Rocco Mastrobuono

Rocco Mastrobuono

COLUMN: Where does it end?

Interior Health’s decision not to replace mammography equipment in Nelson sends a troubling message to the community.

Recently, Thalia Vesterback rebutted an article in the Nelson Star questioning the Interior Health Authority’s recent decision not to purchase a new digital mammography machine for Kootenay Lake Hospital and move these services to Trail, which can absorb the additional capacity. Her response was misleading, neglected some hard truths and has raised more questions than it answered.

The lack of transparency in making this decision is alarming. Who was consulted before this decision was made? The regional health board? The city or regional district? Doctors? Residents? I have a sneaking suspicion that the answer is “none of the above” and this decision is the result of IHA administrators huddling around a spreadsheet.

Ms. Vesterback claims that screening vans coming to Nelson effectively makes replacing the diagnostic mammography machine unnecessary. However, what fails to come across is that screening and diagnostic mammograms are inherently different. Diagnostic mammograms are more detailed and allow physicians to make a diagnosis based on an irregularity detected in a screening. Screening vans are not at all a replacement for diagnostic mammography machines and it is borderline irresponsible to say so.

It is further claimed that the mammography machine in Trail is used more and that additional capacity exists. This is highly misleading and not an apples-to-apples comparison. Breast surgery services have been concentrated in Trail and mammograms are often used as a tool in guiding many kinds breast surgery. With this concentration of services, of course the machine in Trail is used more. But why should this mean that Nelson’s machine shouldn’t be replaced? I highly doubt that it is collecting dust in the corner of some storage room.

As misleading as this is, how this translates to Kootenay Lake Hospital not meeting federal standards for workplace safety and exam frequency is downright insidious. What federal standards is Ms. Vesterback referring to? If the IHA is prepared to make such an incendiary claim, I think it is only fair that they specify the particular standards/regulations where Kootenay Lake Hospital is non-compliant and statistics be presented showing how it compares to other facilities. If it is indeed the case that the Kootenay Lake Hospital fails to meet multiple federal standards, as it is claimed, why is the IHA only doing something about it now?

What Ms. Vesterback and the IHA consistently fail to take into account is the stress and expense of travelling to Trail for procedures. Not everyone can drive themselves to Trail, nor does everyone have someone they can rely upon to take them there. Public transport options are severely lacking, no matter what the IHA claims, and a BC Transit funding freeze will have a negative impact. While driving to Trail from Nelson in winter is tough enough (made worse by the stress of medical problems), one must only consider how much worse it is for someone coming from Kaslo or further. Unfortunately for Ms. Vesterback, apologies for inconvenience caused offer no comfort.

It must be remembered that this decision was not a question of budget cuts. There will be no commensurate reduction in staff at Kootenay Lake Hospital. This is a matter of not wanting to replace an aging piece of equipment. This begs the question: why won’t the IHA allow the foundation to raise the relatively modest $300,000 to purchase the new machine? If the community is willing to purchase the machine and the staff to operate it remains, there is no rational reason why this shouldn’t be seen as a win-win situation for all involved.

The logic that the IHA is using is flawed at best and misleading at the worst, and marks a continued reduction in services at Kootenay Lake Hospital. Will the IHA use the same justification in 10 years when the Nelson CT scanner reaches the end of its lifecycle?

We have one last question for Ms. Vesterback and the IHA: Where does it end?

Rocco Mastrobuono is a Nelson resident who has helped raise money for the Kootenay Lake Hospital Foundation.