A new advocacy coalition has formed to ensure fair care for all of Vancouver Island

On May 16, VIUSU’s legal counsel sent a letter to VIU President Deborah Saucier, Minister of Post-Secondary and Future Skills, Lisa Beare, and the VIU student body. Photo: Lauryn Mackenzie / CHLY 101.7fm

Medical, Indigenous, municipal and regional leaders have come together to form a new advocacy coalition to ensure fair access to health care for those north of the Malahat.

The Fair Care Alliance advocates for those living in north and central Vancouver Island to have access to appropriate and comprehensive tertiary care. The Alliance said it has two primary objectives through their work; to gain a commitment for a new patient tower at the Nanaimo Regional General Hospital (NRGH) that would increase bed capacity and to secure commitment for a cath–or catheterization lab in Nanaimo.

While Nanaimo has the fastest-growing and fastest-aging populations in Canada with the busiest ER on Vancouver Island, the alliance said Central and North Island receive 1/5th of the health resources compared to the South Island.

The Alliance held a press conference on May 29, to announce the coalition and to speak to the current state of care for those north of the Malahat.

Donna Hais, Chair of Fair Care Alliance spoke at the press conference along with several other current and retired medical officials.

Hais started off the press conference by saying for those who may not have heard of what the alliance has been advocating before, the lack of care in the central and north island area may be shocking.

“If we listen to our government, they tell you about this world-class health care system that we all have equal and fair access to,” she said. “And what you're going to hear today is that clearly, if you live north of the Malahat, we do not live within the standard of care. We distinctly live below the standard of care that we are as Canadian citizens entitled to demand.”

Dr. David Forrest is the head of infectious disease and critical care at the Nanaimo Regional General Hospital. He said the NRGH has the busiest emergency department in Vancouver Island and is one of the busiest in the province.  

“It's no surprise then that NRG regularly runs at or more than 120 per cent capacity with 420 inpatients for more,” Forrest said.

He said that the NRGH only has 345 beds for the over 400 patients they see every day.

“This means not only is the [emergency department] overrun with emergency and inpatients in hallways, but on the wards as well,” he said. “Where closets and storage areas are used for patient care.”

He said due to the lack of space, there is no privacy for patients when getting care. He said there is an urgent need for a new patient tower as the current one is inadequate even to renovate.

“The infrastructure, plumbing, electricity and so on, is antiquated and barely able to meet current needs without the ability to upgrade. The walls are filled with asbestos making even simple alterations expensive, inefficient and extremely difficult,” he said. “There is a one in three chance of a major earthquake in Nanaimo in the next 50 years, but the current hospital structure is a deathtrap falling far below any standard of seismic disability.”

Dr. Alison Croom, Medical Lead of Nephrology at the NRGH, and the medical director for kidney services island-wide, spoke about the importance of using the NRGH as the tertiary hospital it is.

She explained that a tertiary hospital is a referral center that can provide full spectrum subspecialty care for patients that require higher level care or more specialized services. 

“These include full-service cardiology program, full-service kidney program, including dialysis for admitted patients, other medical specialties like a neurology program to manage stroke patients, and infectious disease specialists among numerous other medical subspecialties, a trauma program, higher level critical care services, vascular surgery, and the capacity for radiology to perform more interventional or more invasive procedures,” Croom said.

The NRGH is one of three tertiary hospitals on Vancouver Island, the other two are in Victoria, Victoria General Hospital and the Royal Jubilee Hospital. Currently, the NRGH only offers one tertiary program at the hospital for kidney care.

Croom said the NRGH is the referral center for all kidney care for the central and northern island area.

She said recruiting physicians without the required tertiary programs, infrastructure and resources is not sustainable.

“We see physicians come and then leave because they cannot develop nor manage these programs, which has been very restricted to the South Island,” Croom said.

She said Nephrology and critical care are the only two full-service specialties that have been able to recruit and retain physicians and develop robust programs at the NRGH.

“We know that delays in access to subspecialty care worsen medical outcomes, and my colleagues will discuss this further,” Croom said. “In addition, having to travel long distances to access these services, separates patients from their families out from the communities they reside in, and really adds to the stress of illness. And this has many repercussions that are difficult to track.” 

She said this also particularly disadvantages the Indigenous populations on the island.

“We have a responsibility as a health care system to address this disparity and ensure that we have equitable access to health care,” Croom said. “And health services for all peoples residing on Vancouver Island and the responsibility to provide culturally sensitive care.”

Dr. Neil Swartz is the former Head of Internal Medicine at the NRGH, and he said there is a great need for a cath lab in Nanaimo.

Currently, the only two cath labs on Vancouver Island are south of the Malahat with zero servicing the north and central island area. There are 22 cardiologists south of the Malahat,  and only 2 for the north and central island area. The north and central island area makes up 51 per cent of the total population on the island.

Swartz said according to Canadian Cardiovascular Guidelines the standard care for treating a major heart attack is to go directly to a cath lab to check for a blocked artery that can be opened if needed. Because the only cath lab on the island is in Victoria, only those who live in Victoria have immediate access to this type of care.

“And that's why if you're living in central-north island, the best time to actually have your heart attack is when you're visiting with Victoria and having tea at the Empress Hotel,” Swartz said “That's when you're gonna get the standard care, that's when you're gonna go directly to the cath lab.”

He said the treatment for a heart attack at the NRGH is inferior. He explains that patients at any hospital north of the Malahat experiencing a heart attack would be given Thrombolytics also known as clot busters. He said Thrombolytics is a powerful blood thinner that can cause brain bleed. He said most people who get Thrombolytics will still have to be transferred to a cath lab.

“Since heart disease is the number one killer, all health authorities within the country should be prioritizing cardiac care and most in fact, are strategically building cath labs in locations so that healthcare delivery is optimized and the majority of their citizens will have access to this life-saving procedure,” Swartz said.

He said if a cath lab was to be built in Nanaimo, it would become a hub for central island communities 

“Up to 450,000 residents would then have access to the same standard of care for heart attacks that is provided in the Victoria area,” Swartz said.

Nanaimo City Councilor and Chair of the Hospital Board for the Regional District of Nanaimo, Ian Thorpe spoke at the press conference saying the Regional District and the Nanaimo Regional Hospital District board have made the need to improve care at the NRGH a number one priority.

He explained that the regional hospital board has to provide 40 per cent of capital funding for projects and the provincial government pays for the remaining per cent.

“That's a lot of money. Because if we are talking about a new patient tower, we're talking about multi-billions dollars, we have to come up with 40 per cent of that funding,” Thorpe said. “Where do we get it from? We got it from local taxation.”

He said several years ago the NRHD board decided to increase the hospital tax levy as a way to put the money aside and show the provincial government they can fund the project.

“Now, I don't like to announce that we are increasing taxation,” Thorpe said. “but I have never had a single person complain to me about this increase in the hospital tax levy because when you explain the situation to people, they totally understand.”

At the end of the press conference, Donna Hais wrapped up by calling on the community to join in on their movement and make a noise so loud in calling for better care, that the provincial government cannot ignore it.

The Fair Care Alliance also has an online petition on their website calling on the provincial government for improved services and support at the Nanaimo Regional General Hospital for those who live north of the Malahat.

Funding Note: This story was produced with funding support from the Local Journalism Initiative, administered by the Community Radio Fund of Canada.