What's Wrong With BC's Emergency Health Care System?

Vancouver Sun April 03 2014

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April 03, 2014 at 8:00 PM

B.C. ambulance paramedics are now being told to treat many formerly serious calls, such as trauma from car accidents, as "routine" as they wrestle with an under-funded, under-staff system the public depends upon.

The decision by the provincial government to downgrade the response the B.C. Ambulance Service gives to a large number of medical assistance calls is being done under the argument it will allow paramedics to respond faster to truly life-threatening cases.


But when you hear the following story, you may wonder whether the government is missing the picture entirely in its mandate to provide health services to its citizens.

Ambulances parked outside Royal Columbian Hospital’s often overcrowded emergency ward.

On Wednesday my colleague Kelly Sinoski and I reported on how Metro politicians and fire chiefs like Vancouver’s John McKearney are sounding the alarm over the Provincial Health Services Authority’s downgrading of 74 call types from “emergency” to “routine”. (Here’s a video clip of McKearney’s report to council.)


It may sound odd, but how do you consider trauma from a car accident or assault, chest pains, an incapacitating fall or a deep laceration “routine”?


That may be just code-speak. I don’t know what the real difference is between any of those injuries and someone who is in cardiac arrest. Dr. William Dick, the vice-president of medical programs for B.C. Emergency Services says all these “resource allocation plan” changes mean paramedics can get to a life-threatening situation 30 seconds faster now. “When you’re in cardiac arrest, that’s important,” he told Sinoski.


I get that. Were I to have a cardiac arrest, I’d want paramedics at my side fast. In fact, I’d want them at my side if I had a fractured skull, a broken hip, shortness of breath or a deep laceration. Just not in an hour. To me, they’re all worthy of the best emergency medical response we can muster, not a case of “eeny, meeny, miny, moe.”


So it stunned me to learn on Tuesday night that the elderly wife of a friend of mine lay on the pavement outside her daughter’s house for more than an hour with a broken hip while the ambulance service re-tasked a dispatched ambulance four times to other calls. She fell into that ludicrous category of being a “routine” call. What’s routine about being left on cold pavement, unable to get up and in excruciating pain?


The experience alarmed her husband, their family and the first responders who had arrived almost immediately, but who were left holding the bag while the clearly overworked ambulance service played whack-a-mole with its cars.


To make matters worse, once she was taken to hospital, she spent many agonizing hours waiting to be seen by a doctor because the emergency room didn’t have enough staff. She finally had surgery late Wednesday night and it will be a long time before she is up and running.
My friend, who normally has a placid personality, was so angry he planned to write to Health Minister Terry Lake to ask him what he considers to be adequate health care.

“I want to end my letter asking him if this were his wife or his mother, would he be satisfied with her being left in pain on a sidewalk for over an hour,” he told me.

Here’s what it comes down to. The province spends 42 per cent of its $44 billion annual budget on health care. But it can’t manage to get people to hospital in a timely fashion. My friend’s story isn’t unique. McKearney laid out a number of anecdotes for Vancouver council on Tuesday, all of which should have caused the province to say “we’ve got a problem, folks, and we need to fix it.”
Especially when he pointed out many of the injuries turned out to be worse than first reported. Today he sent me a copy of a quick study by the University of the Fraser Valley that looked at the BCEHS changes and concluded problems abound. I’ve appended it below.


If you don’t have enough ambulances or trained paramedics to deliver timely service, the answer is to buy more cars and train more people. Not downgrade calls to “routine” and make injured people wait longer. And if that means reordering how you spend that $44 billion, so be it. Trust me, you won’t lose votes.

 



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