The West Block – Episode 17, Season 12 – National | 24CA News
THE WEST BLOCK
Episode 17, Season 12
Sunday, January 15, 2023
Host: David Akin
Guests:
Dr. Michael Howlett, Canadian Association for Emergency Physicians
Dr. Alika Lafontaine, Canadian Medical Association
Tim Houston, Nova Scotia Premier
Location:
Ottawa, ON
David Akin: At the breaking level with overcrowded emergency rooms and lengthy wait occasions to get a household physician or to get a surgical procedure. Is Canada’s well being care system damaged and the way can we repair it?
I’m David Akin. Welcome to The West Block.
Health care emergency after two Nova Scotia households say their family members died after ready hours for remedy in hospital ERs over the vacations. We discuss to 2 medical doctors who say the system has reached a breaking level.
And Nova Scotia Premier Tim Houston campaigned on a promise to repair well being care, so why doesn’t it appear to be working? We’ll ask him how he plans to deal with the well being care disaster going through his province.
Access to well being care whenever you want is one thing Canadians anticipate from our well being care system, however that system is being examined like by no means earlier than and it’s typically enjoying out in emergency departments throughout the nation. Of course the latest case occurred over the vacations, when Gunter Holthoff took his spouse Allison to the hospital in Nova Scotia with abdomen pains. They waited greater than six hours earlier than she was handled, however by then it was too late.
Gunter Holthoff (spouse died in hospital): “She said I’m—I feel like I’m dying. They’re going to let me die here. And, and I just told her like no, that’s why I got you in the hospital. We’re here to get you fixed up and we’ll just be here…we might be here a day or two, but then we’ll go back to normal. No big deal.”
David Akin: Holthoff says he’s talking out as a result of he doesn’t need his spouse’s dying to be in useless. He says one thing wants to vary. So, what would that change seem like? It’s a giant query and we hope to get to that proper now.
Joining us now could be Dr. Michael Howlett. He’s an emergency drugs doctor and the president of the Canadian Association of Emergency Physicians. He’s in Beaverton, Ontario. And Dr. Alika Lafontaine, he’s an anesthesiologist and the president of the Canadian Medical Association, the CMA, and he’s in lovely Grand Prairie, Alberta. And thanks each gents for becoming a member of us, and I mentioned there’s loads to speak about. I do know each your associations have been speaking loads about numerous the issues in our well being care system, however Dr. Howlett, let’s begin with you as representing the nation’s emergency room physicians. We heard about these issues in Nova Scotia, however we’ve heard about emergency room issues in Ontario, in Alberta, B.C., you title it. What are a number of the widespread denominators? What is a number of the key issues that your physicians are discovering in our emergency rooms as of late?
Dr. Michael Howlett, Canadian Association of Emergency Physicians: The issues that we’re going through are literally nationwide and worldwide in scope. The International Federation of Emergency Medicine and our personal nationwide group, all of my colleagues in fairly effectively each province within the nation are experiencing the identical factor and that’s, we have now massive numbers of sufferers who’re admitted to hospital who can’t get out of the emergency division and into inpatient beds and that creates a backlog, in order that emergency division crowding is the primary difficulty. It additionally ends in numerous stress on the employees and since we’re quick in nursing employees, and in some locations physicians as effectively, we have now many extra sufferers being taken care of by too few caregivers. And after all, that creates a stress on the system with the ability to carry individuals in and see them in a well timed manner, be sure they get inpatient care in a well timed manner and ensuring that the employees really feel like they’re doing their job in addition to they probably can.
David Akin: Dr. Lafontaine, I wish to come at it only a barely totally different manner and we heard from Dr. Howlett that one downside was getting sufferers out of the ER and probably right into a mattress someplace else in a hospital, however why are so many individuals exhibiting up in ERs within the first place? Sometimes it might be a GP is simply overwhelmed and saying, go to the ER. Doctors themselves could also be sending too many individuals to an ER. But let’s begin at that time. Why are so many individuals attempting to go to an ER for all the things from a headache to a sprained ankle?
Dr. Alika Lafontaine, Canadian Medical Association: So you know how that we entry care doesn’t work the identical manner that it did previously. You know, if you’re a affected person with an issue, you’d sit again and say, you recognize, I needed to my neighborhood household doctor. If you weren’t assigned to a household doc, you’d go to a walk-in clinic. You’d entry digital care and also you’d type of pull again to accessing emergency rooms except you actually wanted to since you couldn’t entry these different three streams, otherwise you knew that your downside was so acute that you simply needed to go to an emergency room.
The manner that we entry care now, and the way in which that works for sufferers, is that every one of those locations are fully overwhelmed now and so individuals actually solely have the choice of going to the emergency room as a result of numerous these different locations that they used to entry care simply don’t have room anymore. And, you recognize, the experiences of sufferers actually are that they don’t know how one can navigate the system now. You know, and one of many tales that occurred in Nova Scotia, you recognize, they talked about how they drove to the hospital as a substitute of calling, you recognize, an ambulance as a result of they knew an ambulance would take six hours and so they needed to have it as quick as doable trip into the emergency room. And, you recognize, sufferers try to navigate the system, it’s simply very, very complicated to them. It’s very irritating on a supplier facet as effectively.
David Akin: We wish to discuss options and the way we sort things, and generally should you form of watch the TV newscast or learn the headlines, you’d suppose, effectively if the federal authorities simply gave the provinces extra money, all the things could be alright. I do know it’s not that easy. So once more, Dr. Lafontaine, possibly I’ll begin with you from form of the CMA viewpoint. What may be some productive and but comparatively fast areas to concentrate to, to attempt to enhance our well being care system and naturally, this can be a enormous subject. We’re speaking long-term care houses, to emergency rooms, to the household doctor. What could be some helpful methods to maneuver the ball down the street right here?
Dr. Alika Lafontaine, Canadian Medical Association: You know I’ll begin off inside the emergency room itself. You know, we’re having the identical form of demand, it’s all simply being redirected on the identical level and we’re having little spikes that occur as we have now illness processes make their manner all through the system. You know, we discuss in regards to the triple pandemic that’s been going by with flu, COVID, in addition to RSV for youths, you recognize, the identical form of flu acute spike goes to occur for adults, too, not too quickly from now. And so we have now to deal with stabilizing acute care centres like emergency rooms, ensuring that people have a possibility to work their manner by burnout, which I feel is at an all-time excessive proper now, which actually means fixing working environments. You know, one of many negative effects for burnout that I don’t suppose we discuss an excessive amount of is that numerous our senior personnel are leaving for different locations within the well being care system and in consequence, the those that we depart behind are actually struggling as a result of they are usually extra junior so far as their expertise. Now, so far as fixing major care in the neighborhood and different locations, you recognize, a shift in the direction of how we do issues in a different way, shifting away from siloed care in the direction of group primarily based care, may also help us to extend capability and that’s actually about redistributing workload. You know, there’s an infinite quantity of stress in work that rolls downhill in the direction of individuals who work within the entrance line, and sufferers are actually beginning to see the consequences of that of their day-to-day interactions once they want care.
David Akin: Dr. Howlett, I’ll put basically the identical query to you, after all, maybe with a deal with emergency rooms, however what are some options for fixes?
Dr. Michael Howlett, Canadian Association of Emergency Physicians: I must agree, to start with, 100 per cent with what Dr. Lafontaine has mentioned about major care in the neighborhood and the necessity to emphasize or prioritize ensuring the sources are in place for major care, neighborhood care. I additionally wish to emphasize that our acute care amenities, which is the place we work, don’t appear to have sufficient capability to handle all the acute care that’s coming into our hospitals. But in actuality, a part of that’s the lack of neighborhood care and long-term care out in our cities and in rural areas and in city areas as effectively. So what occurs is, as a result of we lack the long-term care capability in the neighborhood, is people who find themselves in hospital who’ve a number of well being issues and their acute care is completed being handled, they then must go to the neighborhood and their purposeful issues are nice sufficient that the neighborhood doesn’t have the sources. We haven’t deliberate effectively sufficient during the last 20 to 30 years to ensure that these individuals can get out of hospital, so that they languish for weeks and months. In any given day, 10-25 per cent of hospital beds are taken up by individuals who don’t want acute care and in reality, they worsen should you depart them in acute care. And that’s actually what’s stopping us from getting our acute care individuals into hospital is the opposite finish of the pipeline is plugged. And so emphasis and precedence on creating useful resource for neighborhood care on each ends, going into hospital and popping out of hospital, is definitely a part of the reply. And then what Dr. Lafontaine mentioned about basically the ethical misery that occurs in caregivers, physicians, nurses, and so forth., once they wish to give excellent care and so they can’t as a result of they must see sufferers on stretchers, their division is overloaded with admissions. So you could have a nurse who’s not solely managing the emergency care, she’s additionally managing the inpatient care on individuals. She’s doing a little long-term care as a result of individuals have are available in with social and purposeful points. The workload is simply too nice, in order that backs up individuals within the ready room. That backs up individuals for admission and it creates this ethical misery as I’ve mentioned which means the caregivers get demoralized about not with the ability to work as much as what they really feel is an efficient customary. And that’s once they begin getting in poor health or begin wanting to go away and go and work elsewhere, and we’ve seen this mass exodus.
David Akin: Dr. Lafontaine, since you’re, you recognize, comparatively near the B.C. border, and we’ve heard through the years, you recognize, B.C.’s attempting to poach nurses from Alberta. Alberta’s attempting to carry onto individuals. Alberta’s poaching from Saskatchewan. In the final week, we noticed the British Columbia authorities provide some new packages to recruit nurses. On the east coast, we’re going to speak to the Nova Scotia Premier Tim Houston about recruiting individuals. Is it an issue that provinces are basically attempting to poach from different jurisdictions to get individuals? Do we want a nationwide technique to recruit from out of nation? We’re speaking about international skilled nurses and medical doctors coming in and maybe having quick tracks. Are there some options there to having a look on the manner we recruit and retain well being care employees, possibly on a nationwide foundation slightly than these provincial silos, every province competing towards one another?
Dr. Alika Lafontaine, Canadian Medical Association: You know, you described the state of affairs fairly precisely. We have a aggressive mannequin versus a collaborative mannequin. We actually have 13 well being care methods which can be working in isolation for essentially the most half, except they select to overlap. You know, we don’t even know what number of nurses we have now within the nation so far as an agreed upon quantity however, you recognize, what number of household physicians or different sorts of specialists have. There are plenty of totally different databases which have plenty of totally different numbers and it’s typically tough to search out even that variety of what truly represents what’s happening within the system proper now. And so, you recognize, what do we want? We want these collaborations throughout provincial and territorial jurisdictions to work with the federal authorities so not solely can we monitor issues, we are able to additionally monitor the wants of sufferers and match these issues in a extra affordable manner. You know, we’ve run into these issues similar to Dr. Howlett was saying as a result of we’ve carried out numerous cuts within the well being care system which have decreased our capability and it’s as a result of we didn’t know, as a result of we didn’t have the information. We weren’t gathering or sharing it, simply how dire the state of affairs could be proper now. So now that we’re within the state of affairs, what’s the answer? It’s collaboration throughout the nation.
David Akin: Dr. Alika Lafontaine of the Canadian Medication Association; Dr. Michael Howlett of the group that represents emergency physicians throughout the nation. Thank you each, gents and I’m sure we’re going to choose this dialog up down the street. Thank you once more.
Dr. Alika Lafontaine, Canadian Medical Association: Thank you very a lot.
Dr. Michael Howlett, Canadian Association of Emergency Physicians: Thank you.
David Akin: Up subsequent, Nova Scotia’s well being care system underneath fireplace after lengthy wait occasions and overcrowded ERs could have led to the deaths of two ladies over the vacations. We requested Premier Tim Houston what he’s going to do about it.
[Break]
David Akin: The Progressive Conservatives in Nova Scotia gained a shock majority authorities in 2021, with a promise to repair the well being care system. But with hospital emergency departments overwhelmed and 130 thousand individuals nonetheless ready for a household physician, did the PCs dwell as much as these guarantees to repair well being are? Well, becoming a member of us now could be chief of the celebration, after all, and the Premier Tim Houston. He’s in Pictou County. Premier Houston, it’s nice to have you ever with this system. I wish to begin with the tragic occasions of final week, these two deaths. And I do know there are some investigations happening to find out the trigger however nonetheless, there could also be people who find themselves now afraid to go to an emergency room in Nova Scotia. What do you say to these Nova Scotians who’re anxious in regards to the care they could get in an ER?
Tim Houston, Nova Scotia Premier: Thanks for having me. I admire the chance for certain and positively, you recognize it’s a tragic state of affairs after we lose any Nova Scotian, any Canadian, significantly these which can be, you recognize, interacting with the well being care system. But what I’d say to individuals is we have now an extremely proficient, devoted, compassionate individuals working in our well being system and also you’ll get excellent care whenever you get within the system. Now the fact is that, you recognize, there’ll, sadly, individuals won’t make it once they work together with the [00:01:18]. That’s the ER system, I imply that’s the very nature of the emergency rooms and it’s unhappy when it occurs. But what I need Nova Scotians to know is we have now extremely proficient individuals working in our well being care system. They’re underneath strain, like no totally different right here than wherever else within the nation. Our medicare system throughout the nation is underneath strain, however the Nova Scotians shouldn’t be nervous in any respect. They will get good high quality care once they get within the well being care system once they get to the emergency room.
David Akin: I discussed off the highest your election victory from 2021 and you recognize this, however for our viewers outdoors Nova Scotia, huge come from behind victory. You had been behind within the polls in the beginning and also you gained a majority. And I feel you hit the candy spot in your marketing campaign messaging, focusing a lot on well being care and clearly tapping into voter’s anxieties about well being care. But are you able to say now, a yr and, you recognize, a number of months in, the system appears worse off now than whenever you took over within the fall of 2021.
Tim Houston, Nova Scotia Premier: Well the system’s underneath strain, there’s no query about that and I feel Nova Scotians will know that I used to be at all times very up entrance with the standing of our well being care system. I used to be at all times very clear with Nova Scotians that it will take cash and it’s, a major, important investments within the well being care system and we’re undoubtedly not—no person would accuse us of reducing corners, that’s for certain. It’s going to take cash for certain and it’ll take time. This is the well being care system. The standing of the well being care system at the moment is one thing that’s developed over, you recognize, years, many years actually. We’ve been on this crash course for a very long time, so it will take time to repair it. Those are two issues I used to be very sincere. And I used to be additionally very clear, it’ll in all probability get somewhat bit worse simply due to the unfavorable momentum we had within the well being care system, and it’s taking cash and it’s taking time, and it’s underneath important strain proper now. But what I need Nova Scotians to know is it’s the individuals working within the well being care system, the well being management group, the minister of well being, proper as much as the premier’s workplace, we’re fully targeted on fixing this well being care state of affairs and our resolve is stronger now than it ever was. We know that there’s numerous strain however we all know we are able to get there, too.
David Akin: And you’re proper, I imply numerous these issues, you inherited them. They’re going to take money and time, however we had this example, persons are nonetheless fascinated about it in these emergency rooms final week. Are there issues that you are able to do subsequent week? Bring within the Red Cross. Do one thing to ensure that doesn’t occur once more. And can you are taking accountability saying, I wish to see this on my desk. This is, I do know Minister Thompson, your well being minister’s going to get onto this, however do you wish to take private accountability and get one thing carried out subsequent week?
Tim Houston, Nova Scotia Premier: Oh, I do take it very personally, very, very personally. I feel the standing of the well being care system is actually on my desk. It’s on—it’s by no means wherever away from my thoughts. I’m very, very targeted on it and I take it very personally. And after we lose someone, the tragic conditions we’ve, you recognize, we’ve heard about not too long ago, I carry that very closely, very closely on a deeply private degree. But we additionally—I imply look; we’ve been in workplace for somewhat over a yr. We launched the Action for Health Care plan, very detailed plan. It’s obtainable on-line. Nova Scotians can see the plan that can transfer us to fixing the well being care system, statistics about what’s truly occurring in our well being system. They’re on-line, very clear. Nova Scotians can see that. And there are a selection of issues that can occur subsequent week, however there’s numerous issues which have been occurring over the previous couple of weeks with, you recognize, pilot initiatives round emergency rooms and now we are able to have the information and develop them out. So for the sufferers, I feel within the subsequent couple weeks, you recognize, they’ll see some noticeable adjustments from the affected person facet, from the shopper facet, if you’ll, and likewise supporting these well being care professionals who’re in there each single day attempting to avoid wasting lives. And there are numerous lives saved within the emergency room. I imply, I heard numerous tales simply this week of conditions the place individuals got here to the emergency room in dire conditions and acquired care and actually had lives saved. So, you recognize, we—no person likes—we’re all crammed with unhappiness when we have now a unfavorable consequence within the emergency room, however on the identical time, you recognize, we even have to grasp that, you recognize, there’s the individuals in there, are devoted to saving lives and so they’re doing their absolute best and they’re saving lives. They simply can’t save all of them. That’s the, you recognize emergency rooms are of that nature.
David Akin: We’ve acquired a few minutes left and I wish to see—to broaden this dialogue of the federal authorities, the federal-provincial relationship. One of the issues I feel the federal authorities could also be nervous about once they get requested for extra money for well being transfers is that they wish to be sure it’s spent on well being. They don’t need a authorities to present tax breaks or one thing like that. This—final week slightly, Doug Ford in Ontario mentioned he’s be ready to [00:05:59] some form of accountability, some strings connected in change for money. Where’s Nova Scotia on that? Would you settle for some particular circumstances in change for extra well being transfers?
Tim Houston, Nova Scotia Premier: Oh, completely. I imply, we’ve been very clear on that. In reality, numerous premiers are. I feel that’s type of a state of affairs that’s been type of I don’t know, misrepresented possibly in some sense, let’s say. There are numerous premiers that simply wish to—we simply wish to accomplice with the federal authorities. And if the federal authorities has some circumstances and a few issues that they need a direct funding to, that’s the way in which it really works with the federal authorities on each file and well being care needs to be no totally different. And we actually—look, we’re not shy about making investments within the well being care on this province and other people would see it within the first funds we tabled that we’re making important investments. We will proceed to put money into well being take care of certain. We simply need the federal authorities to—we’re hopeful that they’ll be there as a accomplice. And if they’ve particular outcomes, particular focused funding they need, that’s okay, too, as a result of we’re going to spend on major care. We are going to spend on emergency care. We are going to spend on seniors. We’re going to spend on addictions and psychological well being. We’re going to spend in all of those areas, so we simply need the federal authorities to be there as a accomplice. We nonetheless name for a gathering with the prime minister to speak about a few of these issues after which simply look one another within the eye. But look, we’re there. We’re targeted on well being care and the federal authorities is simply too, so let’s get across the identical desk and make it occur.
David Akin: When the federal authorities needed to do baby care offers, it went across the nation and did one-on-one offers with every province. Is {that a} mannequin to assist repair the well being system? Would you settle for that if, for instance, the prime minister did a one-on-one take care of Premier Eve in British Columbia and them got here to you and did a one-on-one deal for Nova Scotians? Is {that a} mannequin?
Tim Houston, Nova Scotia Premier: Well look, my focus is on Nova Scotians for certain. But look, this can be a nationwide difficulty. You gained’t go—there’s no neighborhood on this nation the place the headline story will not be about one thing within the well being care system. Our medicare system throughout the nation is on the ropes. And I consider within the public system and I feel that we are able to work collectively as provinces with the federal authorities to salvage our system of medicare. You don’t have to do this one-on-one. Just do it as a nation. Let’s preserve the nation collectively and let’s get going. We take nice delight on this nation on our well being care system with the general public system. I need that, and I feel Canadians need that. So the federal authorities needs to be—you need to be taking a look at this as a nationwide difficulty.
David Akin: And for our last, about 30 second seconds, difficulty a non-public sector supply of well being care, though sustaining the only payer system? It’s come up a number of occasions as a possible resolution. Where does the Houston authorities stand on permitting personal sector supply however sustaining that single payer?
Tim Houston, Nova Scotia Premier: Absolutely. Let’s do it. Matter of reality, we simply on this province, for sure sorts of surgical procedures, we’re doing that, increasingly more surgical procedures, you recognize, utilizing—look, individuals simply need the care that they want and if it’s going to be the only payer system, we’ll—I consider in that system, however we wish to faucet all of the sources, mobilize ever single useful resource. This was a part of my marketing campaign pledge on addictions and psychological well being, the common psychological well being care. It’s the identical idea. If there may be someone that may present the care, then let’s get that care supplied to them. We’re doing it now. We’ll proceed to.
David Akin: Excellent. Tim Houston is the Premier of Nova Scotia. Thank you a lot for becoming a member of us, we very a lot admire it.
Tim Houston, Nova Scotia Premier: Thanks for having me, admire it.
David Akin: Up subsequent, extra fallout from journey chaos over the vacations. And the deputy prime minister heads to the World Economic Forum in Davos, Switzerland.
[Break]
David Akin: Transport Minister Omar Alghabra is promising to strengthen air passenger safety laws after airways left Canadians stranded over the vacations.
Omar Alghabra, Transport Minister: “It’s clear that there is further room to improve and clarify these rules.”
David Akin: At the federal transport committee, airline CEOs apologize for the journey chaos, however they aren’t the one ones going through blame. Over the vacations, trains had been caught for nearly 20 hours between Ottawa and Toronto. The head of VIA Rail is anticipated to look on the transport committee quickly, to inform Canadians how that occurred. We’ll be watching that story carefully.
And, Deputy Prime Minister Chrystia Freeland is heading to Davos, Switzerland for the World Economic Forum this week. Inflation is bound to be a scorching subject, with a brand new report warning that the price of dwelling will probably be “the most severe global risk for the next two years.”
Well, that’s our present for at the moment. Thank you for watching. For The West Block, I’m David Akin. Have an important week.
