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Will we lose patience waiting for better care?

by GEORGE BROWN / Off the Record

I’ll be the first to admit I don’t have a lot of personal experience with Alberta’s health care system; for as unhealthy a lifestyle as I lead, I don’t get sick. My last hospital visit resulted from an inexplicable slip while outside checking the roast on my barbecue. My right leg was broken in three places below the knee and I found myself in the University of Alberta Hospital celebrating the advent of Y2K high on morphine.

I spent an extra-long weekend in hospital; my wife spent less time in the hospital giving birth to our son 12 years earlier. We might disagree on which experience was more painful. I attributed the few hospital service annoyances (perhaps naively) to holiday/long weekend staffing issues rather than inherent shortcomings in the system.

I first went to the hospital in Wetaskiwin because that’s where my family doctor practices; they X-rayed me and immediately sent me by ambulance to the U of A where I was stacked up in the ER on my gurney. From when I broke my leg at home until I was wheeled into my four-man suite was about six hours, well below the government’s new target of eight hours from triage to bed placement for patients who need hospital admission.

When I was released after parts of four days, I received follow up home care as needed for six weeks or so. It certainly made more sense to have me recuperating at home as soon as possible than taking up valuable space in the hospital. I was taught how to change my own dressings and jab myself daily with anti-clotting medication. When it came time to remove my stitches, the nurse pulled them out and I anesthetized myself — with a few CCs of single malt Scotch.

If we insist on leading unhealthy lifestyles and if the government continues to turn a blind eye to workplace injuries, Alberta will continue to provide health care services that don’t meet expectations. Clearly, education and an emphasis on convincing Albertans to live healthier lives would have a more sustainable effect on the system than emptying the treasury.

But that’s what we’re going to do — again.

Last week the Progressive Conservative government unveiled its five-year health plan to provide better and quicker care. The government promises to add 360 hospital beds and 2,300 continuing care spaces while performing an additional 3,000 surgeries by March 2012. (Coincidentally when the next election must be called.) Within three more years, another 3,000 continuing care spaces would be added and two new radiation therapy centres would be built, one in Red Deer, the other in Grande Prairie. Why it took so long for the government to develop this simple plan after watching the health care system fall apart over the last 25 years is a question to ask our MLA.

We are still suffering the fallout from Ralph Klein’s government not recognizing that the province was in a boom economy and not dealing with the consequences. Immigrants from inside and outside Canada were flocking to Alberta but it took years before the government realized it needed more schools, hospitals, courts, roads and infrastructure to meet the growing demand.

It’s a little simplistic to say more continuing care options at the end of the health care system would relieve the pressure in emergency rooms but chronic or palliative patients would be better served in longterm care centres; acute care and emergency patients in hospitals not in tents. Patients who feel sick need to see a doctor first — in an office or walk-in clinic, not in an emergency room.

Health and Wellness Minister Gene Zwozdesky promises his health care action plan guarantees a publicly funded health care system that will provide better access, shorter waits, safe, quality care and a healthier Alberta. The minister wants nine in 10 seriously ill patients to be treated or admitted to hospital in less than eight hours. Today, just three in 10 patients meet that goal at Alberta’s busiest emergency rooms.

Government MLAs wisely defeated an opposition amendment to the Alberta Health Act that would have enshrined in law emergency wait room times. Can you imagine the mess unscrupulous litigious patients would have made, walking into the ER with a stopwatch?

It’s obvious that health care is political and it’s the politicians who have messed it up, not the frontline doctors and nurses. MLAs are competing with each other to get hospitals and seniors lodges built and expanded in their constituencies so sometimes health care decisions are made for political purposes, not necessarily for the betterment of the provincial system. A long-term political and medical vision is needed to improve the delivery of health care services but the time needed to implement that vision isn’t necessarily coterminus with the election cycle.

For a time Alberta was divided into 17 health care regions: I lived in Capital, worked in Westview, and my family doctor had privileges in David Thompson. While there might be a loss of local decision-making in community hospitals today, it must be simpler for doctors and patients work deal within one bureaucracy.

But if the government was right to create the Alberta Health Services superboard to manage the delivery of health care, it was just as right to step in when former CEO Stephen Duckett went off the rails a few weeks ago. Ultimately, elected officials must be responsible. No one would have protested on Duckett’s front lawn like they did at the Alberta Legislature on the weekend.

Alberta’s voter-patients have proven to be an impatient lot and it remains to be seen whether we will give the government’s five year plan a chance or whether our patience will run out with Premier Ed Stelmach’s mandate in 2012.