By Lawrence Powell
The emergency department at Soldiers Memorial Hospital in Middleton will be closed more than it's open over the next week due to a shortage of doctors. In fact Sunday, Monday, and Wednesday are the only days it will be open 24 hours a day between now and Canada Day, July 1.
Middleton’s town council is sending a letter to the minister of health voicing its concerns after discussing the issue at its June 18 committee of the whole meeting. Bridgetown council discussed the ER closured June 20 at its regular session and is also sending a letter to the minister.
Middleton CAO Clayton MacMurtry said today council voted Monday night to send the letter -- partly due to the recent spate of closures and partly due to what they see as a long-term problem.
MacMurtry said the short-term problem may resolve itself by mid-July.
“We understand a new doctor is coming to Middleton in mid-July and is prepared to work in the emergency department,” he said, adding that it’s council’s understanding a new doctor is also coming to Windsor at the same time and has also signed on for emergency department duties.
He said the current closures have to do with having only two full-time doctors, both from the Kentville area, performing emergency room duties in Middleton. One of those doctors had a personal emergency and is unable to continue in the emergency department in Middleton.
“We’re looking at a resolution short term,” he said, in regards to the new doctors coming in to the area. “But council’s concerned about the long term.”
He said council understands closures in the last year at SMH have not always been due to doctor shortages but with a pay differential between Valley Regional Hospital in Kentville and Soldiers Memorial.
“That’s an ongoing problem they would like the minister of health to address,” MacMurtry said. The CAO said doctors from other areas of the province might travel to Kentville where the pay is higher but may not find it worth their while to drive all the way to Middleton.
“As a result, Middleton is finding it hard to get people to come down here to work,” he said. “It’s not a regional hospital.”
Lynne Herrigan, VP of Medicine for Annapolis Valley Health, said pay disparity is an issue. The higher salaries for doctors in emergency departments at regional hospitals was a provincial decision and said it made a situation that was not already great a little bit worse. On the other side of the coin, she said it shows that the people who are working at Soldier’s Memorial are really dedicated. “They could be making more money down the road,” she said.
Harrigan said that ideally, SMH should have four full-time and three part-time doctors to keep the emergency department running smoothly. Currently, there have been two full-time and about five part-time doctors. She said AVH books doctors to shifts well in advance, especially for the summer. But she said unforeseen circumstances affected two doctors and created the current problem of closures.
Harrigan said she doesn’t see an immediate resolution because the doctor coming to join the collaborative practice in Middleton will be working to establish a practice. She said she wasn’t aware of a new doctor for Windsor, which is in the Capitol Health District, but said there is a new doctor coming to Wolfville who has shown an interest in covering emergency departments. But even that doctor might not be ready for that until September.
“There’s no question we need a long-term solution,” she said, adding that she’s losing a lot of sleep over the issue. “It’s consuming me.”
MacMurtry said council’s motion Monday also included solicitation of support from surrounding municipalities, asking them to sign on to the letter to the minister as well.
Kings West Liberal MLA Leo Glavine said he is also concerned with the frequency of emergency department closures at Soldier’s Memorial. He said the incidents are increasing and the NDP government is not addressing the problem.
He said that since June 1, the emergency department at Soldier’s Memorial had been closed for 98 hours up to June 15; including 26 hours on a weekend where 1,000 people from across Southwestern Nova Scotia participated in the Cancer Society’s Relay for Life in Middleton.
“For the first 15 days in June, the ER at Soldier’s Memorial was closed for four days,” said Glavine. “The district sites physician unavailability as the cause of the problem – the reality is the Dexter government has done nothing to address the province’s doctor shortage since taking office.”
Annapolis MLA and provincial Liberal Leader Stephen McNeil said there’s no question that pay is an issue and the province has to look at that. He said the province felt that doctors deserved more pay at busier hospital. He said he guessed the reasoning for less pay in hospitals like Soldier’s Memorial is because the workload might not be as heavy. But he said the flip side is that ER doctors in more rural hospitals are basically on their own every shift with no backup.
But he said the issue goes deeper than the pay disparity.
“There’s a number of other steps that need to be taken to have a long-term solution to this,” he said. His party has advocated a central lucum registry for the province that would let doctors from across the province know when and where emergency department doctor services are needed. He said there are doctors willing to travel to ERs if they only knew they were needed.
Glavine said the Liberals have a two-step approach, including the locum registry.
“First, you need to develop a database that will help manage the current pool of available doctors – it would help manage moving doctors from one area into another part of the province to cover temporary doctor shortages,” he said.
McNeil also said there are 3,500 Canadian students studying medicine abroad, but when they come back home to Canada to practice they’re treated as if they were foreigners. He said there are more than 100 such Nova Scotian students, and he knows four of them from the Annapolis County area.
“Some of them are our sons and daughters,” he said.
McNeil said implementation of the rural residency program is a good step forward, but isn’t enough. He said the Liberals have introduced a bill that would hire 100 new doctors over five years for underserviced communities in Nova Scotia.
Glavine supports that idea, the second part of the Liberal plan.
“A Liberal government would cover the education costs for 20 doctors for five years as long as those doctors are willing to serve in the communities most in need of help,” said Glavine. “We’ve tabled this bill numerous times and the Dexter government and past Conservative governments have blocked our efforts to bring new doctors to the people who need them the most.”
SMH ED Hours
Since June 15, the emergency department was closed on Tuesday, June 19 for 14 hours, and is closed today from 6 a.m. to 8 p.m. It closes on Friday June 22 from 6 p.m. and re-opens Saturday June 23 at 8 a.m. On Tuesday, June 26 it’s closed from 6 a.m. to 8 p.m. and is closed the same hours on Thursday June 28. Then on Friday, June 29 it closes at 6 p.m. and opens the next day at 8 p.m.
Annapolis Valley Health wants people seeking non-emergency health information to call 811 to speak with a registered nurse, 911 if it’s an emergency. It also said the emergency departments at Valley Regional Hospital in Kentville and at Annapolis Community Health Centre in Annapolis Royal are available for emergency care.