Friday, January 27, 2006

Few long-term beds, growing waits, especially for Interior, North

VICTORIA - If you’re worried about about two-tier health care, take a look at the plight of seniors outside the Lower Mainland.

The average wait for a long-term care bed in the North and Interior was almost three months in December. That’s four times as long as the wait in the Lower Mainland.

The cause is simple - the government’s failure to honour its original promise to add 5,000 new long-term care beds by the end of this year.

Only 440 beds were added in the entire province last year, according to Health Minister George Abbott. Since 2001 only 607 beds have been added.

That's a 2.5-per-cent increase in the number of spaces over almost five years. In the same period the population over 75 has increased by 16 per cent.

The result is predictable, the consequences often devastating for the seniors and their families. People who need long-term care beds wind up in hospital acute care beds, causing cancelled surgeries and jammed emergency rooms.

The problem is worst for the Interior Health Authority, where the average wait was 88 days. The Northern Health Authority was little better, at 80 days. Vancouver Island seniors faced an average wait of 56 days.

But in the Fraser Valley Health Authority, the wait was barely three weeks. In Vancouver-Coastal, it was 19 days. (It is easier to place people in densely populated areas, where there are several options within a reasonable distance. In much of the province the nearest alternative is hours away.)

Abbott said the times are better than four years ago, when seniors could spend more than a year on a waiting list.
Unfortunately that’s a meaningless comparison. The old system encouraged people to put their names on a waiting list long before they required care. Under the improved model, the wait begins when a doctor has agreed care is needed.

So how do the waits in December compare with a year earlier? The health ministry says it doesn’t know right now.

But last February Interior Health Authority chairman Alan Dolman reported that the wait was down to 60 days. Since then it has climbed by 50 per cent to 88 days.
That’s not surprising. By the end of last year the Interior Health Authority had seven-per-cent fewer long-term care beds than it had in 2001.

Have things improved? The government will say 440 beds were added across the province last year, but the number for each health authority is another secret. The health ministry wants to release that next month, when it can provide “context.”

The government’s explanation for its broken promise is that the existing long-term care beds was in worse shape than it expected. Improving those spaces used up the money that would have gone for new beds.

And Abbott says that by the end of this year there will be 2,900 additional spaces, and the government is on track to keep its new promise of 5,000 beds by 2008.

But it’s been a cruel delay, and the shortage has meant great hardship.

Some seniors can manage while they wait. Others receive the best support that sometimes overwhelmed families are able to provide.

And others end up in acute care hospital beds, where they often do very badly. They don’t get needed care and activity, their sleep and living patterns are disrupted and their conditions worsen far more quickly than if an appropriate place was available. It is a a terrible thing for a family to watch.

And since 10 to 20 per cent of hospital beds are occupied by people who have nowhere else to go, surgeries must be cancelled and emergency rooms fill with patients who can’t be admitted. Most communities across B.C. experienced the problem firsthand at some point last year.

It’s good to support seniors in their homes, and provide a range of care.

But when they need a place and more support, they should know that it will be there.

Monday, January 23, 2006

Harper’s tough job gives B.C. an opening

VICTORIA - Now the hard part starts for Stephen Harper.
He’s starting an audition today. The Conservatives can’t rest comfortably on this victory, and not just because they only managed a minority government.
The Conservatives’ success owes much to the public’s anger at the Liberals. That will fade, with the only question how long that process takes. And without that factor, the Conservatives may be another doomed government.
Harper and the Conservatives have to convince Canadians that they can govern effectively. He has to prove to skeptical centrist voters that the Liberal attacks ads about same sex marriage and reckless tax cuts were false.
And his biggest problems will be the 124 MPs sitting behind him on the government benches.
It’s been 13 years since the Conservatives were in power. For the Reform/Alliance side of the party, this is their first taste of government.
And many of the MPs elected Monday are getting ready to fly into Ottawa with great expectations. Some have accepted the need for unity and party discipline in order to win the election. They learned that lesson painfully in 2004.
But now they are going to want action. They have waited in the wilderness, and they are bound for Parliament to make big changes.
Which creates a problem for Harper. Go too far, and the public’s fears will be confirmed and the road back cleared for the Liberals.
Don’t go far enough, and the MPs who believe the Conservative party should denounce gay relationships, or launch any number of more extreme policies will get grumpy and fractious. (These are people, don’t forget, quite willing to form new parties with little chance of real political success for years.)
The successful campaign gives Harper more clout in the party. And the minority government may be a blessing. Harper can remind MPs that getting too radical could mean a brief term in government, and a long wait on the outside.
The minority government is also a good thing for British Columbia. In the 15 elections since 1958, this is only the fourth time that B.C. voters have been on the winning side and had strong representation in government.
But even in this election the Conservatives lost seats in this contrary province. Their share of the popular vote rose, but it appears that strategic voters in key ridings were just too nervous to allow Conservative wins.
Harper must do better in B.C. next time, and that means paying attention to British Columbia’s issues.
There will be some quick tests. The Conservatives promised $1 billion over 10 years to help deal with the pine beetle disaster. They said they would halt the sale of Ridley Terminal in Prince Rupert. After some fumbling they agreed to support the Kelowna Accord to assist First Nations, although they want a clearer spending plan.
Failing to deliver on any one of those would indicate B.C. is being forgotten.
And the number of cabinet seats from the province, and the jobs given to MPs like Jay Hill, Stockwell Day and Chuck Strahl, will signal Harper’s attention to B.C.
Paul Martin is right to resign. The party did better than expected, especially in B.C. But Martin is not the man to give the party a needed new start it.
His decision buys Harper time. The Liberals will now be looking inward. They will be in no rush to topple the Conservatives.
I expect many British Columbians will see these results as the best of a bunch of bad options.
The Liberals are out, the Conservatives in check.
And if Harper wants a majority next time, he has to look to B.C. The Conservatives expected a better performance in the province. Their share of the popular vote actually rose slightly, but they lost five seats.
They need to find out why so many British Columbians were still not ready to trust them in government if they ever expect a real victory.
Footnote: It will likely take until recounts are complete to determine a critical question. The NDP and Conservatives are on the edge of having a combined majority in Parliament. That would open the door to a more stable coalition, and free Harper from dependence on the Bloc Quebecois. It won’t be an easy partnership, but there are near-term advantages for both parties.

Sunday, January 22, 2006

A B.C. election prediction

My best guess is that the Conservatives will win 21 seats, the NDP 10 and the Liberals five in B.C.
But there are so many close races - and strategic voting is such a factor this time - that the Conservatives could end up anywhere between 16 and 22 seats, the New Democrats between seven and 11 and the Liberals between four and 12.
Now that's a margin of error.
The prediction is based on the Conservatives winning every seat in the North and Interior except Skeena and the Southern Interior, which should both end up in the NDP column.
Here on the Island, I'm expect Keith Martin to squeak through in Esquimalt, but the NDP to take Victoria and Vancouver Island North. No changes in the other seats.
I'm expecting Bill Siksay and Peter Julian to hold Burnaby-Douglas and Burnaby-New West for the NDP, and Dawn Black to add New West-Coquitlam to the party's tally. Penny Priddy looks strong in Surrey North.
Nina Grewal will likely hang on in Fleetwood, and Phil Eidsvik will keept Newton for the Conservatives. North Van and Richmond will likely go their way.
But please don't consider this as anything other than a guess. Many of these races are incredibly close.