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November 7, 2003

No Protection for Saint Mary's

The Campbell government has a way with words; they could even teach George Orwell what "New Speak" really means. Its news release on closing Saint Mary's Hospital is captioned "Province Protects Services for Fraser Health Patients". You would never guess that the release concerns pulling the plug on the hospital that has provided 117 years of service to the community.

When asked why he couldn't work with the hospital board to resolve problems, Health Minister Colin Hansen referred to the Morfitt report that is on the government website (pdf). Former Auditor General George Morfitt was asked to report on three issues:

  • the viability of St. Mary's current business plan, including the development of revenue generating programs and services from other sources to support the sustainability of the hospital in its ongoing role to provide services to the Fraser Health Authority;
  • the capacity of St. Mary's to implement the business plan successfully and in the time frame required by the Agreement in Principle between St. Mary's and the Fraser Health Authority;
  • the feasibility of the concept of the "purchaser-provider" Agreement in Principle between St. Mary's and the Fraser Health Authority.

Morfitt was not asked to report on the most important question - will patient care suffer as a result of changes in the Fraser Health Region that involve Saint Mary's?

The first set of changes to the hospital originated in July 2002 when the Health Authority issued a notice of termination of its affiliation agreement with the hospital. Until then the hospital had received $29.4 million in global operating funding. The hospital board and the community reacted in shock. In early 2003 the board managed to negotiate a new arrangement that offered hope to save the hospital. That agreement would have seen funding from the Health Authority reduced over five fiscal quarters, beginning with the second quarter of fiscal 2003-04 and ending by the second quarter of 2004-05, with funding reduced to an annual rate of $10.85 million. Subsequent negotiations increased that to $11.85 million as a result of including a hospice program.

On September 819, 2003, Saint Mary's wrote to Premier Campbell stating that negotiations with the Health Authority were continuing but that the hospital could not survive an immediate cash flow crisis. Morfitt was asked to do his report, and on November 3, 2003, government and the Health Authority issued its New Speak news release which said that "Services previously provided at Saint Mary's will now be provided at other area hospitals". Nothing was said about what will happen to Saint Mary's until NDP Opposition critic, Jenny Kwan, got the Health Minister to say that is not his problem!

Kwan used legislative question period on Tuesday, November 4th, to ask Hansen what would happen to patients who were on waiting lists at Saint Mary's. Hansen spoke about already scheduled increases in operating capacity at Eagle Ridge Hospital but he did not say how much the closure of Saint Mary's would interfere with previous plans for the use of that capacity. Kwan said "The fact is Eagle Ridge's wait-list has actually gone up, and since this government took office, orthopedic wait-lists have exploded, rising by more than 53 percent. St. Mary's is an important centre for orthopedic surgery. Now, as a result of its closure, patients will have to wait even longer."

Saint Mary's may be best known as an eye surgery centre. Kwan said that "There are 1,433 British Columbians waiting now for cataract surgery at St. Mary's. Most of those patients will be transferred to Burnaby Hospital, where there are already 780 patients waiting for the same procedure. Some of those patients have been on the wait-list for six months. Can the minister tell patients how much longer they will have to be forced to wait for cataract surgery as a result of his decision to close St. Mary's?" Instead of answering the question, Hansen said "I have every confidence that the Fraser health authority is going to be able to build the capacity that is necessary to make sure patients continue to get access to the care they are counting on, whether that's at any of the facilities in the region. The decision as to what the future of St. Mary's is, is clearly up to the board at St. Mary's."

There is no reason anyone should have any confidence that patients will not suffer as a result of the closure of Saint Mary's. Those who have waited while nearly blind, or while in extreme pain on an orthopedic wait list, will consider each day of additional agony a violation of the BC Liberal promise that health care would be provided when and where people need it.

Morfitt reported to the government that "A difficulty arises when the authority moves from providing broad-based service funding to the purchasing of a smaller base of services. The service provider is faced with having to either downsize or secure alternate sources of revenue to replace the reduction in funding, and do so over a relatively short time period. This is, as described above, the conundrum facing St. Mary's." Saint Mary's found that they couldn't cut more that $6 million from their $29.4 million budget without negatively impacting on services they would need even if they succeeded in catering to ICBC and WCB. Even though Morfitt recognized that the hospital faced difficulties in either downsizing or finding new money in a "relatively short time period", he concluded that there is nothing wrong with the basic "purchaser-provider concept".

Others who depend on government contracts, whether they be the new providers of contracted out services or companies in the forest industry with their disappearing tenures, need to take a lesson from Saint Mary's. Government can and will act abruptly with no concern for the consequences of its actions. The focus is on the bottom line even if that means longer waits for those in pain.


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