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Healthcare on the mend

LWG holds public consultation outlining its report to VIHA.

PORT HARDY—Around fifty local residents were on hand in the Port Hardy Civic Centre last week as the community took the pulse of heath care on the North Island.

The public consultation was an opportunity for residents to hear the steps being taken to improve the state of medical services on the North Island and for representatives of the Local Working Group on Health Services Stabilization to gather public's input.

Port Hardy Mayor Bev Parnham and Alison Mitchell, Vancouver Island Health Authority's Senior Manager of Rural Health, chaired the meeting, opening with the challenges facing the region and citing statistics that identify the North Island as one of the most demanding areas in VIHA's territory.

The North Island has some of the worst statistics of malignant cancers, particularly in women, teen pregnancies, suicide, and drug- and alcohol-related deaths in VIHA, leading to the lowest life expectancies in the region.

Compounding these difficulties are issues of physician shortage, ER burnout and geographic isolation leading to a "perfect storm" as described by the LWG's report.

The LWG was formed in Nov. 2011 after a series of emergency room closures in Port Hardy led to a protest. The group, comprising health professionals, local government and First Nations representatives, penned a report and recommendations to VIHA in April of last year to which VIHA responded positively.

Last week's consultation was to present some of the aims of the LWG and updated information on its goals, and to gather public opinion on the process.

Two issues in particular were the focus of much of the meeting. First, and most crucial, is the drive to recruit new physicians to Port Hardy. The area currently has two doctors, with six seen as the ideal quotient.

The lack of doctors has led to long waits for appointments and long ER shifts for the physicians. This wait time to see a physician has led to residents using the ER as a drop-in clinic, exacerbating the ER staffing problem which in turn makes the area less attractive to prospective doctors.

The major issue in attracting physicians is seen as competition. With a finite supply of medical graduates each year, Port Hardy faces stiff competition in recruitment.

Compounding the problem is Port Hardy's designation as a "rural" community within VIHA. The designation opens up subsidies and support programs to aid recruitment, but the designation has been applied somewhat liberally, with communities such as Duncan and Comox enjoying "rural" status. The LWG's report recommends a new designation of "remote" to redress the balance.

To address the issue of physician shortage VIHA has added two Nurse Practitioners to Port Hardy to increase access to primary care and is using locums to cover ER hours.

VIHA has also bankrolled specialist recruiters to headhunt doctors who are likely to be a good fit for the North Island. Mitchell announced the recruiters had narrowed a short list to eleven possible candidates, with an update on recruitment efforts expected this week.

The LWG has also recommended a change to the payment model for physicians, moving from a pay-per-visit model to a salaried option, with the hope of releasing pressure on physicians and improving the quality of visits for patients, while making the area more attractive to recruits.

Intertwined with the recruitment drive is the proposal for two new integrated primary care facilities on the North Island, beginning in Port Hardy and following with a new site in Port McNeill.

To that end, VIHA has committed $100,000 for planning of the facility, and Mitchell announced at the meeting that a further $300,000 and a 2014 capital funding marker had been committed to the project.

"The current system is not meeting the varied needs of our community," explained Mayor Parnham. "The urban model is not sustainable. We cannot attract the physicians we need — we have to think better and smarter. I really feel strongly that integrated health will help us."

The vision for the new centre is to have everything under one roof, streamlining the healthcare system for both patients and medical professionals.

A patient would have a team of professionals assigned to their care, and would be assigned to the appropriate entity on each visit. For example, a patient requiring a prescription could be referred to a Nurse Practitioner instead of a doctor, while a pharmacist would be best equipped to answer any questions on the drug itself.

The aim is to use the full scope of each healthcare professional's ability, improving efficiency, promoting communication, reducing waits, and streamlining the process for both the patients and medical professionals. In addition, the integrated model would represent a significant draw to recruits since it reflects the team-concept model used in training.

"We're shooting for the stars here," said Mayor Parnham.

A request for proposals for a suitable interim clinic space in Port Hardy closes on Mar. 1.

A number of other issues were raised during the question period, notably transportation issues which Mitchell acknowledged. "Transport is certainly a huge issue. We see it as a factor in the trends (increase in malignant cancers in the region, etc.). Chronic issues are exacerbated by people not wanting or unable to travel for testing," she said.

LWG members are examining several methods of ameliorating the problems that the area's geographic remoteness presents, from tele-health to the possibility of bringing a mobile MRI machine to the area.

Also noted at the meeting was the fact that since the LWG's formation the ER in Port Hardy has only had two closures — once when the attending physician had to travel with a patient in a serious condition, the other due to illness — information that was warmly received.

The LWG's comprehensive report was made available to the attendees, and covers the gamut of healthcare-related issues and potential solutions. It can also be found online at

The consensus among those in attendance seemed to be that the status of North Island healthcare could be downgraded from critical to stable; still in need of intensive care but on its way to satisfactory.


"Last year I was at the end my rope," said Brenda McCorquodale of Port Hardy. "I'm impressed with the work that's been done."