Wednesday, November 10, 2021

Heath Care overview for Council provides look at current challenges, hopes for improving situation into 2022

Health Professionals from Terrace and Prince Rupert delivered an 
extensive look at that state of health care in Prince Rupert on Monday 


Monday night brought a much anticipated review of the current health care situation in the Prince Rupert area, as City Council Members received an extensive overview of the current challenges for Health Care in the region, as well as a pretty optimistic forecast for the year ahead in recruitment and retainment of physicians and health professionals for the city and Prince Rupert Regional Hospital.

The near two hour presentation which covered much territory included the participation of Julia Pemberton the Health Services Administrator in the Prince Rupert area, Dr. Jaco Fourie from Terrace who is the Medical Director of the Northwest, Ciro Panessa Chief Operating Officer in the Northwest, and Dr. Guillame Coetzee Chief of Staff in Prince Rupert who provided for the fullest overview of the local situation.

The review included a look at some of the current staffing situations related to burn out and fatigue with local staff, as well as a few staff members related to the recent Public Health Order on vaccination status. 

The group also observed how retirements and relocations have provided for challenges across the region.

The early portion of the session provided a look at the scope of the departing physicians in the community many of them familiar names for many in the community, the medical professionals taking leave of the region  after long service in the community





How the recruitment process is moving forward was also a key focus for the presenters; advising how new arrivals have come to town, or are on the way currently, the situation set to improve locally towards the middle portion of 2022.



How that recruitment process works was a significant part of the overview, both in the challenges being faced owing to COVID and the special skill sets that they are locating to the community, with Ms. Pemberton making note of some of the usefulness found in the Make Prince Rupert Home campaign of recent months, as well as the engagement of some of the Council members in helping with the recruitment process.

Northern Health has also taken steps towards temporary housing for new arriving staff to allow them the time to explore housing options that suit their needs, the overview included how local Health authority office has built some team leadership created over the last eighteen months, as well as to outline some of the projects that they have in place locally to deal with the significant shortfalls of medical professionals here.

A good portion of the near two hour presentation explored the approach that Northern Health is taking towards health care in the Northwest, with a comprehensive plan and Capital investments to ensure that services and capacity building is available in the many communities of the Northwest.



Among the measures they continue to work on creating Educator positions, adding to in house training operations, offering more HR support positions and creation of daycare partnerships for health care workers on shift work. 

A look at some of the improvements at the Prince Rupert hospital made for the review, with most of the main floor reworking to be completed by the end of 2022, with new laboratory and other services in place.

"As some of you may know, we experienced a pretty significant fire in May 2021 ... while the fire itself was small the damage was significant. So the outcome of that is we actually are seeing a brand new lab with all equipment, floors, walls, you know like basically a brand new lab put in. 

As well as we've done one out of two ultrasound suites that have been replaced in the hospital. So it's about a 7 million dollar project right now, with  the second ultra sound suite under construction. 

So we will see the main floor basically from rehab up, really redone in 2022, which is going to make a big difference in terms of how our patients experience care, flow through our hospital, wayfind and how our staff and  our physicians are able to provide care for them" -- Julia Pemberton, 

Building capacity in the Prince Rupert Operating room is also a focus for the Northern Health team as they outlined some of the specialist areas that they are hoping to bring to the three Operating rooms in the community.



Creating a layer of redundancy, depth and addition to the available services was a key element of the overview, including the regional scope of how they will be approaching the provision of surgical services across the Northwest.

"We also are looking at increasingly Ciro and I, our chiefs of staff, Julia, Angela to a change in the way that we deliver services. And you probably noticed that with some of the surgeons from Terrace are now starting to do locus in Prince Rupert ... and that's going to be a regular occurrence as well supporting the physicians in Prince Rupert ... but we also would like to see, for instance Doctor Butler doing some visits to Terrace to come teach some of our surgeons here ...  So you're looking at the richer environment of bi directional travel utilizing our operating room capacity throughout the region, but also starting to attract and seek physicians with additional skill sets that we don't have' -- Dr. Jaco Fourie, Medical Director of the Northwest

The Terrace contingent addressed some of the concerns over the build of the new Mills Memorial Hospital, noting of what it will offer in the way of critical care and mental health and psychiatric themes, while looking to reassure Prince Rupert officials that overall health care in the city won't be impacted.



"When we think about the new hospital build, it by design doesn't have any significant increase in its OR capacity. That really has always been by design, knowing that in order to meet the surgical needs of the Northwest and to continue to,  hopefully continue to  repatriate as much surgical and specialist care in the Northwest, you know don't need to build a significant number of new OR's in a facility like the new Mills Memorial Hospital. 

You can effectively, like we are trying to do, use all the OR's and have thriving surgical programs in every facility hospital across the Northwest and really what the Mills Hospital is going to primarily enable us to do, is have that - and we've all seen the need for this -  hire critical care capacity, that intensive critical care capacity and more capability to care for people with serious mental illness and that's where we're seeing the greatest increase in sort of the bed count or service increase with a hospital like Mills Memorial" -- Ciro Panessa, Chief Operating Officer Northwest

Accessing Health Care across the region made for an overview of the Northern Health Connections Bus service and the vital role it plays in providing a health care resource in the region.



"As a physician providing care to patients in this town, I am very very in touch with how patients are having to travel,  having to try and find their services elsewhere when it's not available locally.  And as a group I think it's become a big priority for us to try to give as much as possible services here in Prince Rupert and in the region.  And supported locally from the region itself, so we become almost a self sufficient  region with quality care and that's really our focus"  -- Prince Rupert Dr. Guillame Coetzee

One of the key areas of note prior to the presentation was to introduce a Local Health Committee to reflect local concerns, but instead of creating a new program, Ms. Pemberton recommended returning to the Healthy Communities Integration Committee which stopped a few years ago, something which City Council would subsequently note as a good option moving forward for the community.



The Councillors followed up with a range of questions, as well as compliments for the thorough overview of the evening.

Councillor Nicky Adey made note of the presentation and the work that continues at the hospital and with Northern Health.

"I would like to thank you specifically for the presentation and for the articulate way in which you covered a lot of the questions which we had provided for you. I think it paints a portrait of a much more nuanced work in progress, than perhaps the public discussion credits it with"

Among a key area of focus for the Councillor was the work on mental health and the needs that still exist, which offered the opportunity for a wider overview of the approach Northern Health has towards that area of health care in the region.

Councillor Cunningham noted of the challenges for those in Northern Health, then spoke to two areas of note from the presentation for him. That of orthopaedic services and the concept of responding to population demand and how Northern health decides that factor, noting for the prospect of quick growth in Prince Rupert owing to port development.

"The presentation tonight I think has alleviated a lot of problems, questions that we have been receiving from the public and that. And you know there's some misconceptions of Northern Health and what's going on and things like this. 

And the fear of when you turn left coming over the overpass in Terrace and seeing  that big hole and "my god how big is this hospital going to be and what are we going to lose" and I think you've answered a lot of questions that a lot of people have asked us individually as Councillors or the mayor and I'm just looking ten, fifteen years down the road"

A discussion over the volume of General Practitioners practicing in the region led to a correction on perceptions, with Doctor Fourie  noting that there is currently a significant shortage of GP's in the Terrace area, a situation which is quite difficult than what Prince Rupert faces.

There was also an update on the COPD clinic to be named after former Councillor Nelson Kinney was outlined, with discussions with family continuing at the moment.

Councillor Niesh had a question related to the impact on Operations in Prince Rupert of the Public Health Order on vaccinations. Towards that discussion it was noted by Doctor Coetzee that there has been no loss of physicians as a result of the mandate; with Ms. Pemberton advising that local totals towards other health care workers providing for a minimum impact, advising that it's at under a dozen.

Councillor Mirau followed up with themes on the approach towards forming the health committee planning, as well as to explore the area of designing a master plan for Hospital operations in Prince Rupert and advancing the timeline of that project considering the expansion of industrial growth planned for the community.

Councillor Randhawa's focus was on advice from the Northern Health officials on the ongoing work towards taking on the challenges of COVID, something which offered an opportunity to speak to the themes of vaccination and community support in Prince Rupert as we continue to deal with a fourth wave of the coronavirus.

Mayor Brain brought the presentation to an end, noting of his efforts to lend a hand in recruitment of physicians in the community, while noting that while the theme of Health Care is not a role specific to a City Council, while also putting in motion the City's involvement for the rejuvenated Community health consultation initiative.

"Normally we don't let presentations go this long, but we do know that this is a topic of interest for the community so I think it was important to flush out all the details, the presentation clearly shows how much work has been put into the Prince Rupert hospital.  

I've personally been involved  with the recruitment and retention I've been touring with many doctors, with Doctor Kloppers. We tour them around town in a vehicle, we take them for lunch, and we all work together to try to recruit  ... 

I see it on the ground, I think it was important for the narrative around Northern Health and Prince Rupert in particular to start to shift. Because you know we have regular conversation Julia and Ciro, but the community I would say needs an update, or like a software update, in terms of how it perceives what is happening at the hospital.  

Because I think were still kind of thinking this is 2010 in some ways, when really there's been a lot of progress made and clearly a lot more that needs to be done"

The Full presentation can be reviewed from the City's Video Archive from the opening moments through to close to the full two hours of Monday's council session, the bulk of the information above came as part of the first hour of the review.




For more notes on Monday's Council Session see our Council Timeline feature here.

A wider overview of Northern Health themes can be explored from our archive page here.

Cross posted from the North Coast Review.

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