Thursday, November 3, 2011

Dr. Roland Orfaly - "B.C.'s health care is failing mothers, babies"

On October 5, 2011 the following story was published in the Times Colonist.

B.C.'s health care is failing mothers, babies

An external review of the Aug. 9 newborn death at Victoria General Hospital is now complete. Expectant mothers on Vancouver Island deserve better than the care which is currently available. So do mothers elsewhere in B.C., where the same problems are also being ignored by the provincial government.

By Times Colonist (Victoria)October 5, 2011

An external review of the Aug. 9 newborn death at Victoria General Hospital is now complete. Expectant mothers on Vancouver Island deserve better than the care which is currently available. So do mothers elsewhere in B.C., where the same problems are also being ignored by the provincial government.

Released last week, the report is critical of unresolved safety issues in VIHA's maternal and fetal program, many of which were identified in a 2010 report by Accreditation Canada. Among other safety issues cited in both reports, at issue is whether anesthesiologists' staffing was up to standards and adequate to properly meet the needs of higher risk obstetrical patients.

The external report is very clear. "There is restricted availability of anesthesia services to support obstetric operative procedures [C-sections]. This is a significant risk issue for the VIHA, which should be addressed immediately."

The reviewers recommend that Victoria General Hospital "establish a dedicated obstetrical anesthesiology [DOBA] service."

However, the review, commissioned by VIHA, is dismissive about the 20minute delay experienced Aug. 9 between the time the obstetrician called for a C-section and when that C-section began.

This is at odds with a resolution proposed by Liberal MLA Dr. Moira Stillwell and approved by a Surrey Memorial Hospital advisory committee in 2009. The motion reads, "Obstetrical anesthesia services at Surrey Memorial Hospital should be available within a timeframe of 15 minutes, 24 hours per day, seven days per week to ensure safe patient care."

I'm not sure why the standard for what is safe for women in Surrey is different from the standard for women in Victoria.

What is equally newsworthy is the report's view on staffing. "The Department [of Anesthesiology] would have to recruit additional members to provide DOBA 24/7." And that is the problem. Both VIHA and the Health Ministry claimed in August that "there is no shortage of anesthesiologists at Victoria General Hospital."

By denying a shortage that is evident to everyone else, the government is exposing its true colours. It has no intention of providing the additional anesthesiologist resources needed to ensure the safety of mothers.

Between July and October 2009, the Health Ministry directly contacted over 3,000 anesthesiologists from across Canada in an attempt to recruit staff for a DOBA program. Not a single applicant replied. The external report recommends, "Priority should be given to candidates with specialized training in obstetric anesthesiology." There were no interested candidates, with or without that training.

Instead of admitting its failure, the government has been cynically playing politics with the issue ever since. While ignoring women in the rest of the province, they've tried to download blame for the failed provincial recruitment onto the Victoria Department of Anesthesia.

The DOBA "offer" made through VIHA was identical to what had already been offered by B.C. - and rejected - by anesthesiologists everywhere else in Canada. As VIHA had to admit in August, much of the funding for the "offer" originated from money that was already being paid for current services being provided, leaving little to help attract new anesthesiologists to Victoria.

Solutions are available. Eighteen months ago, B.C.'s anesthesiologists offered to dedicate some of their own funding to help attract more anesthesiologists to staff DOBA in Victoria and elsewhere in B.C. With government approval, DOBA would have been up and running by now. The Health Ministry rejected our offer.

Meanwhile, taxpayers would also be better off with DOBA. Over $12 million per year in operating room resources are wasted due to the lack of DOBA staffing. While the on-site anesthesiologist is attending to obstetrical patients, the OR and its staff come to a standstill waiting.

Gordon Campbell kept promising, "The right care, in the right place, at the right time." What happened to that promise?

Patients and taxpayers in B.C. deserve better.

Dr. Roland Orfaly is spokesman for the Coalition of B.C. Anesthesiologists for Change. He practices at Royal Columbian Hospital in New Westminster.

© (c) CanWest MediaWorks Publications Inc.

No comments:

Post a Comment