As I was mulling over topics for this week’s column, compiling a list in my mind, it occurred to me that I’ve written about healthcare issues several times in recent months. I was about to toss out the topic when I felt an electric spark snap in my mind. Of course! It’s a major issue that is hurting many thousands of Ontarians. Clearly, resolving Ontario’s healthcare issues will take more than slapping on a Band-Aid, taking two Aspirin and calling the doctor in the morning….or should that be calling the Minister of Health?
In recent weeks and months, the news has been full of stories about the closure or near closure of emergency departments (ED) in rural and Northern communities across the province. Unfortunately, Algoma-Manitoulin is not immune to ED closures. Thessalon Hospital is part of the North Shore Health Network (NSHN), including hospitals in Blind River and Richards Landing. Thessalon has twice recently had to close its ED doors because no doctors are available temporarily. In the last year, other hospitals in the region have been on the brink of closing, including Blind River on June 2. And this trend will likely continue all summer long in the North. Let there be no doubt; this will lead to genuine anguish and suffering.
It is common knowledge that we have a doctor shortage across Ontario, especially here in the North. Premier Ford likes to say he is doing everything humanly possible to fix the shortage, but so far, his efforts have proven ineffective. He reminds me of a defenseman who appears to be skating hard to get to the puck cleared to his end, but who is actually holding back to get what he and his team want – an icing call. It’s all just part of his privatization game plan.
Thessalon Hospital has been without a primary care physician for over two years, as have other Northern and rural communities. As a result, these hospitals have had to rely on doctors’ dedication to patient care to fill in the gaps for years. However, while our doctors are selfless in serving their communities, there is a limit to how much extra anyone is willing and able to step up over a prolonged period, especially one that does not seem to have an end in sight.
There are several reasons for the ongoing shortage, one being the Rural Northern Physicians Group Agreement (RNPGA). It was an agreement hammered out in the mid-1990s between Ontario doctors and the Ministry of Health. The goal of the deal was to attract doctors to work in Northern rural communities where population densities are lower but delivering health care is more complex. Initially, it was a good agreement that effectively helped to recruit locums and permanent practices in Northern communities. But, as with most anything, times and needs change, and the agreement has become outdated and problematic. Therefore, it should not be shelved but instead updated.
There are 37 rural and northern communities funded under the agreement, which applies to areas with seven or fewer physicians. In the Canadian Medical Association Journal, Manitoulin Island doctor Stephen Cooper, who worked under the original deal, said that initially, the agreement resulted in a significant improvement. But after so many years and changes, it is not working anymore. Dr. Cooper explained, “The RNPGA needs to be updated to reflect changes in medical practice over the past two decades. (CMAJ, 2018, May 14)
One area of the agreement that needs to be updated is the parameters that dictate when additional funding can be applied when there is a doctor shortage. For example, Wawa has had 6 doctors practicing for many years. However, two of the six have left, resulting in a dire need to replace them. The problem is that the community cannot apply for extra funding to help cover the void until it loses 50 percent or more. Unfortunately, losing 2 of 6 is only 33 percent. Therefore Wawa does not qualify for funding at all despite the need and formidable difficulty they face in recruiting.
The Town of Spanish lost a long-time doctor who moved his practice to a private for-profit clinic in Ottawa, leaving the region without any doctor. The good news is that they have found a nurse practitioner willing to sign on. The bad news…? the RNPGA does not permit using its funding to provide nurse practitioner care. As a result, the community’s hands are tied with no doctor and no primary care.
There is a way to resolve the shortage, but the agreement terms are outdated. They need to renegotiate to allow flexibility to keep up with changes over time.
A third issue is that doctors who had agreed to do locum work in Northern regions, including Algoma-Manitoulin, were not paid on time. In fact, they were forced to wait many months to be paid for their services. Some have huge student loans to pay back. They have bills and expenses just like the rest of us, plus the costs they incur in working as a locum in communities away from home. The problem was administrative at the Ministry level and should have been fixed immediately. Who among us can afford to work for months on end without being paid by our employer? Who would want to work for a deadbeat employer with a slow payment history? Word gets around and negatively impacts potential recruitment for the community.
Once again, Northerners suffer because bureaucrats don’t grasp the ramifications of their failure.
When a government implements policies, regulations and laws, Ontarians expect it to make our systems deliver the services we need fairly and efficiently. We expect them to make our lives better. If a car is not working right, we fix it. If a computer program isn’t working properly, we update it. So if the RNPGA or other policies are not improving people’s healthcare and lives, the government must update them.
And the longer the government puts this off, the more people are hurting – and not just figuratively.
Naturally, when you step back and try to take in the many issues of the Ontario healthcare system’s issues, it is daunting, maybe even intimidating. But when you have a huge mess to clean up, you break it down into manageable parts and focus on one thing at a time. Then move on to the next. Next thing you know, the job is not so daunting after all, and an end comes within sight.
Someone needs to tell Premier Ford that the time to play the blame game is over. He has successfully won two elections and is a year into his second term. Now is the time to get the job done. Northern Ontarians could see real improvement if the government would commit to updating the RNPGA. Doug Ford can no longer put the blame on previous governments.
The onus of resolving Ontario’s healthcare crisis is officially Premier Ford’s.
As always, please feel free to contact my office about these issues or any other provincial matters. You can reach my constituency office by email at my new address, mmantha-co@ola.org or by phone Toll-free at 1-800-831-1899.
Michael Mantha MPP/député
Algoma-Manitoulin
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