Dix health care plan would ‘destabilize’ local health care

I was very disappointed to read the statements in the Nelson Star attributed to Adrian Dix, the new British Columbia NDP leader.

Re: “Dix would bring back hospital services in Nelson,” April 7

I was very disappointed to read the statements in the Nelson Star attributed to Adrian Dix, the new British Columbia NDP leader.

I am a general surgeon who has been working in the West Kootenays for the past four years. The article states that Dix’s $40 million plan will provide 24 hour CT scanner coverage in Kootenay Lake Hospital, an ICU and on site general surgeon. He claims this will relieve pressure on the regional hospital in Trail, which would be able to invest the savings into “more acute care services.”

He is further quoted as saying “Their cutbacks (referring to the current Liberal government) left Kootenay Lake Hospital with the only emergency department in the province serving a population of 30,000 without access to general surgery or intensive care. This has led to multiple documented instances of compromised patient safety and care, and increased pressure on health services in Trail.” This statement is misleading if not frankly in error. Let me explain why this is the case.

Firstly, it is not true that patients living in Nelson and surrounding areas do not have access to general surgery. It is true that Kootenay Lake Hospital does not have a resident general surgeon. However, as a general surgeon at the Kootenay Boundary Regional Hospital in Trail I can vouch for the fact that I am up into the small hours of the morning taking care of patients from Nelson and surrounding areas, working hard to provide top quality care to the patients whom I serve. At least once a week there are scheduled general surgery cases being performed in the Kootenay Lake hospital. At least once a week there is a general surgery clinic in the Kootenay Lake hospital.

Further, there has not been a single incidence of patient morbidity and mortality that can be attributed to a delay in receiving appropriate surgical care since regionalization of surgical services. I suggest that if Mr. Dix thinks otherwise, he should ask for an independent review of these supposed cases of “compromised patient safety” to set the record straight.

We surgeons at the regional hospital in Trail are committed to providing 24/7 general surgery coverage for the Kootenay Boundary region, and we have done so for the last 10 years without a single gap in coverage.

Mr. Dix is in error when he claims that the Nelson population has no access to general surgery. The proposal to place a general surgeon in Nelson is flawed. A single surgeon cannot provide care for 24 hours a day, seven days a week in Nelson — THIS would be dangerous and unfair, as opposed to the current situation which is both safe and fair, with each surgeon splitting on call duties one in four. Would you want a pilot who has been flying non-stop for four days straight with little sleep to pilot your plane? If not, why would you want a surgeon operating on you who has been on call for four days straight?

Secondly, this proposal will not provide the regional hospital with more funding as Mr. Dix suggests, but will take funding away from surgical services at the regional center, and place them in the community hospital setting instead. Funding in health care is limited, even under an NDP government, and when you provide more to one, you take away from another.

Before that decision is made and all of the changes of the last 10 years revoked at great cost, objective criteria should be used to test the theory that regionalization is worse for patients as Mr. Dix claims. In my opinion as a surgeon in this area, Mr. Dix’s suggestions will have a crippling effect on the very stable general surgical services that are in place now.

Thirdly, Mr. Dix’s statement that patients living in Nelson and surrounding areas do not have access to intensive care is also flawed. We now after much hard work have a fully functional ICU in Trail, a local intensivist (a specialist devoted specifically to intensive care), and other very dedicated physicians who are responsible for the care of these very unstable patients. It has been shown in peer-reviewed studies that small ICUs are more dangerous for patients and are not standard of care. Also by bringing an intensive care unit to Kootenay Lake Hospital, further resources will be drained from the regional center, making quality care less likely not more so.

In conclusion, not only do I feel personally insulted by Mr. Dix’s comments, but I think there are good reasons that his plan will only serve to destabilize a system that we have been working hard on for the past ten years. The article reads “Dix would have a group of independent health policy and service delivery experts evaluate the program’s impact after three years” (emphasis mine). Mr. Dix, rather than first destabilize a system, then in three years time evaluate the trauma which you have caused, look before you leap and assess the situation first before making these rash decisions promised for your own political gain.

As an addendum, I would like to propose that instead of these proposals, Mr. Dix should take some of our $40 million and properly fund our BC ambulance service, and pay ambulance attendants appropriately for the hard work that they do. If he is truly concerned about Nelson patients having prompt 24/7 surgical care, I propose he fund a dedicated ambulance to safely and promptly transport patients between Nelson and the regional hospital in Trail. This would do more to ensure the safety of his citizens than throwing money away on risky investments that will not work.

Dr. Andrew Lawe, MD, FRCS(C), Trail