Ralph has worked to attract BC physicians back to family practice; intervened successfully against proposals to downgrade lab services at Lions Gate Hospital; and lobbied for improved drug and alcohol treatment on the North Shore.
Health Care Note from Ralph:
Health spending concerns all of us, and is growing fast. Health spending has gone up by more than a half under the Liberals’ plan. The health care budget was $8.5 billion in 2000, and will be $13.3 billion in 2007/08. It is the biggest growth sector in government. Don’t listen to the baloney about cuts.
There are more surgeries than ever before. For example, between 2000/01 and 2003/04:
• Angioplasties, a heart procedure, increased 40 per cent.
• Knee replacements increased more than 33 per cent;
• Hip replacements grew 21 per cent;
• Cataract surgeries grew 20 per cent; and
• Coronary bypasses increased 10 per cent.
Life-saving surgeries are never waitlisted. There are no wait lists for cancer care.
As for non-emergency surgeries and diagnostic procedures, according to Statscan, wait times for non-emergency surgeries in BC dropped from five weeks on average in 2001 to 4.3 weeks in 2003; and average waits for diagnostic services dropped from three to two weeks over the same period. That’s now the shortest wait in the country.
Affordability has been enhanced: MSP premiums reduced or eliminated for 290,000 low-income seniors and families. While Pharmacare costs doubled in ten years, Fair Pharmacare rates were decreased for 280,000 persons, and frozen or decreased for 82% of clients. BC has second most generous Pharmacare program in the country. Contrast this to our cousins to the south, where medical bills account for half of personal bankruptcies.
New medical schools in B.C. are almost doubling the number of physicians in training. And there is a growing supply of much-needed nurses: 600 more employed than in 2001, compared with cuts in nurse employment under the NDP! We have expanded nursing spaces in colleges and universities by over 2,500 in four years. The contrast in the track record of these two governments is striking!
I am strongly supportive of Lions Gate Hospital’s proposed $300 million capital program designed to increase emergency room capacity, and aiming to improve primary care facilities for general practitioners (family docs) on the North Shore.
I have also become deeply involved in working to reform compensation arrangements in primary health care. We cannot allow the system of family doctors upon which our structure of medical services depends, to erode.
There are huge challenges, no doubt about that, but our health care track record is commendable. In contrast, the NDP closed hospitals and managed poorly. They had no long-term plan for dealing with technological change, the aging population, or finances.
We should measure health care by its results: our citizens are the healthiest of all Canadians. Good lifestyle, excellent medical care -- something we can all be proud of!
Note from Ralph on Nurse Practitioners
Having been married to an RN for 43 years (one who earned a string of nursing degrees, managed quality assurance at Montreal General, taught surgical nursing at Massachusetts General, and owned and operated a rehab clinic) I always felt that I’ve had some degree of nursing absorption into my brain.
Therefore, it was with more than average interest that I noticed amidst the profusion of government dicta, appointments, and press releases on my computer one morning, that:
“The government is launching consultations to seek public input on proposed changes to regulations governing nurses in British Columbia. Draft regulations have been released that would include:
Replacing the Registered Nurses Association of British Columbia (RNABC) with a College of Registered Nurses.
Establishing the scope of practice for nursing, including the reserved actions that may be performed by registered nurses (RN’s) and “nurse practitioners”
Regulation of “nurse practitioners” by the new college.”
The “college” structure is the preferred self-management route for professionals in British Columbia today, whether we are talking about physicians and surgeons, engineers, biologists, or school teachers.
What’s a “Nurse Practitioner”?
Turning to the RNABC web site, I learned that they define “nurse practitioners” as:
Registered nurses who have achieved the competencies required for additional registration as a nurse practitioner with the regulatory body for registered nurses.
The competencies required of “nurse practitioners” are usually achieved through graduate nursing education and substantial registered nursing practice experience.
“Nurse practitioners” will provide health care services from a holistic nursing perspective, combined with a focus on the diagnosis and treatment of acute and chronic illnesses, including prescribing medications.
All of which was accompanied by the headline:
“Coming Soon: B.C.'s newest provider on the health care team”
We also learn that:
RNABC and the Ministry of Health Services are working together with other partners to educate, regulate and
deploy “nurse practitioners” in B.C.'s health care system in 2005. In collaboration with government, guiding
principles were developed following consultation with health care providers.
The goal of introducing “nurse practitioners” in British Columbia is to improve client health outcomes by increasing
accessibility to health care services and filling gaps that presently exist in health care delivery. The government is
responsible for developing legislation and funding education programs as well as employment and compensation
The RNABC Board of Directors has approved nurse practitioner education programs at the University of Victoria
and the University of British Columbia. These two-year programs educate nurse practitioner students at a master's
degree level, with the first students scheduled to graduate in 2005. The government has announced funding for the
establishment of a third program at the University of Northern British Columbia.
The new College of Registered Nurses of B.C. (CRNBC) will regulate registered nurses as well as “nurse
practitioners” in keeping with its regulatory responsibility for the profession of registered nursing in B.C. The
College of Registered Nurses of B.C. will regulate “nurse practitioners” , within government legislation, through
registration, quality assurance, investigation and discipline, standards of practice and codes of professional ethics.
What does it all mean?
My impression is that nurses (and the Ministry) have seen the “gap” in health professional services created by the flight of family physicians from the field – as noted in my note elsewhere in this newsletter. Nurses are happy to oblige by moving “up market”.
Nurses and physicians have, in my personal observation, worked with mutual respect as members of the health care team. The traditional team approach is under pressure, as physicians have increasingly chosen to specialize their practice of medicine. Who, then, will be the front-line family health care adviser?
In the absence of primary care reform, particularly in the compensation of family physicians, and with continued erosion in access to primary care physicians, it strikes me that we shall increasing numbers of nurse practitioners hanging out their shingles as RNP’s (registered nurse practitioners).
RNPs are RNs with a masters degree in patient care i.e. three extra years of training in the USA or a couple of years of extra training in Canada.
We have looked into the future, and see a lot more RNPs filling the family practice void. Nurses, good on ‘ya.
But should we give up on physicians in general practice? This would be a collosal mistake. For the bigger picture, I am writing a story with the provisional title “Can’t Find a Family Doc? -- Welcome to the Club.”