Wednesday, January 7, 2015

Political success, program failure

In February 2013, shortly before the provincial election campaign began, the BC Liberal Government made an announcement about a new program that was to be funded with over $100 million:
GP For Me A Success Says Government

Friday, February 22, 2013 10:23 AM

The Province has announced new incentives and supports to work towards ensuring every family that wants a family physician, can have one by 2015...
It is now 2015 and the objective has not been achieved. But, that surprises no one involved in delivering medical care to British Columbia residents. The announcement was a pre-election ploy by the BC Liberal Party. Two years later, the shortage of family physicians continues and surveys of doctors demonstrate that because of retirements, it is growing worse.

Saanich family doctor can’t give away his practice, Cindy E. Harnett, Times Colonist, September 27, 2014
A Saanich family physician says his inability to give away, nevermind sell, his family practice is an indication of a system broken beyond repair.

Dr. Chris Pengilly, 68, says his futile attempt to find someone to take over his practice exemplifies the shortage of physicians and the challenges posed by a generation of doctors who don’t want the responsibility of owning a family practice.

“I have advertised literally all over the world,” Pengilly said. “I have had not one positive response.

“Not one of this year’s graduates coming out of medical schools and family practice residencies is interested in pursuing full-service family practice.” ...
The GP for Me program rations opportunities for people to be attached to doctors in general practice. Through financial incentives paid to doctors, high-needs patients gain attachment priority. As a result, for a person with less complex medical needs, the chance to engage a family doctor is reduced.

Beyond the paperwork burden imposed on doctors, another problem is that too little money committed by government reaches practising physicians. A significant portion is absorbed by bureaucrats, public relations officers, advertising agencies and quasi-autonomous non-governmental organisations. (Those last mentioned are known in Britain as Quangos and they are infamous for patronage and bureaucratic excess. They are now common in British Columbia.)


NOTE: To assist in a more complete examination of this subject, I encourage readers to share their own stories of difficulties securing an ongoing relationship with a general practitioner. You can do this in comments or by email to me at normanfarrell.ca@gmail.com.




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9 comments:

  1. The key phrase is "A significant portion is absorbed by bureaucrats, public relations officers, advertising agencies and quasi-autonomous non-governmental organizations."

    Sadly, this is how government works in Canada. The bureaucracy has become a quasi welfare job for those who are so incompetent, they can't get a job in the real world. Instead of universities and colleges admitting they are graduating idiots, we have the bureaucracy to give them full time jobs to practice their stupidity. Canada's bureaucracy is filled with people so stupid, they don't realize how stupid they are.

    Welcome to the brave new world of idiots.

    ReplyDelete
  2. GP for Me Press Release

    Firing Health Researcher without cause Minister Margaret MacDiarmid, played a Role:

    "Vancouver – The government of British Columbia and the BC Medical Association are partnering to improve primary care services and ensure all B.C. citizens who want a family doctor are able to access one by 2015. BCMA president Dr. Shelley Ross joined Health Minister Margaret MacDiarmid in launching a new province wide program, A GP for Me. This program is based on a successful pilot program that matched patients with doctors. As well, a separate and complementary program is being created to support hospitalized patients in receiving care from family physicians."

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  3. I live in Victoria. My family GP shut down her practice (not sure why, illness I think). I was without a family doctor until about a year later I found a doctor taking new patients, but her practice is restricted to people over 55 (luckily, I was 57 when I found her). My girlfriend, however, who is 49 is still looking. I consider myself very lucky to have found a new family doctor.

    ReplyDelete
  4. When you write about "quasi-autonomous non-governmental organisations," you could add "self-perpetuating and unaccountable" to the description. One example is ImpactBC, a landing zone for former senior health bureaucrats that has had more over $15 million in public funding since 2009.

    One of Victoria's dirty secrets is that high officials, not satisfied with supplementary pensions that pay five or ten times the amount of standard government pensions, make a second career as highly paid consultants in quangos. The current crop of DM's and ADM's tolerate the situation because they expect to do the same.

    ReplyDelete
  5. Our excellent relationship of 30+ years with one family doctor ended with his retirement. He was burned out from the demands of a big practice and wanted to enjoy doing other things while still healthy. We have been unable to find another GP in our own community. That means getting urgent care from emergency and through walk-in clinics. The lack of continuity results in medical care that is not optimal.

    It is fairly easy to understand why too few young graduates choose family practice as a career choice. It is a demanding profession and the financial rewards have been low when compared to other medical specialties. ( I once knew a dermatologist who said he had never been called in the middle of the night for an emergency skin rash.) One of the barriers to entry is the cost of setting up and administering a general practice. That might be resolved by establishment of public community health clinics where family doctors could run their practices and treat patients without having to finance needed facilities and absorb overheads.

    Elsewhere in our economy, when a product or service is in short supply, the shortage is resolved through higher prices. If citizens want more general practice doctors, we need to find ways to attract qualified men and women. Money is the standard solution. However, make sure that money goes to the bottom lines of doctors. The latest fee initiatives are not very helpful because they have numerous conditions and requirements attached.

    ReplyDelete
    Replies
    1. When my family started to see Shelley Ross she was working at Hannah Medical at the corner of Boundary Rd. and Canada Way. Dr. Hannah set it up so it was surely a private enterprise but it worked well, there were many doctors there and you could always see somebody in a rush, it is now a Starbucks and other assorted shops. Apparently we are going backwards with our medical because at one time it used to work as my previous statement noted.

      Delete
  6. I found that I could have had a new family doctor if I was a pregnant. Being more than child bearing age and male, that didn't work. I also found I could get a regular doctor if I paid an annual service fee to a clinic that offered a variety of extra services, each with a substantial charge not covered by MSP or my extended health care plan.

    Without it ever being fully discussed by the people we elect, BC has have moved toward a non-universal healthcare system. To know where this ends, we can look to our southern neighbours.

    ReplyDelete
  7. In response to North Vans Grumps,
    It is interesting that Dr. Shelley Ross would get on board with this, after thirty years as our family doctor, she pulled the plug and left us all hanging so she could take the BMCA position and we are now in this No family doctor system. Thank You very much.

    ReplyDelete
  8. Among Gordon Campbell’s 2001 election campaign promises was a commitment to provide “High-quality public health care services that meet all patients’ needs where they live and when they need it.” It was one of many promises he didn’t keep, like not to rip up public-sector union contracts, not to sell BC Rail, or not to abandon autistic kids. Some promises he broke with breathtaking speed, indicating he could not possibly have had any original intent of keeping them. Others, like health care, took a bit more time to disappoint. But as time elapsed, his insincerity on that too became apparent.

    But in the face of a history of unfulfilled health care promises, each successive election brought a new set. New hospitals, reduced wait times, thousands of long-term care beds, more doctors, on and on. And in 2005 and again in 2009, the electorate bought what he was selling.

    By the time 2013 rolled around, despite much evidence of a health care system in crisis, shoddy treatment of paramedics, and blatant political opportunism around failing facilities like Burnaby Hospital, Christy Clark’s election platform offered only vague promises to double hospice beds, train more doctors, and add 500 addiction spaces. The electorate was apparently happy with that too.

    As the title of this piece suggests, political success can be gained despite program failure. This because the promise of a program is what the BC Liberals are selling, and what the electorate is buying. Delivery is not included.

    ReplyDelete

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