LETTER: The North Island’s health-care crisis is a complicated matter

Dear editor,

Tyson Whitney’s bleat about health care in the North Island Gazette (June 14 edition) ignores some basic difficulties about recruitment of nurses and doctors to this area.

Happily we live in a system where highly educated people can choose where they wish to live and work. Young persons who have just graduated from schools of nursing or medicine will be attracted to positions in thriving communities where there are many other opportunities for like minded people.

What we see as the advantages of living in the North Island are not universally acknowledged by these recent graduates.

Let’s face it, Port Hardy and Port McNeill still reflect their origin as forestry and fishing communities, and have innate difficulties competing with the South Island or the Lower Mainland to attract such talent.

Health Minister Adrian Dix and his administrators therefore face a basic conundrum. They have tried to offer minimal financial aid to health care graduates who choose to work in underserviced areas, but it seems to be insufficient. Any significant increase in these financial inducements will have all the other young nurses and doctors in the province out on strike demanding similar increases in income.

One scheme some years ago to require new medical graduates to work in remote communities for some years before they got a general licence in this province was quickly thrown out by the courts.

Both nursing colleges and medical schools have tried to give applicants from remote communities preference in admission procedures, to the great annoyance of applicants from major cities. But in fact, graduates from small communities show only minimal enthusiasm for returning to the towns where they were raised.

Some say the solution is obvious. More remote communities cannot expect the same level of medical care as someone who lives within a 20 minute drive of a major teaching hospital, and those who demand such equivalence are deluded.

For the North Island, we likely have to accept that 24 hour, seven day a week emergency services from an MD in both Port McNeill and Port Hardy mini-hospitals is just not feasible. We might be able to arrange to have a single nurse with advanced training available at one site overnight to assess emergencies, with the ability to admit patients to the local hospital if a bed is available.

This nurse would have the ability to discuss patient findings with an emergency room physician in a major centre (who would get paid for the consultation - currently not available for discussions with mere nurses). If this interaction determines that transfer of such a patient offers significant opportunities for a positive outcome, the physician in the major centre may make an effort to have the patient transferred either by road or by air. Such transfers, especially by air, are enormously expensive, and would certainly not be automatic for patients in a terminal state, or with a small chance of survival. We cannot forget the fatal crash of an overnight air ambulance to Port Hardy some years ago, killing a complete medical team of young volunteers.

You don’t like such a hard nosed approach to medical care in the North Island? Your choice may be limited to persuading your fellow citizens across the province to pay a lot more in taxes for a greatly increased medical budget, or you could move to Nanaimo.

Albert Macfarlane,

Port McNeill