Reopening the IHA sore

A few weeks ago a member of our household fell down a flight of stairs and was rushed by ambulance to hospital.

A few weeks ago a member of our household fell down a flight of stairs and was rushed by ambulance to hospital.

I have nothing but praise for the first responders and the ambulance staff, who were all careful, considerate, skilled and professional in their approach. At the hospital, the duty emergency doctor also dealt with her problem and diagnosis with great care and skill. But while a local x-ray showed no broken bones, the doctor  wanted to send her to Trail for a CT scan because of concussion and possible neck injury.

I was flabbergasted. Had not this community just raised a very large sum to buy a CT machine? Was it not around the corner in the imaging department? And hadn’t the main reason been to provide doctors with enhanced and timely diagnostic service in cases just like this? Had not the operating costs been duly considered when the project was launched?

On questioning I learned that the Interior Health Authority, subject to evaluation, had not approved nighttime service because of the cost, and also because they did not wish to degrade the “regional hospital” at Trail.

I understand the former: minimum staffing of a 24/7 service such as a CT scan is not cheap when one considers salaries and benefits, but neither are lives cheap.

Some years ago, when the emergency ambulance system was set up, as a management engineering consultant in the Ministry of Health in Victoria, I was asked to do a study of emergency room services. So I looked at several BC hospitals, large and small, that showed that the greatest incidence of serious trauma, potentially deadly strokes and heart attacks was at night.

The evaluation that IHA required could be done by sampling on the basis of existing records and “waiting to see” is nothing more than a delaying tactic. It’s at night the doctors need the CT scanner, not just in the afternoon.

Years after the negative influence of Gordon Campbell and his financial gurus made the decision to attack the health system I could be accused of a lack of wisdom in reopening the sore of the whole IHA scandal.

Well, in the beginning, who made Trail a regional hospital and gutted the capability of Kootenay Lake District Hospital to serve its people from Meadow Creek to Creston and from Nelson to Castlegar? I am given to understand that the key player on the original planning staff was the former administrator of the Trail hospital. And also, what influence did Teck Cominco have on that decision?

Ironically, before this abortive health administrative system was set up, equipment decisions were made by one mid-level civil servant in Victoria. Now we have over-blown regional administrations all over the province, of which IHA is only one, not to mention all sorts of other “administrators” to massage decisions, and mouthpieces to try to divert anger and favourably influence the public.

Some will say, “enough, already, it’s a dead argument.”  It is not a dead argument when lives are at risk. I think we should return to the former system of local hospital boards sensitive to local needs, regional health districts and a system that is close enough to politicians that the politicians take the heat for inadequacies and stupid decisions, not hiding behind additional layers of costly and unnecessary IHA bureaucrats.

My recommendation would be to fire all the additional IHA administrative staff and with the money put doctors, technicians and nurses where they are needed, at the patient’s bedside. Campbell’s gutting of the old system has not saved money, but like most reorganizations has increased cost and administrative complexity.

Maurice A. Rhodes



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