReplyDelete

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