Frustration mounting with access to health services

The chief of staff at the Golden Hospital is among those in the local medical community who has had enough.

When he submitted his letter to The Golden Star (Apr. 8 issue), Jean-Gaston DesCoteaux, chief of staff at the Golden and District Hospital, admits he had reached his breaking point.

The letter, which details the gaps in Goldenites’ access to healthcare services created a whirlwind of discussion online, and DesCoteaux believes that awareness can only help going forward.

“Make your voice heard. I was hoping, and I think it worked, to encourage people not to just sit back and take it because we are trying to fight for them,” he said.

Much of DesCoteaux’s concerns have arisen because of inter-provincial barriers. World-class healthcare facilities are just three hours away in Calgary, but many locals are being sent to Kelowna and even as far as Vancouver for treatment that they could be getting much closer to home.

“With regionalization…services were pulled away from here and the valley towards Kelowna. We compensated by shifting…or expanding our referral patterns towards Calgary because it made more sense. For a while Calgary was able to handle that but I guess they’re hitting capacity issues also so more and more often they’re saying no,” DesCoteaux explained.

Those sorts of hurdles have become such significant barriers that DesCoteaux has even seen some Golden patients decline to make the trip, essentially refusing treatment because of travel expenses and overall inconvenience.

DesCoteaux isn’t alone among the medical community in this fight, as longtime local physician Dr. Trina Larson-Soles has also stepped up and voiced her opinion on this issue.

“Could we do better? Well, first someone would have to decide that rural people really do deserve the same level of care and actively work to overcome these barriers.  Better yet, let us provide more services in our rural community whenever practical to alleviate the need for travel in the first place,” Larson-Soles wrote in an e-mail.

B.C. has billing agreements in place with every province in Canada, and according to the Ministry of Health, improvements to the relationship between B.C. and Alberta are being worked on.

“B.C. is working to put in place an agreement with Alberta to streamline processes and eliminate the need for B.C. patients to apply and get confirmation of MSP funding before booking a scan or treatment. However, it is important to note that it is up to the receiving hospital or physician to accept a patient and the medical system in Alberta is also likely facing high demand,” the Ministry said through a spokesperson.

For now, there is a Travel Assistance Program in place between the Ministry and a number of private transportation carriers, which ranges from 30 to 100 per cent off regular fares for those who must travel for non-emergency, physician-referred specialist care.

However, both DesCoteaux and Larson-Soles believe that the program remains problematic.

“I checked with colleagues and the travel assistance is rarely used. I’ve never heard of anybody using it. The only public transport out of Golden is Greyhound. Plus, there’s no social service staff to speak of to assist people through the maze of bureaucracy,” DesCoteaux said. “Even if transport is partially paid to go to Vancouver, it doesn’t change the fact that you have to take the bus to get there.”

“They do not reimburse the patient for private travel, which is often more economical.  Nor do they cover accommodation or meals. Twelve plus hours on the bus is hard for a healthy person,” Larson-Soles said.

DesCoteaux stressed in both his original letter and in interviews for this story that he understands that Golden can’t have expensive offerings such as PET scans and MRI machines, and that those and other specialized equipment and treatments are always going to be centralized in major centres. But that doesn’t mean that Goldenites should be left out in the cold.

“There’s patients that just decide that they’re not going to go for treatment. I used to work in Calgary and most of your work is around diagnosing patients, deciding what to do with them…here most of your work is figuring out how you are going to get them the tests that they need and how you are going to get them treatment.”

In the end, it’s not just patients that are affected. Part of working in the field of medicine is delivering bad news, but when the bad news comes with even more bad news, it leads to frustration for both patients and doctors alike.

“We’re all frustrated, there’s no question…(I want) the public to know that we are on their side and we equally as frustrated as they are with the lack of services and we want nothing more than to be able to offer more to the patients here,” said DesCoteaux.