BC continues to suffer under relentless job and service cuts

The Report: April / May 2003 vol.24 num.2

by PAM BUSH

lmost one year after the health authorities unveiled their -health service delivery redesign plans," its clear that this really meant cuts to health services in BC. For HSA members, the most significant cuts have been reductions in acute care services, fewer choices available for seniors and the
disabled, and cuts to rehabilitation services.

This is an updated overview of provincial cuts. The ongoing cuts have been so numerous that they have been difficult to tabulate. This overview was as current as possible at press time. If you are aware of cuts not included in this overview, please contact Pam Bush at @email.

Reductions in acute care services

Hospital Closures
Kimberley and Enderby.

Reductions in Emergency Services
In several communities throughout the province, emergency rooms have been converted into -urgent care centres." This means that hours of service have been reduced, and people in these communities must travel much further for emergency treatment outside of regular hours. These towns include Chemainus, Lytton, Castlegar, Summerland, Sparwood, and New Denver. The emergency room at the University Hospital in Vancouver (UBC) is slated for closure in July 2003.

In Delta, the emergency room remains open, despite the health authoritys original plan for closure. There is little doubt this is the result of the significant public outcry over planned cuts. HSA members took part in a massive fightback campaign that took many forms, including petitions, rallies, motions passed by the municipal council, and a recall campaign of Liberal MLA Val Roddick, which was narrowly defeated. Finally on Valentines Day, the Fraser Health Authority announced a $5 million capital campaign to raise funds for the expansion of the emergency department.

Reductions to inpatient beds
The closures of inpatient beds all over the province are too numerous to list. In the Interior Health Authority alone, 326 beds were closed. In some cases these beds were converted into sub-acute beds, and in some cases they were just closed. One impact of these cuts has been severe back-ups in emergency rooms, particularly in small towns on major transportation routes, such as Hope and Golden.

In a presentation to city council in Golden, one physician explained that in the past, doctors had been able to cope with emergency room pressures by bringing out extra beds if they were needed. Now that cant happen ... -They physically removed the beds so you dont really have that option anymore," said Dr. Larsen-Soles.

Hospital -conversions"
Many hospitals around the province have had reductions in the level of service provided to their communities, in addition to the closure of inpatient beds. Changes to services have included the loss of maternity services, a reduction in the types of surgery performed, closure of intensive care units, and the elimination of all surgery.

In addition to those facilities identified earlier, facilities affected include Eagle Ridge, Mission, Burnaby, Peace Arch, Fraser Canyon, Cumberland, Port Alice, Kootenay Lake, and Chetwynd.

In New Westminster, negotiations continue between the health authority and St. Marys Hospital about what services may continue to be provided. Last July, the hospital was given one years notice that its contract would not be renewed.

Fewer choices for seniors and the disabled: the most vulnerable at risk

The provincial Liberals have completely abandoned their election promise
to build another 5000 long-term care beds. Instead, residential care beds are closing every day, and being replaced by -assisted living" arrangements, if they are replaced at all. Heart wrenching stories about the negative impact this has had on seniors have appeared in many newspapers throughout the province.

The following facilities have either closed beds or are actively planning for closure:

• Gorge Road Hospital (VIHA)
• James Bay Lodge (VIHA)
• Arbutus Hospital (VCHA)
• Mount St. Josephs Hospital (VCHA)
• Heather Extended Care Unit (VCHA)
• Cascade at Burnaby General (FHA)
• Berkley Pavilion at Peace Arch (FHA)
• Parkholm Lodge at Chilliwack (FHA)
• Rocky Mountain Lodge in Cranbrook (IHA)
• Kimberley Hospital beds (IHA)
• Boundary Lodge in Grand Forks (IHA)
• Mount St. Francis in Nelson (IHA)
• Kiro Manor in Trail (IHA)
• Mater Misericordiae in Rossland (IHA)
• Moberly Manor in Revelstoke (IHA)
• Pioneer Lodge in Salmon Arm (IHA)
• Juniper Court - attached to Enderby Hospital (IHA)
• Royal Inland Hospital residential care beds (IHA)
• Ponderosa Lodge in Kamloops (IHA)
• St. Bartholomews residential care beds in Lytton (IHA)
• Cariboo Lodge/Heritage House and Deni House in Williams Lake (IHA)

Some care facilities such as Willowdale Home in Armstrong are also replacing registered nurses with licensed practical nurses in an attempt to save costs.

The government further demonstrated their contempt for seniors on February 24, when they unveiled their new -Fair Pharmacare" program. Pharmacare will now be income tested, which will not only shift the cost of the program onto individuals but will also create a new bureaucracy to administer the program.

Jon Kesselman, an economist at the University of BC, has decried the new program as anything but fair. -The Fair Pharmacare progam operates like an unusual kind of income tax," he said, -one that applies higher tax rates only to the more ill or debilitated among the population."

Cuts to rehabilitation services

The delisting of physiotherapy services in January 2002 has shifted addi
tional costs to seniors, the sick and disabled, particularly when combined with cuts to rehabilitation therapy provided by hospitals.

The closure of residential care beds has resulted in cuts to music therapy, physiotherapy, occupational therapy and social work services provided to elderly patients. And the shift from residential care to so-called -assisted living" services will mean that seniors will have to pay out of their own pockets for services that used to be available in public sector facilities.

In addition, the closure plans for Gorge Road Hospital includes the rehabilitation centre, which will lose ten beds when it is relocated to Victoria General Hospital. And rehabilitation therapy and social work services at Mount Tolmie, Priory, Aberdeen, and Glengarry long-term care facilities have been reduced as a result of budget cuts.

Cuts to acute care hospitals have also targeted rehabilitation therapy services. In early July 2002, the physiotherapy clinic at UBC Hospital was closed after operating for more than 21 years. St Pauls Hospital closed the Therapeutic Recreation and Expressive Arts Department on September 26, 2002.

In the Okanagan, Penticton Hospital has cut outpatient rehabilitation services. Kelowna General Hospital withdrew its $10,000 funding for the Kelowna Coronary Exercise Society, which provides ongoing support to patients recovering from heart attacks and strokes.

And even at GF Strong ... the provinces only tertiary rehabilitation centre ... outpatient services in physiotherapy and occupational therapy have been cut back, leading to longer waiting lists and slower recovery times. Psychology services have also been cut at this facility, as well as at Vancouver Hospital and George Pearson Centre.

Despite valiant efforts by staff, patients and their families, the Skeleem Recovery Centre in Cobble Hill was closed on March 4, 2003. This was the only facility in the province which provided intensive rehabilitation services to brain injured clients. Many of the residents were transferred to Riverview, where it is feared that they will not have access to the rehabilitation services which could allow them to return to independent or semi-independent lives in their communities.

Pam Bush is HSA's researcher.