Submitted by GHCS, Gabriola Sounder, December 8, 2008

Many people are unaware of the distinction, but there are actually two organizations working to improve the stability and sustainability of primary health care on Gabriola Island - the Gabriola Health Care Society (GHCS) and the Gabriola Health Care Foundation (GHCF). The foundation was established earlier this year to be the charitable arm and focus on fundraising. The foundation is able to issue tax receipts for donations and can act as the applicant for philanthropic funding to establish a permanent facility.

Another group of supporters also formed earlier this year - the Gabriola Health Care Auxiliary. This group has been very active in local fundraising and have already been directly responsible for raising more than $15,000 for the GHCF! Both the GHCS and the GHCF wish to acknowledge the ongoing efforts of this dedicated group. Not only have they been active in fundraising, but they have been ambassadors for Gabriola health care and even arranged the recent physicians appreciation dinner. The auxiliary is embarking on a new project - a cookbook! If you have a treasured, tried, and true recipe to share, be sure to contact us to reserve your place in Gabriola’s culinary history! Plus, they are always willing to welcome anyone interested in helping out.

This is also the time of year to consider making any charitable donations to be included in the 2008 tax year. Forms for donations to the GHCF are available at the Gabriola Medicine Centre and more information can be found online at the GHCS website: www.ghcs.ca.

While at the website, visit our webpage detailing the Memorandum of Understanding (MOU) between the Ministry of Health, VIHA, Gabriola physicians and the GHCS as well as our interim report on the actions and accounting for the achievements of the MOU thus far. Some finances do remain for the planning of Gabriola health care into 2009 and the work is ongoing.

Finally, the GHCS has a bit of tentative good news to share - a physician has applied for a position with the Gabriola Medical Clinic in 2009! This physician will be completing her residency in the late spring and has initiated the application process under the Family Physicians for B.C. program.

Submitted by GHCS, Gabriola Sounder, November 24, 2008

On Tuesday, November 11th, Fay Weller, Lawrence Spero, Harvey Graham, Fred Geater and Ian Brownlie, from the Gabriola Health Care Society/Foundation, as well as Margot Kemble, of Architrave, visited the Pender Island Medical Clinic, which is owned by the Pender Island Health Care Society.

The population of Pender is approximately 2,500, rising to about 8,000 in the summer months. Presently, there are two full-time doctors on the island, but the community is looking for a third doctor since there are 300 people on a waiting list.

The original facility of 2,400 square feet was built in 1980. In the early 1990s an addition of 1,200 square feet was added and in 2008 the latest addition of 3,500 square feet was completed. The cost of this addition was $1,480,000, with the money raised from the Capital Regional District, local fundraising, VIHA, and various philanthropic and service groups.

The building consists of three modules grouped around a Japanese-style courtyard. There is a large reception area, an accounting area, and the professional rooms. The urgent treatment room has space for two patients at a time. The whole complex is single storey so there are no steps or lifts.

As the GHCS makes plans to visit other facilities serving similar populations, this delegation was impressed by the commitment and innovation of the Pender Health Care Society - in particular, their executive director, Robert Dill. He was one of the founders of the James Bay Project - known as one of the most innovative health care centres in B.C. He was most forthcoming with information and assistance and was very receptive to the idea of working together with other gulf islands to influence positive change in our primary health care system.

Submitted by GHCS, Gabriola Sounder, November 17, 2008

People with two or more chronic diseases are growing in number. Eighty percent of the total health budget is consumed by individuals with at least one chronic disease. These are statistics from Impact B.C., a strategic alliance between the B.C. Ministry of Health, the B.C. Medical Association and the provincial health authorities. Impact B.C. seeks to improve primary health care, and Integrated Health Networks (IHNs) are a mechanism that supports and formalizes the critical linkages between community organizations and primary health care. They also re-align health authority and specialist services to integrate with primary health care (see: www.impactbc.ca/IHN).

One of the commitments from VIHA was to facilitate access to IHNs for Gabriolans. IHNs provide customized services to support participating family physician offices, practice teams, and patients in managing two or more chronic diseases. The bottom line is that the patient is a key partner and team member in his/her own health care.

Dr. Bosman and Dr. Smith are now both signed up to provide physician services for the IHN. VIHA has also promised the services of mental health workers, social workers, and nurses. Initially, many of the group programs will be offered in Nanaimo with occasional visits to Gabriola by team members (e.g. a nutritionist) as needs and patients meeting the criteria are identified. We look forward to watching the evolution of this network on Gabriola in the months ahead.

This past week, a Gabriola delegation went to the Pender Islands to view their newly expanded health centre and gain insights into the process, priorities and financing of such a venture. Those who visited were impressed by what they saw and they will be sharing information on what was learned in the weeks to come.

Flying Shingle , November 14, 2008

The Gabriola Health Care Society is making advances on several fronts at this time.

Gabriola will be hosting several applicants interested in the Family Physicians for BC position, provided for us by the Ministry of Health, over the next month. Family Physicians for BC supports a recent graduate establishing a practice in a community deemed as "in need" in terms of numbers of physicians relative to the population. The position provides up to $100,000 to cover costs such as student loans and office expenses while first starting their practice and requires them to commit to staying in that community for at least three years.

This week, a Gabriola delegation is going to the Pender Islands to view their newly expanded health centre and gain insights into the process, priorities and financing of such a venture. The Bishop Coleman Memorial Health Centre is owned and operated by the Pender Islands Health Care Society and the expansion houses a new medical wing, an emergency treatment centre, enlarged waiting and reception areas and new offices for health practitioners. The renovations were added on to a pre-existing facility originally built by the Pender Lions Club in 1980 and the whole building was upgraded to meet the latest safety and fire codes. The Health Centre is also now home to a series of community based programs and support services.

Pender celebrated the opening of this $1.3 million facility in October, funded by both local fundraising by the community of 2400 residents and grants from the Capital Regional Hospital District and supported by the Vancouver Island Health Authority - a working example of community and government partnering.

The GHCS is performing its due-diligence in studying several communities to avoiding "reinventing" the wheel as we forge ahead in developing our own plans for a permanent facility.

One of the commitments from VIHA was to facilitate access to an Integrated Health Network for Gabriolans. Integrated Health Networks (IHNs) provide customized services to support participating family physician offices, patients and practice teams in managing chronic disease.

Dr. Bosman and Dr. Smith are now both signed up to provide physician services for the IHN. VIHA has also promised the services of mental health workers, social workers, and nurses. Initially, many of the group programs will be offered in Nanaimo with occasional visits to Gabriola by team members (eg. a nutritionist) as needs and patients meeting the criteria are identified. We look forward to watching the evolution of this network on Gabriola in the months ahead.

Submitted by GHCS, Gabriola Sounder, November 11 2008

The Gabriola Health Care Society is greatly heartened by recent news from Pender Island.

In early October, Pender celebrated the opening of an expanded health centre. The $1.3 million facility project was funded by generous donations from the Pender Island community of 2400 residents and visitors ($700,000) and grants from the Capital Regional Hospital District (CRHD) ($597,396). The project is a fine example of community and government partnering.

Owned and operated by the non-profit Pender Island Health Care Society, the Bishop Coleman Memorial Health Centre expansion houses a new medical wing, an emergency treatment centre, enlarged waiting and reception areas and new offices for health practitioners. The preexisting portions of the facility (built by the Pender Lions Club in 1980) have also been renovated and upgraded to meet the latest safety and fire codes.

The Vancouver Island Health Authority supports health care services on Pender Island and congratulated the community on this new, expanded facility.

The health centre is also home to a series of community based programs and support services and is just one of the sites that GHCS building committee members wish to visit before finalizing our local plans.

Gabriola Island is also now hearing from applicants interested in the Family Physicians for B.C. position and several will be visiting Gabriola in the next month. This position was provided to us by the Ministry of Health and supports a recent graduate establishing a practice in a community deemed as ‘in need’ in terms of numbers of physicians relative to the population. The position provides up to $100,000 to cover costs, such as student loans, and office expenses while starting their practice. It requires them to commit to staying in that community for at least three years.

Finally, the GHCS would like to thank Bea Meyer, Marianne Wunderli and Kathy Petersen who have provided accommodation for the visiting locums over the past few months and Camp Miriam for agreeing to provide accommodation for single physicians throughout the winter months ahead.

by Tracie Der, Vice-President, GHCS, Flying Shingle, October 20 2008

We are fortunate to have David Skinner working as a locum and sharing the on-call responsibilities with Dr. Bosman from October 1st to November 8th. David has worked extensively in communities in the Yukon and is enjoying his time here, savouring the warmer climate of Gabriola - he has also joined one of our choirs! And we’re really pleased that Dr. Renata Lewis enjoyed her time on Gabriola so much last time round (August/September) that she has decided to return as a locum from November 10th to 28th.

The GHCS board of directors recently held a planning session based on the input from the public session as well as community input throughout the past year. There will be four areas the board will be focusing on over the next year: the recruitment and retention of physicians, the development of a permanent clinic, establishing our community partnerships and communications system, and investigating services to support primary health care on Gabriola.

GHCS directors would be happy to come and speak to any group on the island who would like to know more about what we are doing and describe ways in which the community can become more involved. Please let us know if you’re interested - contact Fay Weller at 247-8120.

Submitted by GHCS, Gabriola Sounder, October 14 2008

A special thank you to Dr. Harding for the wonderful contribution he has made to the Gabriola community. On behalf of the Gabriola Health Care Society, the Directors wish him the very best in his retirement.

Great news! Starting November 1st, Kay Holt, a Gabriola resident and registered nurse, will be working on a half time basis out of the community clinic providing ongoing preventative support to patients. The key outcome of her work will be improved health outcomes for patients with chronic care diseases.

On September 19th, the Gabriola Health Care Society hosted a meeting on Primary Health Care. The meeting was attended by eight local community organizations, our Gabriola physicians, the Ministry of Health and the Vancouver Island Health Authority. A key message from the meeting was the need for community engagement in working towards a stable physician population. There are at least thirty similar communities in the province who are having difficulties attracting physicians. It is up to each community to make itself an attractive place to practice and an attractive place to live. The good news is that the last locum on Gabriola indicated she felt very welcomed into our community! The final minutes from this meeting can be viewed by visiting the GHCS website at www.ghcs.ca.

Gabriola Sounder, September 22 2008

The Gabriola Health Care Society is holding an Appreciation Dinner for the Doctors and Staff of all our island clinics. This is not a fundraiser - just fun!

It will be an open bar from 5:30, and a beautiful buffet dinner starting about 6:30, at the Surf Lodge on Tuesday, September 30th.

The MC will keep any speeches short and sweet, to leave room for dessert, and we’ll still have time to catch the sunset, as we hope to be gone by 8 pm.

Tickets can be reserved by letting me know, and they are only $25 per person. Don’t miss out, as we only have room for 70 healthy, happy patients that would like to give a cheer to the many people that help to keep you that way.

Please do mention this to anyone you know, or tell them to contact Nancy at 247-0041, nevamore@shaw.ca for more details.

Hope to see you there.

by Tracie Der, Vice-President, GHCS Flying Shingle, August 30, 2008

Dear Editor,

The Gabriola Health Care Society (GHCS) thanks you for the tremendous coverage you have provided of our activities in working towards stable, sustainable and, hopefully, enhanced health care on the island. Particularly, we appreciate your efforts in bringing us the questions that exist in the community and we hope you will continue to do so as we wish to ensure accurate information is being shared!

In that light, we would like to clarify a few points that were made in the August 15 issue of the Shingle.

Gabriola does not actually require three doctors to qualify for MOCAP - though that would be necessary to achieve full funding at our level of eligibility. Gabriola has qualified for and will be receiving 2/3 MOCAP starting October 1st and, should we be able to attract a third physician, our funding can be increased during an annual review process.

The GHCS has worked very hard to provide opportunities for physicians, other health care providers and community members to become involved. That is, in fact, how I personally joined the board: I read about the activities in the newspaper, contacted a person I knew to be working towards creating this society and offered my assistance! We have a variety of committees and would certainly have a role to interest just about anyone! And, while we have a number of (retired) physicians on our board at present, with Dr. Hoffman’s departure we do not happen to have a physician from either of the island medical clinics on the board. While our by-laws provide that those employed in any facility managed by the society have the right to appoint a representative to the Board, that provision was included with a view to the time when the Society might have a larger facility housing a variety of health care providers. This provision has not been used to date. There is no requirement for elected board members (there may be up to 11 of them) to be associated with the Gabriola Community Clinic at Twin Beaches and we would welcome the participation of any health care professional resident on Gabriola.

There have been four meetings with VIHA and Ministry of Health since the Memorandum of Understanding “negotiations” and planning processes began. Physicians from both clinics were invited to all meetings and at least one physician from each clinic was present at each of those meetings. The last meeting held was the public session and all health care practitioners, as well as all residents of Gabriola, were invited to attend and provide input.

The GHCS encourages everyone in the community to keep the healthy dialogue going. Offer your questions, feedback, suggestions via our website www.ghcs.ca., our blog www.gabriolahealth.ca or by sending an email to information@ghcs.ca; If the computer isn’t your thing, drop us a line by mail, Box 295 - V0R 1X0, at the post office. I also offer myself as a “point person” for contacting the society and I can be reached via the pharmacy. If I don’t know the answer to your question, I will do my best to connect you to someone who does! We will soon have more information available at the pharmacy, on a notice board in Folklife Village and a suggestion box for the shy!

Finally, we invite the community to welcome the locums arriving to help alleviate the workload over the next couple of months. Dr. Lewis will be the first, arriving August 24th. We thank her for coming and we hope she will enjoy her stay on the island!

Flying Shingle, August 30, 2008

Medical On-Call Availability Program (MOCAP) funding can proceed with less than three on-call doctors but full funding is contingent on a complement of three doctors.

Dr. Jim MacKenzie of the Gabriola Professional Centre (GPC) made that point to correct any misunderstandings after the Shingle carried a series of articles about the recent release of a report by the Gabriola Health Care Society (GHCS) about health care on Gabriola.

MacKenzie explained further that MOCAP is usually structured so that if only two on-call doctors are available only two thirds of the possible total funding will be paid, and similarly one third would be paid for one doctor.

MacKenzie also said that the Gabriola Professional Centre (GPC) is currently looking for a physician to replace Dr. G.H. Harding, who would like to retire. MacKenzie said they have no requirement that such a physician be willing to do on-call work. McKenzie said of their search that the rivalry for doctors is fierce, and the “carrots” being offered by other communities to attract physicians are difficult to compete against.

MacKenzie also mentioned that at a meeting requested by the GPC doctors with GHCS representatives, the GPC doctors asked to have copies of the GHCS report sent to them. MacKenzie said that no response on the report was requested of the GPC doctors, and thought it unlikely GHCS would have made any changes to the report based on such responses.

Flying Shingle, August 30, 2008

On-call doctors set for near future will be available at the Twin Beaches (Gabriola Medical Centre) clinic for at least the next two months.

In a recent phone interview with The Shingle, Faye Weller, president of the Gabriola Health Care Society (GHCS), said that a locum doctor will be available at the clinic for the next three weeks. The following two weeks will likely be covered by Dr. Francois Bosman, and another locum doctor is expected to cover the five weeks following that.

As reported earlier, the GHCS has been advertising for a physician to join Bosman in providing on-call emergency work on Gabriola. Bosman has been the only on-call doctor on the island since Dr. Daile Hoffman resigned with one day’s notice. Hoffman, who had been off on maternity leave, said she wanted to spend more time with her family.

The GHCS has been working through the Twin Beaches clinic to establish an Emergency Treatment Room (ETR), and on-call medical service on Gabriola Island. In a recently released report about community wishes regarding health care on Gabriola, the society outlined an expanded intention to work with both Gabriolan medical clinics, island health practitioners, and community members to determine the best possible health care system for Gabriola.

Of the on-call work, Weller said that Bosman had recently been persuaded to take some time off over a couple of weekends. She said that GHCS is supporting Bosman in arranging his time so that he is able to continue in his position in a way that is sustainable. “We need him to still be healthy and want to be here by the time we come through all this”, said Weller.

By Bruce Mason, Gabriola Sounder, August 25 2008

Good news - Gabriolans have made a quantum leap in healthcare, not just in moving from talk to action and entering into all-important partnerships with government, but also by establishing locums and arriving at a far-reaching new focus on community wellness generally, involving health practitioners and organizations.

The milestone is documented in the recently completed and readily available report: “Results of Public Engagement: Primary Heath Care on Gabriola Island, Framework for Action.”

Although more than 40 pages in length, it is an easy read and an essential one, as well.

The Sounder sat down with Fay Weller and Tracie Der (president and vice-president of the Gabriola Health Care Society, respectively) to examine the document and its implications.

Der said: “It is important to note that we got their attention and senior officials of VIHA and the ministry have signed on. We are now moving forward with them as partners in improving healthcare on Gabriola.”

“Input from the community has guided us in identifying the range of actions,” added Weller. “We have amazing groups such as GaLTT, PHC, the Commons and others involved with a focus now on community wellness.

“Establishment of a more collaborative coordinated approach with all agencies impacting health on Gabriola was suggested by many, including at the public session here in June,” she continued, “We don’t see the GHCS as the lead for this, but rather one organization of many providing better links and community wide support to foster the health and well-being of everyone.”

First we addressed the immediate concern of many residents - the departure of one of two doctors currently providing emergency on-call service.

Weller and Der reported that two locums had already been established, one later this month for three weeks and another for five weeks, beginning in October, which will provide welcome relief for Dr. Bosman.

For years, Island doctors have struggled with great difficulty to establish locums here, even prior to the existence of the GHCS and the interim clinic.

As well, recruitment efforts have now been stepped up while locums have an opportunity to work on Gabriola and perhaps make a decision to return and stay.

Gabriola is not unique, the “dearth of doctors” is a nation-wide dilemma. As many as 40 communities in the province alone have been identified as being in a healthcare crisis and it is as a result of the ongoing initiative to improve healthcare on the Island and the outstanding support from the community that Gabriolans continue to make progress.

In fact, there is widespread interest in how the Island continues to search for and develop exemplary solutions in the delivery of healthcare, which is deteriorating across the country. We are now widely considered to be a role model worthy of study.

By way of background: late last year there was a health crisis here. Remarkably the community had developed an interim clinic which includes an urgent care facility – but among the doctors practicing on the Island only two physicians were on-call and they were working excessive hours in performing emergency duties while not being compensated for their services.

This situation was unsustainable.

A primary Health Care community planning process began in May, based on a Memorandum of Understanding between the physicians from both island practices, GHCS, MoH and VIHA.

The ministry established criteria for a process to plan for the future of the delivery of healthcare on the Island, which included an open invitation to all residents, physicians and healthcare providers to meet with MoH and VIHA representatives.

The plan had to: provide sustainable working hours for physicians, be based on population, experience and other data, build on current investments and programs, while including indicators that are important to the community in order to measure progress.

A facilitated public workshop was held in the Community Hall on June 20th and an Internet blog was established to provide further opportunities for comment.

Throughout this ongoing process, health practitioners from each of the clinics have been given equal invitation to all meetings in which MoH and VIHA were present and the GHCS, as always, is committed to continuing this inclusive approach.

A focus for action has been developed, based on the following recommendations and categories: coordination of both preventative and primary healthcare services, improved communication, attraction and retention of physicians and integration of nurses and nurse practitioners.

The report draws together comments and sets out community goals and reasonable steps, as well as agreed priorities and responsibilities. These were published in the Sounder last week as “Next Steps.”

Der recalled: “When the society was created in 2006 the groundwork began and a launching pad was built. This has resulted in an action plan to address concerns and to help us move forward based on the needs which have been clearly identified in the community.”

Weller reported that the GHCS will continue to identify and assess needs on the Island and to integrate and coordinate efforts to meet these, with ongoing community support and input and through the essential partnerships which continue to be developed.

Obviously Gabriolans have accepted responsibility for their healthcare and established partnerships that many never thought possible. The Sounder will continue to report on progress being made in our community and encourages everyone to spend a few minutes with the report on-line or in the library.

The GHCS will appreciate any comments you have on the contents of the report, or Island healthcare generally. Please E-mail: information@ghcs.ca.

By Bruce Mason, Gabriola Sounder, August 18 2008

Island residents have recommended the coordination of primary and preventative healthcare, better communication, attracting and retaining physicians, as well as integrating nurses and nurse practitioners into primary healthcare and long term planning focused on integrated services.

The parties of the MOU have committed to taking first steps and many have already been initiated.

A three month follow-up report will inform the community of progress made within each of the areas of action.

Immediately, on August 1st, coordination and availability of primary healthcare: was integrated in a health network to provide regular services and sessions on Gabriola. The focus is on chronic care management. This is primarily the responsibility of VIHA and Gabriola physicians.

Initiatives will be developed with senior leadership in MoH and VIHA to work with the community to identify appropriate pilot programs that would respond to the primary health care challenges raised in the report.

A physician community attraction and retention group has been established with responsibility to market for physicians and accommodation requirements for locums. Everything will involve the community but the public has a large role to play in this area.

A range of communication actions will be initiated by end of this month and VIHA information will be posted on the GHCS website by mid September.

As well, communication and links between physicians on Gabriola and Nanaimo will be increased.

Also the most effective way to include nurse practitioners, registered nurses, home support nurses, etc., into the current primary health care system on Gabriola will be determined.

In September and October, data requirements of Gabriola for the purposes of effective healthcare planning will be provided by VIHA and the MoH.

Based on the results of public input the GHCS will initiate a planning process open to interested community members, based on relevant data and input from public sessions.

Physicians providing on-call service on Gabriola Island will be paid for their services.

In the area of research and planning: the most effective approach for the inclusion of a variety of health practitioners, including nurse practitioners and registered nurses.

As well, research into a variety of options for the community will include a co-operative model, salaried approach and a review of other jurisdictions.

In addition, plans for a permanent, community owned location for the Emergency Treatment Room and supporting services will continue, with money being raised through community fundraising, foundations and philanthropic organizations by the GHCS and Gabriola Health Care Foundation (GHCF).

By the end of October the three month report on progress will be made to the community. Many of the actions outlined above are first steps and involve discussions with relevant parties to determine the best short and long term courses of action. The next report will also identify those further steps and responsibilities.

Flying Shingle, August 15, 2008

One of the ways the Gabriola Health Care Society (GHCS) plans to rise above its alliance with the Gabriola Medical Clinic (GMC) is to set up a meeting to discuss the employment of nurse practitioners and RNs.

So said President of GHCS, Fay Weller in response to questions posed by the Shingle about how GHCS can both be, and be seen to be, inclusive of both Gabriola clinics.

Participants at the meeting will include the Ministry of Health (MOH) and Vancouver Island Health Authority (VIHA) and “some of the nurses and all of the physicians on the island”, said Weller.

The Shingle contacted Weller regarding a recently released GHCS report on the June 20 community consultation on health. The report proposes a plan for an integrated health care system on Gabriola (for more on the report itself see inside page two).

Weller told the Shingle that the Gabriola Professional Centre (GPC) health care professionals, “have indicated their interest in nurses and nurse practitioners having a more active role in primary health care on Gabriola Island”. She said GPC health care professionals had been invited to comment on the GHCS report before its release but that they had not responded.

Proposal for a nurse practitioner

When contacted about the above, Verna Gregson, Manager of the GPC said that on June 24 the Centre had submitted a proposal for a nurse practitioner to VIHA, who then forwarded it to the GHCS.

Gregson commented: “A Nurse Practitioner is a salaried position, paid by VIHA. If a Nurse Practitioner was located in (GPC), there would be no financial gain from this. VIHA pays minimal overhead expenses for the space used, but there is no profit for the landlord and, in fact, there would probably be a loss.”

“We all believe the addition of a Nurse Practitioner is in the best interests of access to primary health care and stability of primary health care in the Gabriola community. Access and stability are the two most important elements of health care on our island.”

Gregson confirmed that the GHCS report had been sent to the doctors at the GPC. She said however that, “other the physicians, none of the health care providers in (GPC) have been contacted to be included in health care discussions”, with MoH and VIHA.

Plan depends on partnership

In an August 11 phone call to Victoria Power-Pollitt, a VIHA Director confirmed that the GPC nurse practitioner application had been shared with GHCS. When asked if this meant that now GHCS was making the decisions about health care on the island, Power-Pollitt said this was not so. She said that since the signing of a memorandum of understanding (MOU) between the GPC and GMC doctors, the MOH, VIHA and GHCS, anything done regarding primary health care on the island will have to be done in partnership with all of the signatories. She stressed that success will depend on, and be measured by, how inclusive the work is.

Power-Pollitt went on to say that it is also important to create a plan in line with the wishes expressed by the community. Commenting that the GHCS report has tried to capture all of the voices present at the June 20 meeting, she said: “We want to work with all of the signatories of the MOU”, and need everyone’s input. She recognised that not all islanders’ opinions were present at the meeting and hoped that people would continue to utilize the blog created for gathering more feedback at: www.gabriolahealth.ca

Kelly McQuillen of the MOH said that capturing public dialogue is a complex task and that one day’s conversation can’t cover everything, but that the report was a good first step in that direction.

McQuillen said that broad participation from diverse interests in the community is necessary for the plan to succeed. She said that the MOU mentioned above was a commitment on the part of all the signatories to work together and that the evolution of good governance includes learning how to plan together and set priorities. In pursuing this she, “wouldn’t see us excluding anybody”.

McQillen said that the plan is an, “ongoing process with no set script”. In order for that to work she said that there will need to be a great deal of transparency on the part of GHCS as they facilitate the process. She also acknowledged that public engagement needs strong leadership from the bottom up and pointed out that “GHCS took the risk to come to the ministry and say, we believe this is an issue”.

McQuillen added: “As we go through this process there need not be an expectation that one solution fits all. We need to find solutions that work for all primary health care doctors.” She said: “The solutions to the issue of health care on Gabriola are in the community”. The community context is what determines whether the plan is sustainable, and “the risk is to move forward with too narrow a view”, she said

Flying Shingle, August 15, 2008

Without on-call physicians the whole emergency response aspect of the Gabriola Health Care Society (GHCS) could collapse, according to GHCS president Fay Weller.

Weller made that comment in a response to a number of questions posed by the Flying Shingle about a final report regarding a community consultation on health recently released by GHCS.

Weller said that the mandate of GHCS has expanded to address the ‘crisis’ caused by an increasing dearth of doctors on the island. As reported previously in the Shingle, Dr. Hoffman, who was one of two on-call Gabriolan physicians, recently resigned. Meanwhile, a search for a third physician to work on-call and to replace Dr. G.H. Harding of the Gabriola Professional Centre (GPC) (who would like to retire) was and is ongoing.

Weller said GHCS is, “working with the Ministry of Health (MoH) and the Vancouver Island Health Authority (VIHA) to try to alleviate the physician workload via pilot projects - for example, one using registered nurse(s)”.

The attraction and retention of physicians and the use of nurse practitioners were among a number of issues highlighted in the final GHCS report.

Reached for comment on the report, Dr. Jim MacKenzie of the Gabriola Professional Centre (GPC) said that the lynchpin in any primary health care plan for Gabriola should be the recruiting and retaining of physicians.

MacKenzie questioned past emphasis both on building a clinic and on on-call work in terms of finding doctors for Gabriola. He said that younger doctors are the ones most likely to enjoy emergency work. He thought it will be hard to attract younger doctors to Gabriola. He said that Dr. Bosman of the Gabriola Medical Clinic (Twin Beaches), “is an extraordinary doctor in terms of his commitment to the on-call work, as was Dr. Hoffman”.

MacKenzie also pointed out that the Medical On-call Availability Program (MOCAP) requires a minimum of three on-call doctors to proceed with full funding.

MacKenzie said that a triage system could be developed that would deal with medical emergencies and would cut down on the necessity of trips to Nanaimo hospital.

Flying Shingle, August 15, 2008

Two options for where to locate the delivery of health services are discussed in a final report regarding a community consultation on health recently released by the Gabriola Health Care Society (GHCS).

The 22 page report (RESULTS OF PUBLIC ENGAGEMENT PLANNING FOR PRIMARY HEALTH CARE ON GABRIOLA ISLAND: Primary Health Care on Gabriola Island, Framework for Action) is accompanied by 60 pages of appendices. It discusses the process and outcome of a community consultation on health which took place on Gabriola on June 20.

The GHCS plan proposes the following options under which integrated primary health care services could be established:

a) centralized location for all services,

b) centralized location for emergency response plus some services – other services dispersed throughout island with integrated communication.”, and that: “All health care providers and practitioners – traditional and non-traditional” be coordinated.

As reported in previous editions of the Shingle, the consultation was organised by GHCS, with the help of the Ministry of Health (MOH) and the Vancouver Island Health Authority (VIHA) to assess the wishes of Gabriolans regarding health care. The meeting was made a requirement by VIHA, who 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.

Other action plans outlined in the report include: establishing a coalition/council of community organisations with a funded coordinator, chronic health management education, integration of Home Care into the primary health care system, data collection, a communication plan, and establishing more on-island services such as home support, mental health & addictions etc.

Gabriola Sounder, August 11, 2008

This document is nowavailable to the public and is the result of community participation in the two year initiative to improve health care here on Gabriola. Visit the library or go to the GHCS website ghcs.ca. We will have more in next weeks Sounder

Flying Shingle, July 31, 2008

The Gabriola Health Care Society (GHCS) has “reluctantly accepted a decision made by Dr. Daile Hoffmann not to return to practice at the Gabriola Medical Clinic on the completion of her maternity leave this fall”.

In a recent news release, GHCS pointed out that Dr. Hoffmann had worked to establish an emergency treatment facility and an integrated multidisciplinary health care clinic.

The health society cited the demands of lobbying for Gabriola health care, providing on-call services on top of an already heavy workload, and the needs of a young family as reasons for Dr Hoffman’s decision.

The society is calling on islanders to let them know if they are aware of any doctors who would be wiling to work on Gabriola, as well as possible accommodations for visiting locums.

Society members say they are still working on the final report of the June 20 community consultation, and that: “Discussions are underway with VIHA to have an integrated team, including a registered nurse, social worker, and other health practitioners to provide ongoing and regularly scheduled support to Gabriola”.

Those who would like more information or who have suggestions are invited to contact the GHCS. Website address is: www.ghcs.ca ; email: information@ghcs.ca snail mail: PO Box 295, V0R 1X0.

By Bruce Mason,Gabriola Sounder, July 21, 2008

The Gabriola Health Care Society has reluctantly accepted a decision made by Dr. Daile Hoffmann not to return to her practice at the Gabriola Medical Clinic on the completion of her maternity leave this fall.

Dr. Hoffmann has been involved with the GHCS since its inception in the fall of 2006, having taken on the cause initiated by Dr. Madeline McPherson to try to establish an emergency treatment facility and fully integrated health care clinic.

She helped to establish the interim clinic and actively participated in the efforts of the GHCS to improve the provision of health care to Gabriolans and ensure that Gabriola is treated more equitably by the Ministry of Health and the Vancouver Island Health Authority.

Unfortunately, the demands of lobbying for Gabriola health care and providing, what is essentially volunteer on-call services on top of an already heavy workload have taken their toll on Dr. Hoffmann and her young family.

The GHCS understands her need to care for them first and thanks her for all her efforts on our behalf over the past two years with the GHCS and, even longer, as a community physician.

However, Dr. Hoffmann’s departure places further stress on Gabriola’s remaining doctors and the GHCS recognizes that it will have to take an even more active role in recruiting physicians.

To that end, now is the time to let the GHCS know of any physicians who may be interested in relocating to the Island or providing locum coverage to reduce the burden on our remaining physicians.

There is also a need to provide accommodation for visiting locums and anyone who knows of anything appropriate and available is also asked to contact the GHCS. Conversations are already underway with several physicians who have expressed an interest in practising medicine here on the Island.

IN related news, the GHCS was invited to participate in the “Patients as Partners Forum” in Vancouver, on July 14th, contributing information on the Gabriola experience. The conference also provided a networking opportunity - an opportunity to hear what other communities are doing and to make contacts with those who may be helpful as Gabriola moves forward with its own planning to improve Island healthcare.

The GHCS has also been busy collating all the data collected at the community workshop held on the Island on June 20th in preparation for producing a final report.

One theme that emerged from the workshop was the desire for integrated health services on Gabriola. Discussions are underway with VIHA to have an integrated team - including a registered nurse, social worker, and other health practitioners - to provide ongoing and regularly scheduled support to Gabriola. Details are still being worked out.

The GHCS encourages the community to stay involved. Visit the GHCS website at www.ghcs.ca for more information or contact your healthcare society through information@ghcs.ca, or PO Box 295, Gabriola, V0R 1X0.

Your suggestions and assistance are always welcome!

Submitted by Tracie Der, Flying Shingle, July 16, 2008

The Gabriola Health Care Society (GHCS) is pleased to announce that Gabriola is now eligible for MOCAP - the Medical On-Call Availability Program - something our local on-call physicians and the GHCS have been striving to acquire for more than a year now.

The provision of on-call pay to on-call physicians who are struggling to provide an adequate level of emergency care, means the difference between making a living or, essentially, providing volunteer services.

Funding for MOCAP is provided by the provincial government while the management of the budget is the responsibility of the individual Health Authorities around the province - Gabriola Island falls under the Vancouver Island Health Authority (VIHA).

A moratorium was placed on MOCAP while the GHCS was working on fulfilling the criteria for obtaining it. The government became aware at that time that there were some inequities in the system for determining eligibility. As a result the moratorium was put into place while the process was reviewed. It was announced on July 1 that Gabriola will be one of the communities eligible for MOCAP when the new contract begins on October 1!

While the level of funding provided for Gabriola is not at the top level, the new system is still far more equitable than the previous arrangements. The budget for Gabriola Island is the same as that for Pender Island and is close to those of Ladysmith and Chemainus. The option exists, with a regular review process, for our budget to increase if another physician joins the on-call group. This will improve Gabriola's ability to attract another physician to share the on-call work load and improve the lifestyles of our dedicated doctors.

MOCAP was created in 2001 to address the needs of on-call physicians. These physicians make themselves available, on a rotating basis, to attend medical emergencies all day, every day of the year. Paramedics must be able to reach an on-call physician within 15 minutes and that physician must be able assist any patient requiring their emergency care - their own patients, other patients and "unassigned" patients (those without a regular doctor). MOCAP compensates them for the time they are available outside of office hours as well as billed time they miss with their regular patients when attending to emergencies during office hours.

By Bruce Mason,Gabriola Sounder, July 7, 2008

At press time, our Health Care Society was very pleased to announce that Gabriola is now eligible for MOCAP - the Medical On-Call/Availability Program - something our local on-call physicians and the GHCS have been striving to acquire for more than one year.

The GHCS recognized the need to qualify for MOCAP early on, an essential component that has been reported on many times as information became available and complex and sensitive negotiations took place.

Fay Weller, president and Tracie Der vice-president, said: “In order to be able to provide an adequate level of medical services for the Island, particularly for emergencies, the provision of on-call pay to our on-call physicians means the difference between making a living or, essentially, providing volunteer services.”

The funding for MOCAP is provided by the provincial government, however the management of the budgets is the responsibility of the individual Health Authorities around the province - Gabriola Island falls under the jurisdiction of the Vancouver Island Health Authority (VIHA).

The GHCS reports that while the society was in the process of ensuring that we could meet the criteria for obtaining

MOCAP, it became obvious to the government that there were some inequities in the system for determining eligibility and a moratorium was placed on the program while the process was reviewed.

After several delays, it was finally announced on July 1st, that Gabriola would now be one of the communities eligible for MOCAP when the new contract begins on October 1st of this year

“While the level of funding provided for Gabriola is not at the top level, it is important to note that the new system is far more equitable than the previous arrangements,” Weller and Der noted.

They added that the budget for Gabriola Island is the same as for Pender Island and is close to those of Ladysmith and Chemainus.

The GHCS also reported that the option exists - with a regular review process - for our budget to increase if another physician joins the on-call group.

This will improve Gabriola’s ability to attract another physician to share the on-call work load and improve the lifestyles of our dedicated doctors.

MOCAP was created in 2001 to address the needs of on-call physicians. These physicians make themselves available, on a rotating basis, to attend medical emergencies 24 hours a day, seven days a week, 52 weeks a year.

Paramedics must be able to reach an on-call physician within 15 minutes and that physician must be able assist any patient requiring their emergency care - their own patients, other patients and “unassigned” patients (those without a regular doctor).

MOCAP compensates these doctors for their time available outside of office hours as well as time they miss with their regular patients when attending to emergencies during office hours, when they would be unable to bill for the patients they would have normally been seeing.

The Sounder congratulates everyone involved in getting us this far, including our doctors, especially Drs Hoffman and Bosman, the GHCS board who have volunteered to work tirelessly and selflessly through difficult times, Weller, Der, Lawrence Spero and Fred Geater who now head the foundation that will build a permanent facility, and Harvey Graham, who continues to play such a vital role.

There are organizations such as the Lions Club to thank and please feel free to do that; along with the folks who have been there from the start and joined in the process, to Al and Louie Strano, Pat Smith, and other groups and individuals who have made history and improved healthcare on this Island for everyone.

To all those in this community who kept the faith and continue to do so: well done. You know who you are, give yourself a pat on the back.

It has been our great pleasure to report on your efforts. The Sounder has been accused of not presenting all the facts by people who haven’t read our reports, who have looked for hidden agendas and said it would never happen. We are guilty of promoting the ongoing initiatives. And we would like to thank them, as well.

As we said at the outset - and keep in mind we have some distance to go - “Let’s build this clinic, let’s improve healthcare on Gabriola.