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About the SOS Committee - Salient Points
In 2004 a new "state of the art" operating room was completed at Lady Minto Hospital (LMH) together with an excellent Central Supply Room to provide sterilisation of instruments as required by the new standards. This project was funded by the Capital regional District (CRD) , the Vancouver Island Health Authority (VIHA) and, at the request of the VIHA, $780,000 from the Lady Minto Hospital Foundation (LMHF).
Dr. Preshaw, the then resident surgeon, was informed in 2007 that, on the recommendation of Dr. Shane Barclay, his privileges at LMH would not be extended beyond December 2007. He had the right to appeal this decision and did so.
As a result the Vancouver Island Health Authority accorded an extension of his privileges to June 30 2008.
All the above is from correspondence between Phyllis and Dr. Preshaw, not marked confidential. However the Driftwood (DW) in an article published on July 02, 2008 does refer to Dr. Preshaw stating that " my privileges have been terminated as of June 30th against my wishes".
It is worth noting that had his privileges been cancelled for a serious question of incompetence it would be totally inappropriate to permit any extension!
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In April 2008 an LMH Operating Room (OR) Review was carried out at the request of the VIHA. Members of the review committee were Dr. Shane Barclay, Chief of Staff, Dr. Hansie De Kock, President of the Medical Staff, Mr. Bill Relph, administrator of LMH and Manager of Rural Health, Ian Drost, a retired judge and community representative, Gil Schultz, president of the LMH Foundation and Gaynor Jones, retired LMH Clinical Coordinator. The report concludes that, with certain caveats in regard to the number of cases etc., surgical services should continue to be supported at LMH and that the VIHA should be asked to explore possible extended surgical services in the form of day care which could be done at LMH.
This report was signed by all members of the committee.
In April 2008 Dr. Don MacGregor, visiting ophthalmologist to LMH, wrote to the LMH Foundation expressing his willingness to carry out cataract surgery at LMH and the LMH Foundation agreed to fund the $200,000 or so required to purchase the necessary equipment. This offer was not accepted by the VIHA.
When it became public knowledge that Dr. Preshaw was leaving there was a significant degree of concern expressed in the community followed by a number of relevant articles in the Driftwood (DW).
On June 18, 2008 the DW published an article stating that Bill Relph, LMH administrator said that rumours that there was an imminent danger of closing the OR at LMH were not true.
On July 2nd Dr. Owen Heisler, Executive Vice President and Chief medical officer for the VIHA, wrote an open letter to the community, which was published in the DW, stating that the VIHA is committed to maintaining a surgical program at LMH.
In the same issue the DW stated that "LMH is operating without a surgeon or on-call anaesthetic services until further notice, as a persistent rumour transformed into fact on Tuesday".
Dr. Ray Dykstra, a general surgeon with many years of experience in B.C. arranged to rent office space in Ganges and had announced his intention to practice here, after having made four trips to the island to meet with LMH and VIHA staff. On August 24th he sent an open letter to the community stating that "as of August 22nd I have withdrawn my application to join the staff of LMH". He added that "I developed and presented them (LMH and VIHA administration) with some options through which we could provide an improved surgical service by improving the volumes. This would mean a modest increase in operating and capital budgets". This offer was not acceptable to either the LMH or the VIHA administration.
On November 25, 2008 Dr. Barclay sent an e-mail, which was forwarded to all soccer player parents on Salt Spring, stating that "contrary to the obvious rumour mill on salt spring, VIHA is NOT intending on closing any aspect of LMH. In addition I met with Mr. Howard Waldner, President and CEO of VIHA and with DR. Owen Heisler, executive vice President and Chief medical Officer VIHA, last week and they are completely committed to continuing surgical services as well".
The unrest in the community increased after the news that Dr. Dykstra had withdrawn his application to join the staff at LMH and the South Island Registered Nurses Association arranged to convene a public meeting at the local movie theatre on November 27, 2008. This was very well attended and after lively and sometimes hostile comments, ended with various suggestions as to what should be the next steps. After the meeting a group of eight individuals came together to form an action plan.
That group asked Phyllis Bolton, R.N. (Rtd), with an extensive background in hospital administration, if she would act as an advisor to the committee, and at their first meeting asked if she would chair the meetings. Phyllis agreed to do so.
The group named itself the Ad Hoc Save Our Surgery Committee (SOS) and began holding regular meetings, the minutes of which are available to view on request.
The SOS felt it necessary to hold a further public meeting to ensure the full support of the community in the purposes and goals of the SOS. This meeting was held on January 15, 2009 at the Community Gospel Hall. The Terms of Reference proposed by the SOS were approved with minor alterations as were the purposes and goals of the SOS. The SOS then continued to hold meetings and to arrange meetings with government officials who, it was hoped, would forward their cause.
The SOS determined that it would be necessary to form a series of questions to be submitted to our MLA, Murray Coell and to other government officials, including the then Minister of Health. These were drawn up and provided to Mr. Coell at a meeting with a delegation from the SOS on ?
The SOS also decided to obtain signatures from members of the community who were in support of maintaining surgical services at LMH and were pleased to receive 1200 of these, which will soon be forwarded to the new Minister of Health and to Mr. Coell
In the meantime a number of SSI residents wrote to various government officials seeking their help in assuring the continuation of surgical services at LMH. Replies to these enquiries, e.g. from the then Minister of Health were received saying "have contacted the VIHA and are assured that no specific changes are being planned at LMH. Acute care services will continue and surgical services are planned to resume once a surgeon has been recruited". Other responses indicate the more cautious attitude that the VIHA is in the process of exploring all options to ensure that the surgical services provided at LMH address the needs of the people on Salt Spring in a safe and effective manner.
The SOS convened a further public meeting on June 1, 2009 and invited Dr. Heisler to attend. He accepted the invitation and at that meeting said clearly that he was not convinced that LMH or Salt Spring required the services of a surgeon. This complete about face from his earlier statements in writing published in the DW raises the question of what occurred to cause the VIHA to change their opinion to this extent. There can be little, if any, doubt that the fact that the VIHA had already assigned the budget for the OR at LMH to another activity was a major problem and suggested an earlier decision by the VIHA to no longer fund LMH for the amounts necessary to maintain a functioning and fully operative OR.
This complete reversal, on the part of Dr. Heisler, Dr. Shane Barclay and the VIHA administration is, to say the least, remarkable.
At the June1st meeting Dr. Heisler was also asked how many times the position had been advertised and he replied "twice". Firstly, this can hardly be considered sufficient exposure for a situation as urgent as this one. and secondly, the individuals conducting the interviews with the applicants were Dr. Shane Barclay, Chief of Staff at LMH, a VIHA appointee and a person who had appeared on Shaw Cable T.V. stating that LMH did not require a surgeon, and possibly Dr. Owen Heisler who was to repeat the same sentiment at the meeting on June 1, 2009. It seems most unlikely that any positive spin could have been provided during these interviews given the openly stated negative opinions of these individuals.
At that meeting the only comments about requiring a surgeon at LMH were those of Dr. Heisler, who said he was not satisfied that a surgeon was needed at LMH and an obviously pre-prepared speech by a general practitioner who practices part time at LMH and part time in Ontario stating that she did not miss the presence of a surgeon at LMH.
A delegation from the SOS met with the VIHA Board on April 1, 2009. The meeting was amicable and the delegation well received. However it has produced no results nor correspondence from VIHA.
A delegation from the SOS also met with Murray Coell, MLA for Saanich and the Gulf Islands on four occasions in which his support was solicited and was given. The most recent meeting with Mr. Coell was on June 26th at which time he was asked to arrange a meeting with the new Minister of Health, the Honorable Kevin Falcon and asked if he would accompany the SOS group to that meeting. He agreed on both counts.
The Islands Trust trustees Christine Torgrimson and George Ehring together with our CRD elected official, Garth Hendren met with Mr. Coell on July 17, 2009. The discussion was described as congenial and, while all three representatives made the point that LMH and surgery here was extremely important to the community, Mr. Coell listened carefully but committed to no specific action.
Phyllis Bolton had a follow up telephone conversation with Mr. Coell on July 31, 2009 and asked him about the two commitments to which he had agreed at their June 26th meeting. Phyllis learned that Minister Coell had reneged on both accounts and had chosen to take the back door political route instead.
Minister Coell informed her that he had met with Howard Waldner, President and Chief Executive Officer of the VIHA, and to the Minister of Health, Kevin Falcon and that their decision was to carry out a needs assessment study in regard to the LMH only and not the local community. Phyllis commented that she viewed this needs assessment study as a delaying tactic and displayed a clear unwillingness on the part of VIHA and of our MLA to address the issues at stake. It is worth noting that the idea of carrying out a "needs assessment" study for Salt Spring has been used by VIHA as an issue avoidance device for many years now.
This is where matters stood as of August 13, 2009 .
P.S. A couple of comments here.
Firstly, the safety issue which is so often cited as being a major factor, is simply not significant when one is dealing with the types of interventions envisaged as being carried out at LMH. That the surgeon needs a trained OR staff and good nursing support on the ward, yes he/she does, but we would have these individuals if the funding was there, and it is not.
Secondly we have an excellent OR at LMH and on several occasions SSI patients who needed to be transferred for surgery, given that we have no surgical programme at this time, have been unable to be accommodated in Duncan or Victoria because their hospitals were already filled to over capacity. It makes no sense on a local or broader scale to have this facility sitting virtually idle when there is a recurring shortage of OR capacity in the immediate region. This is true "bottom line " management without consideration of what is best for the people in the community and absolutely no thought given to the requirements of the Canada health Act in regard to access to care and what some like to term a "social contract".
VIHA Minutes:
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