Of health care and massive group discussions

By Art White:

In the jammed packed gym at the high school in Annapolis Royal last Thursday, the "writing was on the wall" the minute angry AVH board chair David Logie took issue with the reporter whose newspaper article besmirched the integrity of his domain. He berated the medium, then off-handedly thanked the 5th estate for calling us all together.

Hardly a user-friendly welcome to those of us who came by the hundreds to get answers from those who represent our health care interests to the government, esp. health care as it concerns the growing rumor that emergency services will remain less than 24/7 in future for ACHC, possibly leading to a closure of said services, even of the centre.

To quell the rumor, what did he and president/CEO Janet Knox propose? They arranged for a massive group discussion of our needs. A what? A massive group discussion (in 15 minutes it turns out). Come on, get real people... They said they wanted to know about our experience (as if study after study hadn't already determined this). What has been your health care experience? What changes would you like to see? Come on... What do we patients know that you health care providers should already know? That study has been done, AHV. When I served on the board many years ago, the local hospital paid for a study. I supervised it. It was ignored then, my guess is it'll be ignored again if Thursday's meeting is any example client sensitivity. What was the worth of this very long exercise on Thursday? I say it was worth as much as many more carefully controlled-community wide studies that went before it - Zilch.

Here's what we (and AVH) need to know. What are the guidelines Dr. Jonathan Ross used when evaluating emergency services across the province? I mean, what was his check-list and how did we fare? How did Berwick and Digby and Soldiers Memorial fare? Were our special circumstances ever taken into consideration by this ER physician from METRO? Such as: the disproportionate number of potential users of our ER by our own seniors and by tourists here to visit the three national parks, Historic Gardens, tidal power plant, our world-class historic town, our live theatre, museums, B&B's and welcoming Nova Scotians...

Dr. Ross surely knew our catchment area was figured at 10,000, but were the thousands of users at Upper Clements Park included? Was the three million dollar contract with the Sea Cadet Program considered (they demand 24/7 ER services - without it, kiss that contract goodbye.). We are not just a small town health centre; we are a one-of-a-kind community with well-recognized rare resources (I won't list them). Were these things considered on Dr. Ross's check-list? We don't know. What? We may never know (it's privileged information). The board doesn't know, I asked Ms. Knox. She said they requested this information but haven't heard back. How come? Are our official representatives being stonewalled? What's the story, Ms. MacDonald (Minister of Health)? Darrell, you campaigned on NO CLOSURES. Did you mean this? Tell me you meant it and aren't now being snookered by those who run the system? Do they, or does the government run the system? Please tell me the government can carry off its election promises.

A friend emailed this: "I am near speechless with indignation at how cynically -- and successfully -- the meeting was manipulated so that the concrete issues did not get addressed. Polling the audience to ask "how could we make this better," worthy though the question is, was in my view a complete and utter waste of time. AVH knows this already, and if it doesn't, could find out by survey or other polling without burning up the time of the entire meeting -- but then I suspect that was their whole strategy tonight. Keep it personal, so it won't get political. "

Sounds cynical, doesn't it, but I call it astute. Such crucial matters call for us to be, "Wise as a serpent, harmless as a dove." Mr. Editor: I plead with you to make it your top priority to find out everything there is to know about this critical issue for us and for all Nova Scotians. Readers: I plead with us not to let up demanding that the government put up or shut up on ER services. By their own definition and evaluation, the ACHC "team approach" is a model to be emulated across the province. Oh really? I mean, really? Why do I think this is smoke and mirrors and that the harsh bottom line (cutback or closure) was written long ago before the present government took office.

What's the bottom line? I think a failing ER facility in Digby will get the final government nod regarding approved hours of service and support, while Anna Royal will get reduced to a shell of its present self by cuts from a thousand budget knives. Then, when the less-well managed Digby crew continues to fail Dr. Ross's acid test, they too will bite the dust and we will be left with some kind of up-graded Paramedic Emergency Service that will ferry our ailing bodies up to Soldiers Memorial or down to Yarmouth Regional: ya pays your $158, ya takes your choice (did you know that 911 ambulance rides cost the passengers? I didn't.).

To paraphrase the Bard: "There's sometime rotten in the state of health care provision," and Lordie I voted for the gang that promised to stop the rot. Mr. Editor, keep this on your front burner. Please. Readers, we gotta help these bureaucrats and elected representatives get off the dime and get us back to square one. Let's stay on top of this one ‘til the barn door is closed tight on full service health care. My suggestion: demand a meeting with Health Minister MacDonald, ASAP.

Writer's note: after Mr. Logie insisted the next two meetings would follow the same rigid format of off the cuff feedback, I decided not to attend the meetings I had already inked in on my calendar. Perhaps AVH succeeded after all. But, Geez, I was so gung ho, Ms. Knox and Mr. Logie, along with all those folks gathered together on Thursday night to back your board working for constructive, doable changes. Obfuscating the real issues we could have been taking on together was a opportunity you let slip by. My wife, friends and I went away very disappointed that our system might never find its way to a higher road. Alas.

Okay, could we start again, this time meeting with all cards on the table? This time with the Health Minister taking questions (along with local physician stake holders)? I'd be hopeful and up for it if we could. Yes, let's start again...

ART WHITE is from Annapolis Royal and describes himself as “a proud Nova Scotian ‘Townie.’”