By Bruce Mason,Gabriola Sounder, June 30, 2008

The headline above is a quote from one of the locals who took part in the recent Primary Health Care Community Workshop on the Island. It is representative of the historic meeting and those who attended.

Almost 100 people participated on Friday, June 20th in the Community Hall to discuss the future of Primary Health Care on Gabriola. It was a long day but there was agreement that the time and effort spent was well worth it.

The newly elected Gabriola Health Care Society Board described the unique event as an opportunity to talk with a “variety of people from different areas of interest” and reported that if was a “great process that encouraged safe dialogue and positive ideas - focused discussion.”

The GHCS thanked everyone who came to help identify the issues, express their opinions and offer their visions.

“We would not be as far as we are today without the volunteer efforts of a significant number of community members,” said Fay Weller, GHCS president.

The Society was formed about a year-and-a-half ago out of the recognition that our community was at risk of a serious health care crisis unless a local effort to meet community health care needs was undertaken.

From its inception goals were established to: Assess and respond to community health care needs; Work with the health professionals and Vancouver Island Health Authority to develop programs that address those needs; Provide facilities to licensed health care practitioners in a way that fosters integrated team care and accessibility wherever possible; and Work in partnership with other community agencies to improve conditions affecting health.

In a remarkably short period of time, the GHCS has managed to secure an Emergency Treatment Room for the Island and has attracted the interest and earned the respect of both VIHA and the Ministry of Health.

At a time when the health care system across the country has reached a state of dysfunction, Gabriola is helping to provide a unique opportunity to identify new visions for health care provision and create a template, or prototype for the delivery of improved health care in similar communities everywhere.

More than 70 residents attended the workshop through the day, plus representatives from the GHCS, VIHA and the Ministry of Health. The event was well organized and lead by a professional facilitator in order to provide opportunities for detailed discussion, generating ideas and raising locally relevant issues - most of which came from the participants themselves.

“What was particularly heartening for the GHCS was the wealth of local knowledge and concern and the interest in creative, home-grown solutions using innovative methods and a pragmatic, step-wise approach in moving forward,” said Weller. “A lot is possible, but it is important to prioritize.”

She and vice-president Tracie Der identified two dominant themes that emerged from the varied discussions:

• The need to improve communications, both from the GHCS to the community and from the community to the GHCS, as well as liaising between the various agencies supporting some aspect of health-related care on Gabriola Island.
• And the desire for coordinated and integrated health care on Gabriola, providing services, programs and information/education, preferably from a central access point or facility.

The GHCS is committed to both concepts and invites the community to keep up the dialogue.

Watch for new opportunities for giving and receiving information in the weeks and months to come. In the meantime, it is still possible to offer your comments through the “blog” established at www.gabriolahealth.ca.

All comments submitted until mid-July will form a part of the report being produced by the GHCS to move the Gabriola project forward.

As well, all transcriptions from the workshop discussion groups and evaluations are being posted, both on the blog and the GHCS website: www.ghcs.ca.

The next steps?

The GHCS will analyze the input from the workshop and - in partnership with VIHA, the Ministry of Health and community stakeholders - set priorities and determine the necessary actions, as well as who will be responsible for seeing them through.

It is also clear that there is a need for hard data and statistics to quantify and measure needs, service use and costs.

The goal is to have the report prepared by the end of July, although some actions may begin earlier as they are identified during the review of the information collected.

The good news is that both VIHA and the Ministry of Health are listening.

Weller and Der once again quoted a participant: “Now, we can all begin working towards developing a coordinated effort to address the health care concerns on the Island.”

This will be a community vision - we all hold power, accountability and ownership, they added, This includes the Gabriola community, GHCS, MOH and VIHA in a true partnership.

The Flying Shingle, June 30, 2008

Communication and coordination between organisations and health providers were the repeated recommendations made by dialogue groups at the day long Community Consultation on Health Care on June 20.

As mentioned in previous editions of the Shingle, the meeting was organised by the Gabriola Health Care Society (GHCS), the Ministry of Health (MOH), and the Vancouver Island Health Authority (VIHA) to find out what Gabriolans want regarding their health care. As also mentioned in earlier editions of the paper, VIHA made the meeting a requirement because they questioned whether GHCS represented the wishes of the majority of Gabriolans - particularly when they discovered that close to 50% of Gabriolans are receiving their primary health care needs off-island.

According to GHCS the meeting was attended by close to 100 people. Participants said that this number included a large proportion of representatives from VIRA, MOH, health care professionals, and members of GHCS.

As evidenced by the many sheets of paper on the walls, attendees discussed a range of subjects from prevention and self-care, to primary care, to emergency services, to community dialogue and engagement, and community vision and many other topics in between.

Among other things, attendees highlighted a need for more information about what resources are available in the community, clarity about what different sections of the health care system are responsible for, issues of sustainable workloads for doctors, and the need for accurate and current data. The "community vision" group called for, "a fully coordinated integration of traditional and non-traditional practitioners", as well as other support providers.

Also included in some discussions was a question as to why more people had not attended the meeting.

GHCS member Don Butt suggested that what is needed is a central coordinator who is able to assess and refer folks based on their needs and the resources available.

Verna Gregson of the Gabriola Professional Centre said, "The facilitator (Ian Curtin) has done a wonderful job, and there are many people here with great ideas and dreams".

GHCS president Fay Weller and past-president Lawrence Spero both said that the day went well. Spero said, "People have been motivated by the structure of the day".

All recorded comments are posted on the GHCS website at http://www.ghcs.ca/phc.html, and folks can continue to add their comments at http://www.gabriolahealth.ca. Comments posted there before July 15 will be included in the report, said Weller.

by Chris BowersThe Flying Shingle, June 30, 2008

Gregory Bateson once said, "Information is the difference that makes a difference". When it comes to the media, how information is transmitted is the difference that makes a difference. Marshal McCluhen has famously pointed out that "the medium is the message", but the transmission of information also depends on how well someone reports all sides of an issues, and accurately portrays what occurred. Nothing less is acceptable, and nothing less fulfills the obligations of the fourth estate to its democratic responsibility.

One of the most basic "rules" that follows from this is that, to quote Michael Bean, "you can't make the news and also report it". This means a reporter sits as a silent observer in pretty well every occasion she officially attends. Certainly a new experience for me!

The Shingle is working hard to make clear the distinction between news and opinion. This is one of the reasons I am so sorry that in the last edition of the paper I did not check out my assumptions about the person for whom the eulogy on page one was written. I will work hard to not make that mistake again.

Meanwhile I want to be clear that this is definitely an "opinion piece".

In the interests of full disclosure, I will say that I am one of the 50 (ish) per cent of Gabriolans who has a doctor in Nanaimo whom I adore. I won't be transferring my primary health care to Gabriola any time soon.

As mentioned in the report on page two, the overwhelming conclusion of the community consultation on health was the need for coordination and communication. To some degree this is unsurprising given that the implicit question of the day was whether folks are interested in an "integrated multidisciplinary medical clinic" (IMMC). Clearly, based on the response to the few folks who turned up to this meeting who have doubts about this idea, the majority of the folks at this meeting were supporters, perhaps even avid supporters of the idea.

There is nothing wrong with that as long as dissenters are allowed to ask their questions and speak their piece. Unfortunately, as others in this edition of the Shingle testify, that did not happen.

There are a number of very important questions that remain unanswered about the idea of an IMMC not the least of which is: do the majority of Gabriolans want one?

Community response to the idea of an Emergency Treatment Room has been overwhelmingly positive. Response to the idea of an IMMC seems to me to be overwhelmingly narrow. Perhaps it is not, and it just a coincidence that according to reports the same few folks keep showing up to support it, but the meeting on June 20 did nothing to clarify that.

Tracie Der, Vice-chair of the Gabriola Health Care Society (GHCS) has sent in a report which was too late to publish in this edition. In it (among other things of course) she re-iterated the main message of the meeting (see above) and the availability of the website for folks to continue sending in their opinions. I would guess that the society will accept submissions by good old fashioned snail mail as well. I hope those who have an opinion will make use of those options.

Given the treatment by other participants (not the facilitators) of those who had questions at the consultation meeting, GHCS faces a very large challenge. That is to understand that even greater than the imperative to explain their vision to the community they now need to find a way to listen to it. Especially to those who disagree or have concerns.

Sadly not only did those folks not attend the meeting, but they didn't do so in droves. This is also unfortunate. Not only because GHCS needs that input to do a good job, but also because their attendance in numbers of higher than two or three might have made it possible for their message to be heard in a more respectful way. Or at all.

By Bruce Mason,Gabriola Sounder, June 16, 2008

Primary Health Care: What is it? What does it look like on Gabriola? How can we build on our partnerships on the island?

Find out and help build the future by participating in a landmark workshop on Friday, June 20th, from 9 am to 3:30 pm, at the Community Hall.

The importance of the event can’t be overemphasized in the ongoing initiative to improve Island healthcare. It is sponsored by GHCS, the Ministry of Health, and the Vancouver Island Health Authority (VIHA). Participants will be limited to 200 and lunch will be provided.

It is essential that the MoH and VIHA officials leave the Island with a clear indication of the degree of support that the initiative has on Gabriola. If you can’t attend, you can still make your comments and opinions known - and part of the record - by going to a new website, gabriolahealth.ca. There is a link at: www.ghcs.ca.

Lawrence Spero, outgoing president of the GHCS, newly elected to the Gabriola Health Care Foundation explained: “The blog has the same topics that will be discussed in the afternoon Café sessions. The topics to be discussed in the morning session (Open Space) will be determined by the participants.”

Individuals and groups helped to determine topics in a recent planning session on Gabriola.

Fay Weller, new president of the GHCS, said: ”Make a difference! The public session is about local decision making - what do Gabriolans want healthcare to look like on Gabriola Island, now and in the future?

“The response at the public session and through the blog at: gabriolahealth.ca will provide the GHCS with an understanding of what health care issues are important to Gabriolans and what actions are required to respond to an Island-specific vision.

“Your comments will be heard by MoH and VIHA who are participating and supporting this public session,” she added, “As we’re well aware, their support is crucial in ensuring a healthcare system that works for Gabriola.”

Weller and Spero agreed that Tracie Der’s comments below are must-reading for all residents. Spero said: “She has put it very well. This is a chance for residents to help design a Gabriola Solution, the healthcare equivalent to the 100 km diet.”

Der, a pharmacist and founder of the GHCS was recently elected vice-president of the society. The Sounder asked her to provide the following statement for our readers.

She responded: “Gabriolans have a rare opportunity! We have a chance to offer input to government in determining what the future of our health care could look like. And the government is actually listening and agreeing to act.

“In general our health care system is rapidly becoming dysfunctional - virtually everyone recognizes that - but Gabriolans can now actually do more than merely complain.

“We can be leaders and help provide the prototype for health care provisions that actually work to meet the needs of the patients and the community.

“But only if we know what those needs are.

“Please, please make the effort to visit the planning session on Friday, June 20th, even if only briefly, to learn what has been accomplished thus far, offer any suggestions for improvements for the future and ensure our ‘home-grown’ healthcare will meet the needs of you, your family and your community.

“The session has been designed to make it easy to offer your input. The format is not that of your typical “public meeting” - the goal is to ensure participants are comfortable with learning what has been done thus far and what is possible.

“Everyone is encouraged to pose questions and present suggestions. You can focus on areas that specifically interest you (such as elder care, or preventative medicine), viewing the displays and sharing your ideas, either verbally or in written form.

“You can participate in the small discussion groups, or submit your views online at our blog, or in a written submission to the organizing committee.

“Either way, let your imagination run wild - think outside the box. Everything offered will become part of the permanent record and form some portion of the vision to which we all aspire in designing health care to meet Gabriola needs,” Tracie Der said.

Spero added: “The focus should properly be on the GHCS ahead of the public consultation. It is the society that will be involved in the healthcare partnerships.

“The Gabriola Health Care Foundation has three functions. Keeping in-trust donations made to the Foundation, issuing tax receipts and most important of all: applying to foundations, philanthropic organizations and governments for funding to conceptualize, plan and build a permanent community clinic,” he added.

Flying Single, June 13, 2008

One problem with our health care system is the way in which it has become "siloed" so that different parts of the system don't talk to each other, according to Fay Weller, new president of the Gabriola Health Care Society (GHCS). The society wants to rectify that on Gabriola by creating a community clinic that encourages interdisciplinary communication, she said.

Weller made those comments in a June 5 interview with the Shingle in response to a question about the use of the word "integrated" by both the GHCS, and the provincial government's recently passed Bill 21. Bill 21 is looked on by some health care activists to be enabling greater privatization of health care. Those activists see the word "integrated" as suggesting increasing privatization.

Weller clarified that for the GHCS "integrated" means that health professionals with different specializations are talking to each other. She went on to say, "It is a shame that the word integrated becomes subverted into meaning something else". What the society wants, said Weller, is for health care on Gabriola to be local, community driven, and accessible by everyone.

As has been discussed in previous Shingles, the GHCS has created an Emergency Treatment Room (ETR) on Gabriola, and is presently working towards finding a permanent and central location for the ETR. The society also has a vision of turning the primary care medical clinic currently located at Twin beaches into a centralized, integrated, multidisciplinary, community clinic.

For more of the discussion between Weller and the Shingle see page seven.

By Chris Bowers, Flying Single, June 13, 2008

On June 5 The Flying Shingle met with new Gabriola Health Care Society (GHCS) president Fay Weller to discuss the upcoming Community Consultation (June 20, 9 AM to 3:30 PM), the proposed community clinic, and the Emergency Treatment Room (ETR). Highlights of the conversation follow. More information on the society and this conversation can be found pages one to three of this edition. All comments by President Weller are paraphrased, except direct quotes, which are in quotation marks.

Community Consultation Meeting

Shingle: Lots of folks in the community have ideas and/or questions about the idea of a community clinic. For example, some have suggested that the clinic might best be set up as a cooperative, as it would be safer from the dangers of privatization.

Weller: It is very important that people come to the upcoming Community Consultation Meeting to express their opinions or ask questions about what they want for the clinic. In order to proceed, GHCS really needs to hear from, and be clear about, the wishes of a majority of the people in this community.

Vision for Clinic

Weller:

• The society would like Gabriola to have the medical services it needs on the island so that folks can have be treated here, rather than having to leave the island. The society "wants to do what we can do within the current structure" .

• There are two ways to pay for doctors: salary, and fee for service. The society made a request to have salaried positions but the British Columbia Medical Association fought to have the majority of the budget allotted to payment of physicians into "fee for service" rather than salaries, so there is no money left to pay for salaried positions.

Emergency Treatment Room

Shingle: How would medical emergencies be dealt with if they can not be resolved at the Gabriola ETR?

Weller:

• Patients would be assessed and stabilized by the on-call doctor, who would then call ahead to the appropriate facility to let them know what to expect.

• "Many people don't end up having to make the extra trip into Nanaimo because they are diagnosed here and find out they don't have the heart attack or stroke. Others are diagnosed here, stabilized here and that is continued in the ambulance, so dangers on the trip from Gabriola to Nanaimo hospital are reduced substantially. In addition Nanaimo emergency will now respond to the diagnosis from the on-call physician and ensure that the CAT scan team, or whatever is needed is called in and ready to respond (something that can take half an hour to an hour if the patient arrives there without that diagnosis). If the patient arrives at the ETR and there is a need to get them to Nanaimo immediately then the physicians can call the harbour patrol and they will get the patient over there immediately - Nanaimo hospital will also send acute cardiac life support crew over with it to be with the patient on the crossing."

• If transportation via helicopter is necessary it can be available in very short time. When Chief Medical Officer Owen Heisler came to visit he was "shocked at the rapid response rate" to one situation.

Shingle: What are the protocols for emergencies at the ETR?

Weller: First Responders would make the decision about whether to bring the patient to ERT or go directly to hospital. First Responders usually make that decision in consultation with the on-call doctor.

Discussions with doctors

Weller:

• Doctors at the Gabriola Professional ~ Centre (GPC) were included in the discussion about the ETR from the beginning. At that time the original focus was on who would do on-call work. The Twin Beaches doctors recognised that the GPC doctors had their fill of on-call work. The GPC doctors "stepped out of the conversation" prior to the society being formed .

• The conversation with the GPC doctors re-opened when negotiating the Memorandum of Understanding (MOU) between physicians, the society, the Vancouver Island Health Authority (VIHA), and the Ministry of Health.

On-call issues

Weller:

• Both medical clinics are looking for a doctor, as another on-call doctor is needed and Dr Harding wants to retire. VIHA allocates Family Physician for BC positions based on the number of doctors in the community.

• The new doctor will decide out of which clinic she or he works. Regardless of which clinic the doctor works out of she or he will be on-call.

• It is usually recommended that on-call work be shared by five doctors. Gabriola presently has one on-call doctor. A community can manage with three on-call doctors but that is lower than recommended.

• One problem regarding on-call work is that it can take months before doctors are reimbursed for that work.

• VIHA put MOCAP (on-call funding) on hold in the spring of 2007, and did not tell the society about this until the fall.

Shingle: The Rural Isolation allowance has been proposed as another form of funding for Gabriola doctors. What has happened with that?

Weller: VIHA said Gabriola had seven doctors and so didn't qualify. VIHA counted some doctors who work part time, and some doctors who are no longer here. The physicians and the society are appealing this decision.

By Bruce Mason Gabriola Sounder, June 9 2008

How about those Gabriola Lions?

Where would this community be without them?

The most recent example of their remarkable ongoing service and generosity is a $20,000 donation toward equipment for the emergency treatment room of the Gabriola Health Care Society community clinic.

The club voted unanimously in favour of making the gift, which is deliberately ear-marked for the ETR and was written on the display cheque, presented at the joint annual general meeting of the society and the recently formed Gabriola Health Care Foundation, which is the fund-raising arm of the GHCS.

Lions’ president Linda Olsen told the Sounder: “We have been aiming all year to make a donation to the clinic because we believe in it and want to demonstrate that.

“Our motto is ‘We Serve’ and club members all agreed that this is the best way to spend the money we have raised through our many activities, such as the Concert on the Green (Thursday, August 7th ),” she added.

Dr. Don Butt had a foot in each camp - as well as wearing a variety of other hats - the Lions’ delegate to the GHCS board of directors. He said: “Doctors give the society a list of what is needed in the ETR and we had a close look at it.”

“What is absolutely essential for people to realize is that the emergency treatment room is for everyone, all residents and visitors,” he continued. “It doesn’t matter who your doctor is, the ETR will be available to you when you need it.”

There are still a few folks who are confused about this fact. It doesn’t matter if your doctor is in Nanaimo, Nunivik or Nepal, there now is a facility on Gabriola where you can be treated in an emergency, diagnosed and stabilized if you have to be transported to hospital.

A handful of people also still struggle with the concept that everyone is a member of the GHCS with no obligation whatsoever to be treated by the doctors who practice at the clinic. And yes, doctors who don’t practice at the clinic can and do utilize the ETR.

You can easily opt out of this free membership by contacting the GHCS. Still you will have access to the ETR when you require it.

There was a great deal of information at the AGM. Faye Weller is the new GHCS president; Tracie Der is vice-president. Moving over to head the GHCF is Spero, with vice president Fred Geater, who is also a former head of the GHCS.

We will have interviews with all four in next week’s Sounder, along with more from the AGM.

Along with the generous donation and election of officers there was a very important item for all Gabriolans to note: the Public Consultation Meeting hosted by the Ministry of Health will be held at the Community Hall on Friday, June 20th from 9:30 am to 3:30 pm. It is an integral part of an ongoing process to determine the future of healthcare on Gabriola.

It is extremely important that the community expresses its support for the initiatives to improve healthcare on the Island. Even if you can’t attend, there will be opportunities for your support - including organizations - to be recorded.

The meeting will be divided into morning and afternoon sessions. The first part will be less formal and groups will be formed around specific questions and issues.

This meeting is not only an ideal opportunity to ask questions and discuss issues, it is also the place to say what you like and don’t like about the work of the GHCS. This is your chance.

However, if you do support the work of the society. say so, let the government know that you want an ongoing partnership between Gabriolans the MoH and VIHA.

Butt is an example of the expertise at work. Among other things he was President of The College of Family Physicians of Canada, both the Ontario Chapter, (1975-76) and the National (1985-86). And in 1992 was chosen Canadian Family Physician of the Year.

On a personal note he told the Sounder: “I once scratched the cornea in my eye while gardening at our cottage in Ontario, perhaps the most painful experience of my life.”

“I desperately needed a drop of pain killer and a facility with a Slit lamp, which enables the cornea to be seen more clearly,” he added. “This is one of the pieces of equipment that the Lions’ donation will make possible and hopefully there will be more.”

By Bruce Mason Gabriola Sounder, June 9 2008

Physiotherapist D’arcy Boulton will be in Beijing this summer in his capacity as a trainer with Canada’s Olympic Men’s Field Hockey Team.

But he is also going for gold here at home in his Sandstone clinic.

And he has put together an outstanding team of highly trained professionals to achieve winning results for his clients on Gabriola.

Just back from training in Malaysia with the elite field hockey team, he announced that he has given notice at his practice in Vancouver for the end of the month and will be working closely with Brenda Hall and Lesley Standerwick here on the Island.

Hall is a former well-known resident and a kinesiologist who is highly trained and experienced and will be offering, among other things, deep tissue massage and soft muscle and joint release. She intends to close her popular and successful practice which is well established in Comox in order to return to the Island to live and work.

Standerwick - who wowed Gabriolans by raising $1,000 in the Tour de Gabriola - is also highly trained, including earning a Bachelor of Human Kinetics degree from UBC. She also brings with her a decade of experience, specializing in rehabilitative training, working closely with physiotherapists, massage therapists, chiropractors, and doctors to develop fitness programs suited to individuals.

A former resident of Bowen Island, she purchased a home here on Gabriola with her husband Brett, a golf pro - at Fairwinds Golf Club in Nanoose Bay, considered to be one of the finest in the province - to raise their two young children and obviously to also become actively involved in the community.

It is a leap of faith for Boulton, given the size of Gabriola’s population. But his part-time practice has met his expectations and he is carefully studying the needs of a growing community.

When the interim community heath clinic first opened its doors last year it signaled a new era in Island healthcare, which extended beyond life - and cost saving emergency treatment.

Among the many features of the clinic is the greatly increased opportunities for healthcare professionals on the Island to provide more integrated and comprehensive services, to work together to benefit patients who no longer have to go to Nanaimo for complimentary and coordinated treatment.

More and more, local healthcare professionals are sharing their expertise. And new equipment, which is available at the interim clinic, which is growing in quantity and quality.

Boulton’s approach is one more important step in realizing this vision which is resulting in increasing numbers of local residents who are finding welcome relief from pain and enhanced health right here at home.

Many folks are saying they haven’t felt better in years and are grateful for not having to take the ferry and find their way to various locations on the big island.

There is comfort too knowing that not only is the highly qualified person providing your treatment right in your own backyard but also is able to monitor your condition, make referrals and consult others.

For example, if you have injured your back - a common occurrence - and visited your doctor, you will likely be referred to other healthcare professionals for further treatment and hopefully advice on how to avoid repetition of the injury.

“I wanted to find a way to best use the facility and meet the needs on the island,” said Boulton during an interview with the dynamic trio. “This meant searching for professionals with formal training, which is expected by doctors who make referrals.

“Then suddenly both Brenda and Lesley appeared and I decided to go for it,” he added.

The implications for residents are enormous. There are now more treatment options available and more people who can put their heads together to heal you.

Apparently many of us who have spent a lifetime behind a desk are suddenly renovating houses, sending more time in gardens, taking up sports and getting involved in fitness programs. The result is an increase in injuries. Now when this happens, help is close at hand.

Think about it: along with injury recovery and prevention there are new opportunities for surgery preparation and recovery, weight loss and fitness motivation, improved athletic performance, reduction of health risks such as osteoporosis, improved response to stress and more.

Currently D’arcy Boulton is at Sandstone Sport and Spine Physical Therapy Clinic on Mondays, Tuesdays and Thursday. Call the Community Clinic at Twin Beaches Mall (1-377 Berry Point Road) - 247-9922 - for more information.

By J.R. Young Gabriola Sounder, June 9 2008

For many years the Gulf Islands has been the destination of individuals who wanted to “stop the world and get off.” Today a mix of ageing hippies, retirees and young artisans are no different. A typical retiree will arrive, examine the housing available, and spend a year decompressing. Gardening is high on the agenda until the reality of the deer and the necessity of fencing becomes paramount. Eventually they peer over the fence and join some sort of volunteer group. As a result an amazingly talented group of permanent resident volunteers exist on Gabriola. The common thread is a respect for others talents, and an agreement to cooperate to achieve some worthwhile result. The result is that a group of type ‘A’ individuals calm down and agree to cooperate. I call this Gabriola Calming. As with any group of high powered individuals there is extensive discussion as to what the worthwhile result should be.

The doctors coming to Gabriola should be expected to be similar in temperament, but the product of an extremely competitive environment. There is no way anyone can become a doctor without a great deal of resolve and determination. Expecting any group of Gabriola doctors to agree unanimously on anything is highly unlikely. The best we can hope for is to allow Gabriola Calming to influence some doctors to cooperate on common objectives, and yet retain their independence.

The ‘small town’ nature of Gabriola can allow a unique opportunity for a bottom up model of cooperation. An independent primary health care facility run by the Gabriola Health Care Society should, and perhaps has, formed a framework to attach other health care operations. The objective is to increase communication, and to allow communication to start to focus on health improvement rather than health treatment.

The first 911 call brings the first responders, part of the volunteer fire department, followed by the BC Ambulance attendants. Depending on the time and severity, the call out doctor and the Gabriola Health Care Clinic is used. Further on, perhaps the ferry or the emergency boat transportation to Nanaimo. Nanaimo paramedics are followed by the Nanaimo Hospital Emergency, and so on into the big expensive health care system. Returning discharges will likely involve home care. All of this must be viewed with the understanding there are a significant number of mental health problems in patients.

The objective should be to provide a low level diversion to serve patient health needs. Clearly an operating room response will require the ‘big system’. But a high percentage don’t, and we suspect a percentage of the patients that need emergency services could be helped by counseling and diversion into the array of health improvement services available on Gabriola. Results to date have been extremely encouraging, with anecdotal evidence of many lives saved, and at least eight trips per week diverted from the ‘big system’. In order to maintain our present system MOCAP or equivalent is a necessary and essential part of a sustainable system.

An opportunity also exists to provide a vastly better health care system. Strangely enough the start of a better system may only be possible within a small and enthusiastic community such as Gabriola. By including facilities that would bridge the communication gap between emergency medical services and home care, we can start to move toward prevention rather than fixing a problem after it has occurred.

The Gabriola community consists of an intertwined group of friends and acquaintances, all willing to assist one another. This support should not be underestimated as a vital underpinning for people with mental problems. Isolated, there is no other choice other than the ‘big system’. Frequently retiree couples end with one spouse taking on a caregiver role as difficulties emerge with advancing age. Sometimes children or other relatives also become caregivers. This community is woven into a series of health prevention activities from walking trails in the forest to yoga clinics. Here people live full and energetic lives in their own homes.

We are a community that needs to create a better system with the Gabriola Health Care Society as the nucleus.

By Rachel Stern Nanaimo News Bulletin, May 28, 2008

Cyclists will take the grand tour for health care during the Tour de Gabriola this weekend.

The fourth annual cycling event is Sunday (June 1). Each year, it raises money for islander's goal of a permanent Gabriola Health Care Clinic.

Last summer an interim clinic opened at its Twin Beaches location. The clinic provides a Gabriola emergency treatment room so injured residents don't have to suffer through ferry waits or leave wounds untreated until they can reach Nanaimo's hospital.

There are now three doctors - two full-time and one part-time - who treat regular and emergency patients.

The Vancouver Island Health Authority provides the equipment and supplies for the emergency treatment room. If it is after hours a person calls 911 and one of the doctors is paged to the treatment room.

This year the Gabriola Health Care Society, which runs the clinic, started a sister foundation - the Gabriola Health Care Foundation - to oversee the fundraising efforts, receiving charity status in February.

"We just felt the society was involved with managing the clinic and interacting with VIHA and the ministry of health and it's hard for and organization like that to get fundraising status," said Lawrence Spero, president of the foundation.

Spero said the foundation's vision is to build a health centre with space for physicians, emergency treatment and other health professionals.

So far Gabriola fundraisers like the Tour de Gabriola have raised about $125,000 for the proposed clinic.

Spero said realizing the vision is still four to five years away, but June 20, the foundation is holding a public consultation at the Gabriola Community Hall from 9 a.m. to 3:30 p.m.

"It's just getting confirmation on what we are doing so far and if this is going in the right direction," said Spero.

Cyclists can choose from three tours

There are three tour routes this year that participants can choose from. The traditional tour is 27 kilometres and begins at Gabriola elementary, continues to Silva Bay, and circles back to the school.

The junior tour is approximately 6 km and begins and ends at Twin Beaches Shopping Centre. And the Peterson Tour is 8 km, starting at Silva Bay Inn cyclists make their way to Peterson Road and then circle back to Silva Bay Inn.

Registration is 9:30 to 10:30 a.m. at each starting location and organizers are asking for a minimum of donation of $20 for adult cyclists and $10 for child cyclists, donations more than $20 are eligible for a tax receipt.

Also organizers ask that cyclists bring their own water bottles to reduce plastic use on the island.

Cyclists must bring their printed registration form, which people can download from http://members.shaw.ca/primarycaregabriola/ or by e-mailing primarycaregabriola@yahoo.ca.

By Dustin WalkerThe Daily News, Monday May 26, 2008

CREDIT: Glenn Olsen/Daily News

Gabriola resident Shirley Szeliga has lived most of here life in small towns and has no concerns about living on an Island without a critical care centre.

Newly discharged emergency patients have had to sleep in the ferry terminal as they waited for a ride home to Gabriola Island, while others have let their wounds fester because immediate medical care was simply too difficult to access.

These "horror stories" were traded often among residents of the island, but thanks to a successful grassroots campaign to establish an interim emergency treatment centre there last summer, such grim tales aren't heard nearly as much.

However, although emergency medical services are more accessible now, Gabriola's booming population could one day push the community into a severe health care crisis. People there don't want emergency medical services to be as scarce and inaccessible as they once were. "Many, many times it's happened where people waited in the emergency room in the middle of the night, couldn't find a motel room and sat in the ferry terminal all night. That's happened dozens of time," said Gabriola resident Bruce Mason, who writes for the Gabriola Sounder. "I was getting tired of writing about all these medical crises."

Gabriola pharmacist Tracie Der has also heard tales that would make mainlanders cringe. One problem, explained Der, is that people are sometimes apprehensive about calling an ambulance, and making the trip to Nanaimo, unless they're sure it's an emergency.

The people left out are folks who need a few stitches or other immediate medical treatment that doesn't require travelling off the island. Instead, they wait for treatment that should be rushed.

"I've heard horror stories of people going over on stretchers in an open Zodiac in the middle of the winter," she said. "They let (injuries) linger and maybe a harbour patrol boat was unavailable (to go to Nanaimo). Those kind of stories circulate all the time."

Until last summer, the Island had only one full-time physician who was also on-call for emergencies serving the population of about 4,000 people (up to 7,000 in the tourism season). That's changed now, with the formation of the grassroots Gabriola Health Care Society.

Made up of concerned residents like Mason and Der, the group helped to raise money for an interim emergency treatment clinic that operates out of an old renovated liquor store.

The health authority also brought in an additional full-time doctor, and is currently hiring for a third physician.

There are also two private clinics on Gabriola, but these doctors may not be on-call or available for emergencies.

That's helped reduce the need for residents to travel to Nanaimo for some emergency services, but the two physicians are increasingly being stretched thin, said Lawrence Spero, president of the Gabriola Health Care Society.

"Basically, when you have only two physicians on call they get burned out really easily," he said, adding that most communities with Gabriola's population have up to six on-call doctors.

And although the treatment centre can stabilize patients, it doesn't provide nearly the same level of care that a true emergency room or complete medical centre can.

Some residents were not as concerned as others. Shirley Szeliga, 53, moved to Gabriola about two months ago, knowing there was no hospital.

"When you're an hour outside of a hospital it doesn't matter," said Szeliga on Sunday, as she was preparing to board the ferry. "Maybe in 20 years (I'll be concerned)."

Two years ago, about two-thirds of all ambulance trips from Gabriola Island to Nanaimo's emergency room were minor enough that they could have been treated in a clinic in Gabriola.

"When the clinic is fully staffed by three physicians, it's quite likely you'll see two-thirds less people going to Nanaimo. But that hasn't happened yet," he said.

Over the past year, residents have raised about $140,000 as part of the society's vision to fund an integrated medical clinic on the island, which would allow room for other services, such as mental health care and preventative care, to be offered occasionally.

Some Gabriola residents, such as those with mental health issues, may not be willing to seek help off the island.

Emergency care would also be enhanced and will help the community attract and keep doctors, which would mean fewer trips to Nanaimo for minor medical reasons and a reduced strain on the city's ER.

Gabriola resident Barbara Henderson knows how important timely access to medical care is -- it may have even saved her life.

After she was bitten by wasps while gardening last summer, the 19-year resident immediately began to swell up. She knew that the interim emergency clinic had opened just days earlier, and quickly went to see a doctor.

She wasn't too worried at first, but once there the doctor told her she was going into anaphylactic shock.

A series of needles treated the problem, but Henderson shudders at the thought of what might have happened if she travelled to Nanaimo for treatment instead.

"Being that I was already going into anaphylactic shock, I'm not sure that I would have made it," she said.

Gabriola's population grew by 15% between 2001 and 2006, according to Statistics Canada. People between 50 and 64 years old made up the largest increase, representing a group that often requires more complex medical care. If that trend continues, and medical services aren't enhanced, the island could run into a serious problem.

"We don't have the same older population as say Qualicum, but we're getting there," said Spero.

"If the physicians became so burned out that they couldn't manage they'd leave, it hasn't been threatened or even discussed, but it's something in the back of our minds."

The society is currently applying for government and other grants to fund the new medical clinic, which they hope to have up and running in about four years when the lease for their interim clinic is up.

They've been working with the Ministry of Health and Vancouver Island Health Authority on the project, and will hold the first public consultation regarding plans for clinic on June 20.

DWalker@nanaimodailynews.com

250-729-4244

(c) The Daily News (Nanaimo) 2008

By Bruce Mason Gabriola Sounder, May 26, 2008

In case you hadn’t heard, the final tally for the Clinic Fund Run at the Gym @Twin Beaches was an impressive $3,260.45.

If that makes you want to jump for joy, wait a bit and save your energy, because in case you also didn’t know: the Fourth Annual Tour de Gabriola is set for this Sunday, June 1st.

Organizer Al Strano reports that for those folks who are thinking about participating in the cycle tour, but feel they don’t have the energy, Village Food is providing free oranges and Thrifty Foods has also generously donated energy bars for each rider. As well, refreshing pure chilled drinking water is being provided by Coast Realty Group. Bring your own bottle to cut down on plastic.

“Hopefully this show of support from the business community will be matched by the residents of our Island,” said Strano.

“We need everyone, young and old, to support the effort,” he added. “So, ride a bike, make a pledge to a rider, or simply stop by one of the starting points and make a donation,” he added.

Pick up pledge forms at the Medicine Centre and upstairs at Artworks in Folklife Village and at Gabriola Elementary School (also see page 6).

This year there will be three tours: the traditional ‘round the island tour, a junior tour along Berry Point Road, and a circular tour from Silva Bay Inn via Peterson Road.

Please note: you can also start the long route from Silva Bay rather than make your way to the school and back.

Registration will take place from 9:30 am until 10:30 at all three locations.

For those who want to cheer riders on, here is more detailed route information.

The Traditional Tour de Gabriola commences and finishes at the Gabriola Elementary School, North Road, approximately 1.5 km. from the ferry.

Riders will depart from the school; turn right onto North Road, then left onto Lockinvar Lane, which will take them to South Road where they will turn left. The route continues along South Road all the way to Silva Bay where the road name changes to North Road and comes back to the starting point, making a loop around the island.

The length of the ride is approximately 27 km. and will take approximately 1.5 to 2 hours to complete.

The Junior Tour will start and end at the Twin Beaches Shopping Mall, 377 Berry Point Road, approximately 2.4 km. from the ferry. Riders will depart from the mall, turn right onto Berry Point Road and will turn left past the Surf Lodge, continuing out to the picnic tables at Orlebar Point. Riders will return via the same route, approximately 6 km.

The Peterson Tour will start and finish at the Silva Bay Inn near the junction of North Road and South Road on the east end of Gabriola, approximately 15.5 km. from the ferry on South Road. This route is 8 km in length.

More information and online registration forms are available at http://members.shaw.ca/PrimaryCareGabriola/ or by E-mail: primarycaregabriola@yahoo.ca.

Thanks to everyone who is participating and don’t forget that the Gabriola Health Care Society Annual General Meeting is Thursday, May 29th, at 7 pm at the WI Hall. Along with reports on the society’s finances and activities for the year there will an election of directors in which you are entitled to nominate and vote.

By Doris McLaughlin Gabriola Sounder, May 26, 2008

THANKS, an expression of gratitude, seems like such a small word to use to show appreciation to those that made the Clinic Fund Run at the Gym @ Twin Beaches such a success.

First and foremost thanks to Bruce Mason and The Sounder… we could not have done it without you!

Next, thanks to Lou & Kim Brooks from the Gym@Twin Beaches, a place like no other, whose support was there from Day 1.

Thanks to Marilyn Geater, Val Toomey, Village Foods, the Bakery at Twin Beaches, Eternal Flow, Tracie Der, Pilot Bay Guest House (Dick and Suzanne), Cliff Cottages B&B (Jacoline and Lance), Gallery Press (Regan and Sylvie), Shirwin Construction (Shirley and Winston), Christine Gagnon (Raven Feed & Pet Supplies),

And thanks to all those who took pledge sheets: Judy McNair, Annette Warwick, Michelle Delesalle, Val Toomey, Lenore Couper, Cheri Korol, Connie Connor, Christine Gagnon, Shirley Cerniuk, Tessa Spero, Marilyn Campbell, Tracie Der, Pam Asquith, Doris McLaughlin and Cheryl Brown.

Last but certainly not least, all those who sponsored the participants on the machines and those who sweated it out on the machines!

By Bruce Mason Gabriola Sounder, May 19, 2008

Doris McLaughlin is pumped and for good reason. Last week's Clinic Fund Run exceeded even her high expectations.

And Al Strano is waiting in the wings, ready, willing and able to build on the remarkable momentum, which is the real story of the ongoing initiative to improve healthcare right here, right now.

"Sylvie Gendreau and Regan Lall of Gallery Press and Jordan and Kerry Sorrenti were at The Gym @ Twin Beaches and leapt on the machines as soon as we opened the doors at 7 am," McLaughlin reported.

"A steady stream of people - including folks who just wanted to put money into the donation jar - continued to arrive and 12 hours later Bill Miner, Judy McNair and Christine Gagnon of Raven Pet Foods were there when it was time to close."

All day people sipped water from Village Foods, bars from Twin Beaches Bakery and Aunty Val's healthy muffins, chatted, sweated and raised funds.

When Doris had counted she appeared to be a few hundred shy of three grand. No problem. Suzanne Bizon and Dick Hamilton of Pilot Bay Guest House topped it up. Turns out that wasn't necessary, although McLaughlin has no intention of giving the money back.

At press time the Clinic Fund Run has added more than $3,000 to the Gabriola Health Foundation.

"The support is truly amazing and further proof that this community is determined to improve healthcare on Gabriola," said Doris McLaughlin.

In the meantime, Al and Louie Strano are working hard on the Fourth Annual Tour de Gabriola. They could use some help, so please consider volunteering and lending a hand by E-mailing: primarycaregabriola@yahoo.ca.

There are three courses in this year's fun-filled tour, something for everyone and another opportunity to continue to help save lives and money without raising taxes.

Last week the Sounder reported that pledge forms were available at Artworks. In fact they are available online at http://members.shaw.ca/PrimaryCareGabriola, at The Medicine Centre and Gabriola Elementary.

Guess what? They are now at Artworks, as well.

Everything you need to know about the 2008 Tour de Gabriola is on the above website.

Obviously we are well along in the process of building the best damn little clinic and healthcare system on the west coast, no matter what some folks tell you, or what issue, problem or obstacle gets in the way or has to be solved.

Full stop.

Thanks for your ongoing support.

Finally, consider attending the Gabriola Health Care Society Annual General Meeting Thursday, May 29th at 7 pm. Along with reports on the society's finances and activities for the year there will an election of directors in which you are entitled to nominate and vote. Fresh blood is healthy and everyone in the community has a role to play.

The Flying Shingle, May 15, 2008

"They didn't just move the goal posts they changed the whole playing field."

This was Gabriola Health Care Society's (GHCS) Tracie Der's response when asked by phone why the society did not wait for Medical On Call Availability Program (MOCAP) funding to be in place before establishing the Emergency Treatment Room (ETR) on Gabriola. The process has turned out to be much more complicated than they had previously believed she said.

She echoed statements made at the Gabriola Ratepayers' Association meeting on April 21 by Society member Lawrence Spero. Spero said that the society was originally told that once they set up an Emergency Treatment Room (ETR) and met other conditions VIHA would provide funds. Spero said that GHCS met those conditions, but complications have arisen. Spero said MOCAP funding is on hold province wide (see story page 3) as is further VIHA funding pending an upcoming community consultation process (see story page 3).

In a telephone interview with the Shingle, Dr. H.G. Harding of the Gabriola Professional Centre (GPC) said the issues around ETR and after-hours funding are much more complex than they have been made out to be by some. Harding said that while he does not oppose the ETR in any way, has many concerns about its feasibility.

Large enough patient base?

Harding said he did not think Gabriola has the patient base to justify a full time emergency clinic, and wondered whether the government has agreed that Gabriola needs emergency coverage. Harding said that with the pressure government is feeling with the health budget he believes it is unlikely they will come up with more money for the ETR.

Harding said further that three full time doctors will be required for on call funding. He asked, "With the competition for doctors is any suitably trained doctor going to move to island for a marginally busy operation?"

Harding said that nevertheless the GHCS is making a great attempt to make the ETR viable.

Clinics Cooperating

Asked at what point the doctors at the GPC became involved with the ETR process, Harding said that he and Dr. J. MacKenzie were not originally invited to be part of the new clinic or of the decision making process. He gave Dr. MacKenzie credit for reaching out to the Society. He said that the first cooperation between the four doctors was at a meeting with VIHA Chief Medical Officer Dr. Owen Heisler in January 2008.

Lawrence Spero told the Shingle by phone that the GPC doctors are not interested in being on-call after hours. This was confirmed by Harding who said: "Neither of us, being in our older years, want to get up in the middle of the night for on-call work."

The Flying Shingle, May 15, 2008

Rural physicians on hold for on-call Funding for on-call work by all rural doctors, including those on Gabriola is on hold while a province-wide review is conducted into the Medical On-Call Availability Program (MOCAP).

This information was given to the Shingle by Victoria Power-Pollitt, Director of Primary Health Care and Chronic Disease Management for the Vancouver Island Health Authority (VIHA).

Power-Pollitt, said in a telephone interview with the Shingle that the Province is reviewing what types of communities will be eligible for MOCAP. She said Gabriola's application for funding will be evaluated once those parameters are determined.

As noted previously in the Shingle, the issue of on-call funding has long been the focus for the Gabriola Health Care Society (GHCS), a society that has established an Emergency Treatment Room (ETR) on Gabriola.

Calls by the Shingle to Dr Hoffman and Dr. Bosman (the on-call doctors for Gabriola) asking whether they would like to comment on this and other issues were not returned.

The Flying Shingle, May 15, 2008

Close to 50 % of Gabriolans receive their primary medical treatment off island according to Victoria Power-Pollitt, Director of Primary Health Care and Chronic Disease Management for the Vancouver Island Health Authority (VIHA).

In a phone interview with the Shingle, Power-Pollitt said that the Ministry of Health (MOH) has provided the Gabriola Health Care Society (GHCS) funding to undertake community consultation with Gabriolans regarding their primary health Care needs. She said that the community consultation is meant to discover what is worldng medically for Gabriolans, and where the gaps are with their primary health care. She said she was using the broadest sense of the word 'health' including community care and mental health care.

Power-Pollitt said that VIHA won't try to 'repatriate' islanders who have Nanaimo doctors, but they would like to make the system work as well as it can for those who are using on island care. Perhaps then, fewer Gabriolans would seek health care off island, she suggested.

Power-Pollitt said that GHCS and VIHA will collaborate to create an agenda for the meeting, which will be fine-tuned in consultation with all Gabriola doctors. It is hoped the meeting will happen sometime in June, she said.

Power-Pollitt said a Memorandum of Understanding (MOU) reached between the MOH, VIHA, GHCS, and all four doctors on the island will be available to the public at the forum, and may be released earlier so folks can read it ahead of time.

"Blended Funding" Model

When asked whether there was any likelihood of the Ladysmith Clinic model (mentioned last Shingle) being brought to Gabriola Power-Pollitt said that model came into place in the '90s. It has been grand fathered in communities in which it was instituted but it is not an option for new clinics, she said.

Power-Pollitt said the Ladysmith Clinic was set up so that two streams of funds come into the clinic. A block of funding is allotted to the community per year per patient based on the percentage of community members the clinic doctors belie\-e regularly attend the clinic. It is the clinic's responsibility to take care of those patients Doctors can also bill the government for service if a community member for whom block funding is not being received attends the clinic. Money is also deducted from the clinic when an identified clinic patient uses a different clinic.

The Flying Shingle, May 15, 2008

An agreement has been reached between the Ministry of Health (MOH), Vancouver Island Health Authority (VIHA), the Gabriola Health Care Society (GHCS) and all of the island physicians to recruit an additional physician for Gabriola. That is what Victoria Power- Pollitt, Director of Primary Health Care and Chronic Disease Management for the VIHA said in a phone conversation with the Shingle.

Power-Pollitt said the MOH is providing funding, and VIHA is helping with advertising.

Dr. H.G. Harding of the Gabriola Professional Centre (GPC) confirmed that agreement. Harding said further that much of the time spent working out a Memorandum of Understanding (MOU) between all the above parties was devoted to the wording of the ad for the new doctor.

Harding said that GHCS is looking for a third doctor for the Gabriola Medical Centre (GMC) while the GPC is looking for someone to replace him, because he wants to retire.

Harding said that requirements for doctors at the GPC are different from those one would look for in an emergency clinic. He said that VIHA wanted to combine the ad to try to find someone who would fill all the requirements. He said he thought it would be unlikely such a person would be found.

By Chris Bowers,The Flying Shingle, May 15, 2008

Thanks to an influx of a few nice big ads it was possible to splurge on four more pages for what is usually the eight page (mid-month) edition of the paper. This is fortunate because there has been close to four pages of news, and columns in follow up to the stories about the Gabriola Health Care Society (GHCS) in the last Shingle.

Following-up

Besides the news stories you've made your way past on the way to this column, Tracie Der has written a response to the questions and concerns raised in both the lead article and the guest editorial (see page eight). I have also written a back grounder on the issue based on the responses to questions the Flying Shingle has asked members of the GHCS board (see page nine).

The gist of the matter

As I see it the gist of the information the Shingle has received since the last edition is twofold. The first is that The Emergency Treatment Room (ERT) is a separate entity from both the Gabriola Medical Clinic (GMC), and the GMC drop-in clinic. Those differences are outlined on page nine.

The second answers what started out as one question and ended up as a series. It goes thusly: "Why are Gabriolans being asked to donate money towards only one of the two medical centres on the island?" and "Why are Gabriolans being asked to donate towards the new medical clinic and not just towards the ETR - especially as both medical clinics on Gabriola will "co-locate" a number of health care professionals?"

The medical clinic

Paraphrasing GHCS spokesperson Lawrence Spero's response, the medical clinic being proposed by GHCS will be a community owned facility which will use an integrated multidisciplinary approach to health care. Spero outlines a number of other positives about the new medical centre. I have quoted his answer in its entirety on page nine.

Well and good. I can see why some folks might be willing to invest time and money into such an enterprise. Especially when there is a permanent invitation to the community on the GHCS website to come and join their Board. (http://www.ghcs.ca/help.html)

The ETR

Unfortunately there are apparently few stat's on the operation of the ERT, and there was not enough room to include them in this Shingle. While I think the idea of an ERT intuitively makes sense (it seems as if it can't help but save lives, limbs, and money), folks really do need to have that kind of information to make an informed decision as to the effectiveness of the facility. What stats there are (see: http://www.ghcs.ca/questions.html) seem promising. I look forward towards seeing more definitive information in the future.

Democracy requires debate

Which brings me to the topic of informed decision. What became abundantly clear to me while I was investigating this issue, is the level of fundamentalist fervour among the fans of the clinic.

Among the many questions the Shingle received about the GHCS project, came comments about the discomfort folks felt about asking questions about it. Some said they were treated disparagingly, were subjected to sarcasm, or treated like pariahs for not immediately jumping on board. Others simply found it hard to ask questions about such a "motherhood" issue.

As I was given less than subtle invitations to drop the subject after the last edition of the Shingle, I have no problem believing this is true.

Forget the fact that such responses are a signal to any semi-decent editor that deeper investigation is necessary. Let's consider the harm this does to any legitimate enterprise and democracy in general.

What does it tell community members about a project when queries and/or doubt are met with snideness and hostility? And what good advice does the Board miss out on when those who counsel caution are frozen out of the conversation? In many ways this project appears to have been the victim of being loved unwisely and too well, and that has done no favours to the GHCS Board.

The Board, on the other hand, has answered the Shingle's questions (many of which were both blunt and pointed) civilly and quickly, and have welcomed the opportunity to clarify their project and intentions. Hopefully others will take instruction from this.

The Flying Shingle, May 15, 2008

In the midst of several GHCS fund raisers, DON"T MISS the fourth TOUR de GABRIOLA bike ride, original GHCS fund raising event. The tour will be start at 9:30 AM on Sunday, June 1.

To provide easier registration and varied courses for different levels of endurance, there will be three starting points: the Gabriola Elementary School parking lot, Twin Beaches Shopping Centre and the Silva Bay Inn. Riders may now do the full island tour (27km), the Berry Point tour (6km) or the Silva Bay - Peterson Rd. tour (8km).

As usual, there ",i.ll be fruit available. However, to support plastic reduction on Gabriola, riders will be provided with ice water refills for their own bottles.

Registration and pledge forms will be available at the Gabriola Medicine Centre Pharmacy, the Gabriola Elementary School and 3235 South Road. More information and online registration forms are available at http://members.shaw.ca/PrimaryCareGabriola/ or by emailing PrimaryCareGabriola@yahoo.ca Tax receipts for donations of $20.00 or more are available.

The Flying Shingle, May 15, 2008

Submitted by Tracie Der Gabriola Health Care Society

The Gabriola Health Care Society (GHCS) has faced a number of questions recently about the processes leading to the opening of the interim health care facility and the future, permanent, one.

There are misunderstandings and concerns being raised. Many of these were highlighted in the newspaper and the GHCS would like to ensure Gabriolans have the facts. Some very good questions were asked by The Flying Shingle and the answers have been posted on our website. Please do visit: www.ghcs.ca/questions.html.

Some issues do not have any association with the activities of the GHCS - for example, "privatized" or "for-profit" health care. While it is true that we, as a community, are engaged in building a "facility," the provision of health care will continue to be within the public system.

A "new" relationship has been struck between the Vancouver Island Health Authority (VIHA), the Ministry of Health (MOH), the GHCS and all of the local physicians - this has been formalized in the legal Memorandum of Understanding (MOU)

The concept of "rostering" (registering community members at the clinic), while once suggested, was discounted immediately and does NOT form part of the MOD. Neither the GHCS nor the physicians would give it consideration. There are no restrictions on who Gabriolans see for health care and the Emergency Treatment Room (ERT) is available to anyone who needs help - there is no requirement to be a "patient" of the Medical Clinic! Yes, all Gabriolans are members of the GHCS (the bylaws were fashioned after those of the Community Hall) to ensure Gabriola "owns" the facility and has a role in determining the GHCS operating policies - but, there is no membership "list!"

The physicians in the clinic are not being subsidized in any way by the GHCS - they are paying fair market value rent as well as paying their share of the expenses involved in renovating the space. Their presence in the clinic is actually a necessity for the Emergency Treatment Room.

The up-coming public meeting is definitely NOT an "enquiry!" It is part of a process with our partners VIHA and the MOH that must be undertaken to ensure the ultimate viability of the project and allow for the 2-way exchange of information: informing the public of the facts and possibilities while allowing them to share their ideas and visions for improving health care on Gabriola.

The GHCS welcomes community participation and encourages anyone with any questions, concerns or ideas to share them. We can be reached at information@ghcs.ca or Box 295, Gabriola, V0R lXO. There is plenty of information posted on our website: http://www.ghcs.ca and you'll also find our Board of Directors - any of whom would be happy to explain the activities of the society.

It's worth reviewing the history that brought us to where we are today.

The original visionary was Dr. Madeline McPherson.

In June 2006 she first contacted VIHA and the MOH to say, "A most pressing and desperate need exists for the health care of the 5000 plus residents of Gabriola Island: A Diagnostic and Treatment Centre that would be available 24 hrs a day, 7 days a week ... staffed by nursing staff, physicians on call, and a nurse practitioner ... equipment to carry out diagnostic stabilizing and monitoring procedures for such emergencies as heart attacks, syncopies, acute allergic reactions, acute asthma attacks, while awaiting transfer. We do not have any area where acutely ill patients can be stabilized and observed ... treatment of simple lacerations and fractures, acute upper respiratory infections, ear aches etc. could be done at the Centre and these would not need to go to the ER in Nanaimo after office hours."

Dr. McPherson eventually received a reply from VIHA suggesting a meeting. Unfortunately Dr. McPherson was making her plans to leave Gabriola and knew she wouldn't be available to see the process through. She asked Dr. Daile Hoffmann to take on the project and Dr. Hoffmann agreed.

The community learned what was going on and people stepped forward to help. Al Strano was one of the early volunteers - he previously helped Dr. Bob Henderson fundraise for a portable defibrillator and was excited to organize a bike tour to start raising money to build on the vision. Bruce Mason saw the spark and started spreading the word. Soon, others were volunteering - Fred Geater and Harvey Graham took the lead, then many more, in rapid succession.

By December of 2006, a planning group had begun working with several branches of VIHA. A public meeting was held in January 2007 and the first AGM of the newly formed Gabriola Health Care Society took place in March. By July 2007, the community had gained a new physician and a new interim facility to immediately improve services while the work for a permanent facility got underway.

While a phenomenal amount of work has been accomplished in an inordinately short amount of time, this has been due primarily to the motivation and expertise of a team that has been committed to this vision and seeing it through to completion - not without some personal costs in terms of frustration, stress and time lost with family/loved ones.

But, it has been worth it. Gabriola is in position to be the prototype for a new model of the provision of public health care that can be applied in many other communities around the province.

By Chris Bowers The Flying Shingle, May 15, 2008

The majority of the following information was gathered through an emailed exchange of questions and answers between the Flying Shingle and Gabriola Health Care Society (GHCS) members Lawrence Spero, Tracie Der, and Fay Weller. This back-grounder is an attempt to answer a number of questions including those the Shingle has received from community members. Even when not explicitly stated, attribution for the information in the following backgrounder can be assumed to either have come from that email exchange or from the GHCS website.

The complete set of questions and answers can be found on the GHCS website at: http://www.ghcs.ca/

On its website, the Society lists as its goals: "To develop and maintain a fully equipped health care facility to deliver integrated Primary Health Care services to people on Gabriola." It is a non-profit organisation, and has recently added a foundation "wing" to its structure so that it can apply for grants to pay for the capital costs of the permanent clinic.

Society respondents say the Society has been set up so that all Gabriolans are members unless they don't want to be. Among other reasons this was done to ensure that "all Gabriolans would have a vote in determining the GHCS Board of Directors, and thus a role in determining GHCS operating policies." Anyone who wants to be removed from the association should contact the GHCS at either: PO Box 295, Gabriola Island, BC V0R lXO or Email information@ghcs.ca.

The Society's stated vision for their medical clinic is a community owned multidisciplinary facility. They hope to bring many medical professionals under one roof to better serve the community. Society members say that they have contacted other VIHA health services who are interested in increasing their presence on Gabriola.

The respondents say that besides relocating the facility's doctors from the old Gabriola Medical Clinic (GMC) (once located in the house beside the Coop), the Society has also established an Emergency Treatment Room (ETR).

The respondents clarified that the ETR is a separate facility from the medical clinic. Specifically equipped to assess and handle emergencies, the ETR was partially funded by the Vancouver Island Health Authority (VIHA) after Society members jumped through 13 pages of hoops to meet the required regulations. Anyone who needs it is eligible to use the ETR and to be seen by the on-call emergency doctors.

Society members say that when required the ETR is staffed by doctors Hoffman and Bosman from the GMC (Twin Beaches clinic). Hoffman and Bosman also provide after hours on-call medical treatment when necessary. The ETR is accessed by dialing 911.

Respondents further clarified that the ETR is also separate from the drop-in clinics at both medical centres. The weekend clinics are a convenience provided for patients who are unable to see their doctors during the week.

Respondents say that renovations necessary to turn the liquor store at Twin Beaches into a medical clinic and ETR were paid for by donations from Gabriolans. VIHA helped pay for some of the costs for the ETR. The GMC doctors are paying rent for their facilities at Twin Beaches and are paying down the renovation costs so that the money can be used to pay for a permanent clinic. Professionals who use the future clinic will also pay rent.

Society members say that although a decision has not been made, GHCS believes purchasing a permanent clinic is necessary because they will need a large space to "co-locate" all the professionals they would like to house. Members of the society also believe owning the clinic has advantages over leasing or renting.

Asked why Gabriolans are being asked to raise funds for the GMC clinic and not for the clinic at the Gabriola Professional Centre (GPC), society members said VIHA and the Ministry of Health will not pay for infrastructure. The society is therefore fundraising for a permanent ERT and to realize their vision of a multidisciplinary facility.

As the GPC also houses a number of health care providers, the Shingle asked whether the building of the ERT is the only significant difference between the GPC and the permanent clinic. Lawrence Spero responded with the following:

• Better co-ordination of patients' interaction with all of the components of the health care system
• Not for profit, community owned
• Room for expansion as the island grows
• All physicians in the community clinic will be in the on-call group
• Designed to meet the needs and requirements for delivering integrated Primary Health Care as the new Provincial model contemplates
• Built to house all the VIHA public services in the new centre and integrate them, the MDs, and other professionals in the clinic and in other independent healthcare practices
• The Primary Heath care initiative could attract more VIHA services to the Island, e.g. increased Mental Health Services, Chronic Disease Education (Diabetes etc.) on Gabriola rather than going to Nanaimo.
• More of the taxes we pay to the Province will be spent on Gabriola rather than Nanaimo."

The society says that: "There will be no specific tax or special Gabriola 'levy' that people will be asked to pay for building the clinic.

In terms of funding - past and future, Society respondents say the Society has been granted a Family Physician for BC position. The position comes with up to $100,000 from the Province for "startup costs". The society is also looking for funding from VIHA for funding through the Medical On-Call Availability Program (MOCAP) program. This money is used to compensate physicians for being on-call and for lost opportunities to see their own patients.

Respondents say the Society is looking for long term financial commitments from the "various VIHA entities", and for funding for any new ETR. They are also asking VIHA to pay rent for the current ETR and any space used that might be used "by any VIHA service groups in the proposed new facility".

By: Bruce Mason, Gabriola Sounder, May 12, 2008

Al Strano is one of those Gabriolans who is pumped up about improving healthcare on the island. It’s a mission of sorts and his roots go deep into the ongoing initiative.

He’s set a goal to raise $5,000 and is certain he can do just that in one day - the first of June - particularly if he can get our youth on board in their own all-important efforts in the Fourth Annual Tour de Gabriola.

“Last year Sam Prior and Mackenzie Jenkins challenged each other to raise money through pledges and got out on their bikes and raised more than $150 each,” Strano reported.

It was impressive, he added, but also inspirational, especially if you count young heads on the Island. There are many more than 48 more youngsters here, who, with a little encouragement could be up to the challenge and the opportunity.

After doing the math, Al pointed out that’s all it would take - 50 youngsters with pledges!

Strano has been offering encouragement, talking up the Tour de Gabriola at the school and places were young people gather. The 4-H Club is just one of the groups getting involved.

Al and Louie Strano started in the bad old days of emergency healthcare, before the Gabriola Health Care Society got together, before the interim clinic opened its doors and the foundation was formed.

He read an interview with Dr. Bob Henderson in the Sounder about how the Island desperately needed a LifePak unit and came up with the idea of the cycle tour as a fundraiser.

Later Henderson - a Gabriola resident who conducts part time locums on Hornby Island - reported that the newly acquired Life Pack unit was indeed saving lives.

However, because the Island didn’t have a clinic, there was no place to store clot-busting and other medications.

“Bob had been a real catalyst all along,” Al noted. “My wife Louie and I are avid cyclists and we decided to stage an annual tour to help establish and support a primary care clinic on the Island.

“I told you then that I thought I would need a clinic someday,” Strano recalled. “I am 67 now and I was right.”

The first Tour raised $3,000, the second brought in $2,200 and last year, bad weather had a negative impact and the final tally was $1,700.

‘It’s my baby,” said Strano who describes himself an optimist. “And this year we have come up with a third route that almost anyone can do and is also very scenic.”

The new route is a flat and flat out gorgeous 6km from the clinic at Twin Beaches to Olebar Point and back.

The second is a bit more of a challenge - although only slightly longer - 8km starting at Silva Bay and continuing in a circle along Peterson Road.

The whole Tour de Gabriola enchilada is 27 km around the Island, starting this year at the school. Strano advises that cyclists can also begin this grand tour route from Silva Bay rather than make their way to Gabriola Elementary and back home again afterward.

He’s spreading the word off-island because any of the three Tour de Gabriola routes rank favourably with cycling events anywhere. Water (bring your own bottle) and fruit will be available at strategic locations along each route.

As Ralph Waldo Emerson once noted: “Charity begins at home.” In this case, your own home.

One of the misconceptions around improving Island healthcare is that the initiative is for older folks. It isn’t. The young also get ill, sometimes seriously, and are involved in accidents. The Tour de Gabriola is their opportunity to help make certain that care is there when they need it.

Pick up a pledge form from Artworks or E-mail: PrimaryCareGabriola@yahoo.ca.

Everything you need to know - including forms - and more information is on the website: http://members.shaw.ca/PrimaryCareGabriola.

In other healthcare fundraising news, Nancy Nevison reports that more than $400 was raised in the Mother’s Day Flower Sale.

Apparently not everyone made purchases for Mom. For Norma Stone it was an opportunity to say thanks to three of her generous care-givers, while supporting a worthy cause.

Even a well-known farmer - who recently turned 80 - took advantage to purchase flowers for his wife for the first time. “Because of my occupation I have given cauliflower in the past,” he said, jokingly, “but this is such a great cause.”

Like we have been saying all along: the ongoing initiative to improve Island healthcare is of, by and for everyone.

We all benefit and the Tour de Gabriola is an outstanding, healthy, fun-filled opportunity for the young and young-at-heart to get in the cyclist’s seat.

And for the rest of Gabriola residents to pledge support for their efforts.

By: Bruce Mason, Gabriola Sounder, May 12, 2008

Unfortunately a recent article and opinion piece published elsewhere created widespread and unnecessary confusion and anxiety about the ongoing initiative to improve healthcare on the Island.

However, this also provided an opportunity to go back and correct some misconceptions about the Gabriola Health Care Society, the interim clinic, current and potential arrangements with the Vancouver Island Health Authority and the BC Ministry of Health and Island healthcare professionals, as well as the newly formed Gabriola Health Care Foundation.

A series of 12 questions and answers - which are essential reading - has been posted on the website: www.ghcs.ca, along with other important information, much of which has been reported in dozens of articles in the Sounder dating back several years.

In this case there is absolutely no reason to have your questions, ideas and concerns unanswered. Simply E-mail them to information@ghcs.ca. You will get a response ASAP.

Better yet, attend the GHCS Annual General Meeting, Thursday, May 29th, during which an election of directors will be held and final reports on the society’s finances and activities for the year will be made public.

Obviously if you have questions and concerns this is your opportunity. And if you think you can improve progress on Island healthcare, volunteer, stand for election and most certainly vote.

The 2008 GHCS AGM is separate and distinct from an upcoming meeting being scheduled by the MOH, to be announced. This will provide an opportunity for residents to take part in envisioning the future of Island healthcare.

Clearly this important ongoing initiative is supported by the vast majority of residents, healthcare professionals and officials.

It is, in fact, a community role model to rise above the petty bickering, capricious misinformation and low level of public discourse that has bedevilled Gabriolans for too long on virtually every front.

Since the creation of the GHCS, every possible attempt at transparency has been made. All information has been reported as it has become available as volunteers continued in difficult and ground-breaking negotiations.

This is not about “left” or “right.” Or “I’m right, you’re wrong.” This is quite simply too damned important and too much good work has been done and remains to be done, to let community healthcare be dragged into long-standing rivalries and simmering ancient disputes.

On a positive note, Sandstone physiotherapist D'Arcy Boulton is currently in Malaysia with the Canadian Men’s Field Hockey team on a training tour in preparation for the Summer Olympics.

During his short absence new relationships and services have been established at his clinic which is part of the interim community healthcare clinic at Twin Beaches.

Massage therapist and kinesiologist Brenda Hall has returned to the Island and will be working out of the Sandstone Physiotherapy clinic for this month at least.

As well, personal trainer Lesley Standerwick is now associated with D'Arcy’s clinic.

Finally, the GHCS and GHCF have a new address: It is PO Box 295, Gabriola Island, BC V0R 1X0.

Flying Shingle, April 30, 2008