Whitehorse Daily Star

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Photo by Vince Fedoroff

HOSPITAL OVERCROWDING DEBATED – Dr. Chris Simpson, the president of the Canadian Medical Association, addresses Yukon Medical Association delegates last Friday in Whitehorse.

‘Hospitals are toxic for people with chronic disease’

The president of the Canadian Medical Association says solutions to overcrowded hospitals lay in home-care and long-term care, rather than beefed-up hospitals.

By Christopher Reynolds on November 13, 2014

The president of the Canadian Medical Association says solutions to overcrowded hospitals lay in home-care and long-term care, rather than beefed-up hospitals.

“We think that if we can fix seniors’ care, it will go a long way toward fixing what’s wrong with health care in the country,” said Dr. Chris Simpson, addressing doctors at the Yukon Medical Association’s annual general meeting last Friday afternoon.

“We don’t have a health care system that’s designed to deal with chronic diseases like diabetes and dementia and heart disease and lung disease.”

Simpson noted older individuals are more likely to fall prey to chronic diseases, rather than acute problems, “whereas hospitals are for people with acute illnesses.

“What we want to do is find ways to build the infrastructure and the community to look after people with chronic diseases better and free up the hospitals to do what they’re supposed to be doing, which is acute care,” Simpson said in a post-speech interview at the High Country Inn.

His remarks followed a drawn-out, anger-spiked question to Premier Darrell Pasloski — who also addressed the gathering along with Health Minister Doug Graham — by Dr. David Storey, one of four general surgeons at Whitehorse General Hospital (WGH).

Storey asked why little was being done in the short-term to free up surgical recovery beds for elective operations patients.

Several have been turned away at the door this year, in some cases because the beds were occupied by long-term care patients, he said.

Palliative care patients have also been sent packing, transported to Watson Lake due to a lack of space at hospitals and long-term care facilities in Whitehorse.

For solutions, Simpson pointed to Europe, “where they’ve managed to deliver better quality care for cheaper.”

He identified Denmark, which has invested in home care at a rate five times that of Canada, as the poster child for efficient health services and adapting to the needs of an aging population.

The Copenhagen-based public health system there has not added new long-term care beds in two decades, and has even removed thousands of acute-care beds “simply by shifting the focus on delivering the care where seniors need it, which is in the community and in their homes,” he said.

Simpson, the medical director of the cardiac program at Ontario’s Kingston General Hospital, said his own institution faces similar problems to WGH.

Last month at Kingston General, 18 of 31 days — nearly 60 per cent — were spent in “gridlock,” meaning all beds were full.

Scores of patients were waiting for long-term care facilities, home care “or really should never have been there in the first place,” Simspon said.

“No elective surgeries got done. No transfers came in from the periphery to our tertiary care centre.

“The whole place was basically shut down for 18 of the 31 days, simply because we’ve got people in the wrong place.”

“Hospitals are toxic for people with chronic disease,” added Simpson, also a professor of medicine and chief of cardiology at Queen’s University.

“We put these people to bed — because that’s what we do in hospitals — instead of lifting them up and restoring them and helping them live a dignified life at home.”

He summed up his recommended strategy: “de-hospitalize the system.”

The Yukon government announced last July it would move ahead with a $72-million Whitehorse hospital expansion, now underway. It includes a new emergency department, shell space for more beds and an MRI (magnetic resonance imaging) program.

The two-storey WGH renovation is slated to include 17 treatment spaces on a 2,200-square-metre (23,700 sq. ft.) footprint along the east side of the current building, cutting into the parking lot.

Above it will sit a slightly smaller space with 10 new in-patient beds. How exactly those beds will be used is not yet determined.

At the meeting last Friday, Pasloski noted health care takes up one-third of the government’s operations and maintenance budget.

“I’m not going to back down saying that I think we have an incredible health care system,” he told the assembled doctors.

Pasloski also pointed to the new Alexander Street seniors’ residence, which had its ribbon-cutting ceremony this morning.

The Yukon currently has four long-term care facilities — three in Whitehorse with 182 beds and one in Dawson City with 11 beds.

A planned 300-bed continuing care facility, with a price tag of around $126.2 million, is still years away.

Described by Graham as a “huge, huge building construction project,” the plan has been criticized by the Opposition as over-centralized and lacking in public consultation.

Last March, more than two dozen patients were on a waiting list for continuing care.

A report from June 2013 by Kobayashi + Zedda Architects notes the Yukon will need upwards of 320 new continuing care beds by 2021.

The need to replace the 1970s-era Macaulay Lodge and the Thomson Centre – just 22 years old – will also factor into the number of new beds needed, the report notes.

During building reviews, the writing team found that Macaulay Lodge does not meet the building code for its current use.

The Riverdale facility scored under 50 per cent on the technical assessment and has a 7.5-year life expectancy.

Some suites and numerous bathrooms at the lodge are too small for a wheelchair to manoeuvre, one of several difficulties with the space.

Since the report was published, the Thomson Centre has reverted back to the Yukon Hospital Corp., no longer the responsibility of the Department of Health and Social Services’ continuing care branch.

Graham has said the expected new facility — 59,000 square metres (194,000 sq. ft.), and initially holding only 150 beds but with room for expansion to 300 — will eventually replace the beds at the Macaulay and Thomson facilities.

The government-commissioned report also stresses the need for various types of care that should be incorporated into the continuing care hub.

These include respite care, specialized secure care for residents with dementia, palliative care, day care programs, stabilization and assessment facilities, facilities for obese patients and mental health facilities.

Comments (5)

Up 89 Down 86

Some parts of Yukon Gov't Toxic to Work in on Nov 19, 2014 at 7:23 pm

Yukon Government needs an overhaul in senior management and if you look at the 100's and 100's of employees going on leave because a toxic work environment the people of the Yukon would be in shock how bad it really is. The Yukon Government inherited a toxic work place from the Federal government when they took over the services in the 1990's. The Yukon Government system has to be changed for the betterment of all including the employees of the Yukon Government.

Up 100 Down 87

Atom on Nov 15, 2014 at 1:21 pm

The Yukon will always have this type of government run mismanagement.....too small to pick from any crop of real politicians (Cathers yikes), too small town and set in it's ways....I actually like it that way in some ways...... something of note is the level of professionalism in the Hospital itself.....the wait times in Whitehorse ER are not significant and I find the staff of nurses and Dr's there to be awesome people who really care about patients.

Up 114 Down 88

north_of_60 on Nov 13, 2014 at 9:11 pm

The problem is that YTG hijacked the long term care beds at the Thompson Centre so more people could have private offices.
Typical self serving government ineptitude we've seen many times elsewhere.

The problem isn't the facilities it's the inept management by YTG bureaucrats who are way above their maximum level of competence.

Up 102 Down 99

Wilf Carter on Nov 13, 2014 at 7:53 pm

It is interesting I was in Kingston just a month ago and a family member told me that we in the Yukon are so lucky to have the heath care services we have in the Yukon. Because in Ontario it could take months to see a specialist. I total agree because I have had to have many specialist look after my health.

Up 102 Down 87

June Jackson on Nov 13, 2014 at 6:15 pm

Its really convenient for health care incompetents to blame poor health care delivery on seniors in Canada. As soon as we run out of money it's, damn those aging Canadians and jack those income taxes. However, read on, because the experts are saying:

"There is a worrying rise in health care spending in Canada, but it doesn't have much to do with population aging. To stay with the oceanographic metaphor, aging might be, at most, a modest tidal wave. The real tsunami of health spending is the result of changes in the way all patients are treated in the system, resulting from both price inflation (drugs and doctors cost more than ever) and technical progress (new diagnostic tests, surgeries and drugs).

The yearly increases in total health care spending in Canada -- approximately 10 billion dollars per year nowadays -- does not result from aging per se, but the costs of treatment, including diagnostic tests, drugs and doctors, for all patients, young and old. It's not that we have too many seniors that will break the bank, but how those seniors, and others, are treated in the health system that affects the bottom line.

Put another way, aging on its own adds around two billion dollars to the annual health care bill while changes in the cost of treatment per average patient adds eight billion dollars.

What are we paying for inferior health care anyway?

All this being said, it doesn't mean Dr. Simpson is wrong. If he can get his ass out of the blame everything on aging myth, oh.. and Paslowski and Graham can pull their butts out of that myth too..it IS good for all folks to remain in their homes with their remote in one hand and the pet snoozing beside them. They are far more comfy with that scenario rather than a really uncomfortable narrow bed with the occasional drunk wandering into their room (wandered into my room while I was in the shower) and all the other annoyances that go with it. But it comes down to the money again doesn't it? Stick someone in the hospital, its free, send a nurse to check up on them and it's what? 110.00 an hour? If they go into Continuing Care the government takes everything, and I mean every single penny, they have and gives them back $100. a month "comfort money".

Bottom line? Dr. Story..there is a lot more to the 'not enough beds' and 'too many seniors' tale of woe. Health care will continue to be overwhelmed in all areas as long as you don't go any farther for solutions than.. "Aging Canadians"....

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