In July 2002 I became one of the outraged. An outrage, not just about cuts to health care, but also about Canada’s bedrock of democracy: accountability and democratic process. It was a dark era for democracy.
In one fell swoop, bureaucrats damaged Nelson’s hospital — like officials removing children from a family, without warning or consultation. One year after being elected, BC Liberals made audacious and sweeping reforms to health care, devastating morale and teamwork at Kootenay Lake Hospital, established since 1893. The community felt disempowered and a loss of control over their destiny. Like a scalpel slashing a vital organ, officials swiftly closed down residential and emergency surgery at the local hospital.
Before July 2002, I hadn’t heard of acute care. Kootenay Lake Hospital was where you went if you needed serious stuff done. I’d never marched, picketed or attended protest meetings. It was time to act, I realized, and became one of the raging hundreds in this small community. The outrage triggered weekly community and committee meetings, bubbling over into marches, demonstrations, sit-ins, vigils, mock funerals, fundraising, lawsuit threats, ER watch and equipment watch. Sombre meetings ensued with officials and politicians for months, even years.
The Interior Health Authority was one of five authorities formed by BC Liberals as a bureaucratic buffer between its citizens and government. Rural BC saw them as bold new edifices built on shaky foundations. Adopting authoritarian positions, they took orders directly from the paternalistic government. Like a boomerang, the government repeatedly referred people’s complaints back to Interior Health, which was building up and defending their bureaucratic fortress. They employed controlling methods, muzzled or neutered employees, hiring media people as spin doctors. Their drawbridge had been metaphorically pulled up, giving neither a sense of social justice nor a public duty to local citizens. It was an ill-fitting urban health care template, rigidly applied to rural settings. Sole accountability was to government with a sacred bottom line, and an unspoken loyalty to the BC Liberals’ political epicentre in Trail.
Interior Health capitalized on a simmering regional rivalry between Nelson and Trail: health care became a regional blood sport. Trail, given Level 2 regional status, was bestowed the crown jewels. IHA talked about distances between communities “as the crow flies”— not heeding geography, weather, seasons, road conditions, mountains or alas, the battered environment. Relying on ambulances, they offloaded responsibility for patient travel, assuming everyone had transportation. Individuals responded: “Crows don’t fly over mountains; in our winter, it snows.”
Ironically, rubbing salt into rural wounds, Interior Health administrators proposed bonuses for themselves if they kept within budgetary cuts. Elsewhere, touting his government strategy, Premier Gordon Campbell bragged about rural BC as The Heartland.
In one stroke, Interior Health officials became heartless radicals, giving a Level 1 designation to Kootenay Lake Hospital meaning: no residential surgeons or emergency surgery; cutting six intensive care beds; reducing beds from 45 to 30, and maternity and lab services to be reduced to a basic level.
Interior Health tried taking the pressure off the steam pot of public opinion by making a significant promise: in “building a new regional hospital in the Kootenay Boundary region in 10 to 15 years.” Well, this decade is up and not even a smoke signal of the promise.
Ten years is a long time to rage. It’s easier to go with the flow, sitting in the pew with the silent majority. Sitting politicians like that, believing in closed-door strategies — thinking protesting is so dreadfully undemocratic. But paternalistic approaches and a continuing lack of accountability has fostered a “Big White Chief” culture, which pervades many other Canadian halls of power and business.
People still carry on, but advocacy requires effort. Some diehards attend ER Watch; groups meet regularly, seeking to improve health services, but face an Interior Health stonewall. (The Interior Health dropped “Authority” from their name, to soften their battered image.)
There have been victories: maternal care was maintained. Equipment is no longer taken from KLH to be transferred to Trail. Visiting surgeons perform some limited day surgeries and, though it only operates during the day, there is a CT scanner. The Community First Health Co-op is viable. Inter-city buses run between communities.
Health care is too serious to leave to bureaucrats, administrators or politicians. In acute care, safety should be paramount and accountable locally by a meaningfully engaged public. BC Liberals have unleashed a dangerous, anti-democratic legacy for following generations. The lines in the democratic sand must be redrawn.
Before he was elected BC NDP leader, Adrian Dix announced he would restore residential and emergency surgical services to Nelson if he were elected premier. Let’s hope he keeps his promise and, importantly, creates democratically elected, accountable health boards. Maybe Mr. Dix could hold Interior Health accountable for its promise of a new regional hospital — for democracy’s sake, or risk alienating his local political base. People still talk about the Interior Health scalpel to Kootenay Lake Hospital.