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‘Real disconnect’: Provinces and feds point fingers as Canada’s ER crisis continues – Global News

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Emergency physician Dr. Raghu Venugopal doesn’t mince words when describing the realities his patients have been facing in the emergency departments in which he works in Toronto.

“It’s really a dire situation,” he said after a recent shift in the ER.

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Wait times are “exceedingly long” for even the most urgent care, with some patients waiting 100 to 125 hours for treatment, he says.


Toronto ER Dr. Raghu Venugopal says the situation in ERs right now is “dire.”.


Submitted photo.

“My trauma victim may stay on a stretcher for four days straight. My elderly senior citizens will easily be on a stretcher for three days, having their entire admission on a stretcher in the ER.”

Venugopal is one of many ER doctors and other front-line health-care workers who have been raising the alarm about a “national crisis” in Canada’s health-care system.

Read more:

Doctors say health system has ‘collapsed’ as patient surges fuel ER closures

For months, these doctors and nurses have used any platform available to them urgently call attention to the situation in ERs across Canada that they say has become unsustainable due to an unprecedented shortage of staff. It is a phenomenon happening in tandem with a recent surge in demand for health services. COVID-19 is partially to blame for this spike, but so too is a national shortage of family doctors that has resulted in many patients without preventative care becoming sicker and in need of more intensive health interventions.


Click to play video: 'Code Blue: Emergency rooms across Canada struggle with staff shortages'



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Code Blue: Emergency rooms across Canada struggle with staff shortages


Code Blue: Emergency rooms across Canada struggle with staff shortages – Aug 23, 2022

Canadians can be forgiven if they are confused about whether the situation is indeed a crisis, given the lack of urgent response from governments and mixed messaging from some politicians, Venugopal says.

Read more:

Code Blue: A Global News series delving into Canada’s health-care crisis

For example, last month, after more than 20 emergency departments across Ontario had to temporarily close and divert patients due to insufficient staff, Health Minister Sylvia Jones downplayed the situation, saying that to call it a crisis is “completely inappropriate.”

“What we’re observing is a real disconnect on the facts,” Venugopal said.

Read more:

‘Mind boggling’: ERs big and small across Canada struggle amid staffing crisis

The situation in emergency rooms across this country is “demoralizing,” he says, and many nurses and doctors are speaking out because they see a “a gap in leadership” that is not doing enough to remedy the situation, he said.

“They really lack credibility and they really seem out of touch with the experience of the day-to-day patients and day-to-day nurses and doctors.”

What are governments doing to address crisis?

Despite Jones’ dismissal of the term, the Canadian Medical Association (CMA) has repeatedly called the hemorrhaging of hospital and health-care staff a “national crisis.” And while provincial politicians have promised action, all 13 of Canada’s premiers also argue more federal funding is what’s needed.

They presented a unified plea to the federal government to increase the share of health care costs through the Canada Health Transfer from 22 to 35 per cent during a first-ministers summit in July.

Read more:

Canadian premiers push for boost in health-care funding from Ottawa

They say provinces are paying the lion’s share of health costs, despite health-care funding being a shared responsibility between provincial and federal governments, and an influx of cash is needed from Ottawa to “support the reallocation of services,” B.C. Premier John Horgan said at the summit in July.

But Prime Minister Justin Trudeau has repeatedly responded to these demands saying he wants to see “tangible results” from the provinces with the $45.2 billion they will already receive this year for health care.

In the past, “huge investments” by provincial and federal governments haven’t always delivered necessary improvements, Trudeau told reporters in July.

But he has remained vague about exactly what results Ottawa wants to see achieved, saying only broadly that Canadians should have better access to family doctors, mental health treatment and that medical backlogs should be reduced.

Read more:

Trudeau says Ottawa wants to make sure health spending delivers ‘tangible results’

Federal Health Minister Jean-Yves Duclos declined multiple requests for an interview with Global News, but in a brief response to two questions outside the House of Commons last week, he said he wants to respect the jurisdiction provinces and territories have over health care delivery in Canada, while also acknowledging that Ottawa shares the “responsibility of serving the same Canadians with the same (taxpayers) dollars.”

“I’m there to support them,” he said.

“I know their job is difficult and that the health-care crisis is there because it is a health-care workers crisis – which has been and keeps being exacerbated by the COVID-19 crisis – and for which we need to do dramatic investments.”

But when asked why Ottawa has not yet delivered on its election promise last year of $3.2 billion for provinces and territories to hire 7,500 new family doctors and nurses – money that was supposed to begin rolling out this year – Duclos walked away without responding.

B.C. Health Minister Adrian Dix says provincial governments cannot be left to bear the financial brunt of what has become a more costly system to manage in recent years. These costs are only projected to rise with Canada’s aging population, he said.

“The federal government has said they expect higher standards in various areas, including long-term care and others, so they’ve got to come up to the table. And unfortunately, in the last little while, they simply haven’t done it.”


British Columbia Health Minister Adrian Dix speaks during a press conference in Victoria on Dec. 21, 2021. THE CANADIAN PRESS/Chad Hipolito.


CAH

Instead of increasing transfers, Ottawa has instead preferred to provide targeted, one-time payments in specific areas, Dix says, such as increasing surgeries or reducing backlogs.

He argues these are “short-term” fixes that don’t allow for longer-term planning, especially in staffing.

Read more:

Health workers to premiers: find solutions to ‘crisis,’ don’t just ask Ottawa for funds

“If you’re going to build a surgical team in a hospital, one-year funding doesn’t cut it, two-year funding doesn’t cut it,” he said. “It’s not that we say no to it when it’s offered. Of course not … But they’ve got to step up.”

A shared responsibility

So, who’s job is it to fix the problems plaguing Canada’s overburdened health system?

It’s both the federal and provincial government’s responsibility, says B.C.-based health policy analyst Andrew Longhurst.


Health policy analyst Andrew Longhurst.


Submitted photo

While provinces and territories are tasked with overseeing health-care delivery – responsibilities that are often split with municipalities and regional health authorities – Ottawa also has a vital role to play in “setting and administering national principles for the system under the Canada Health Act,” in addition to providing financial support, according to Health Canada’s website.

Read more:

Patient dies in waiting room of N.B. emergency room, eyewitness speaks out

But even as the federal government came to the provinces’ aid over the last two years with billions of additional dollars toward the public health response to COVID-19, health care access has declined and premiers have continued to ask for more money, Longhurst said.

“I think in all of this and the federal government is very right to be concerned about continuing to write cheques to the provinces without certainty and accountability of how those dollars are being spent.”

But, he adds, Ottawa should also bear some responsibility in showing leadership and ensuring that accountability is built into funding models, he said.

“This back and forth of playing blame-shifting where the premiers are telling the feds: ‘We just need more money.’ And funding is a big part of that, no question, but a lot of the policy changes aren’t about money,” Longhurst said.


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Canada’s ambulance system facing nationwide crisis


Canada’s ambulance system facing nationwide crisis – Sep 18, 2022

“They’re about how we organize the delivery of health-care services, how we pay physicians … how do we reform?”

A lack of timely changes in the health system to respond to shifting health-care needs across the country “absolutely falls to the provinces who have not been focusing on the issue,” he added.

But some political leaders are indeed ready to embrace the changes needed to help stabilize health-care services, including the mayor of Perth, Ont., John Fenik.

His town’s hospital emergency department was forced to close for almost a month in July due to critical staffing shortages. This had a significant impact not only on his residents, but also those of several surrounding townships that rely on Perth’s ER, he said.

That’s why he says he’s willing to do whatever it takes to come up with urgent and implementable solutions that will keep health services open and available to patients.


Perth Hospital emergency entrance.


Global Kingston

But this can’t happen until all government leaders take responsibility and stop pointing fingers over whose job it is to fix the problems, Fenik said.

“It’s time for leaders in the provincial and federal positions, (for) Prime Minister Trudeau to not say, ‘It’s your responsibility, Doug Ford,’ or Doug saying, ‘We need more funds.’ It is our issue. We have to collectively sit around the table and solve it,” he said.

“This back and forth does nothing for one of my citizens that needs to get to the ER when the doors are shut. So, the buck stops here with me.”

What are provinces doing?

Even as they call for more federal funds, most provinces have been trying to address the challenges in their health systems in their own individual ways.

For example, Saskatchewan recently announced new investments to bolster health staffing, including a new agency dedicated to recruiting and retaining nurses and doctors, as well as money to increase the number of family medicine residency training seats and nurse training seats.

Manitoba’s budget this year had money for a special task force to address surgical and diagnostic backlogs and is investing in new education and recruitment programs for nurses.

Last month, Ontario announced it would increase the number of publicly-covered surgeries performed at private clinics, as well as waive exam and registration fees for internationally trained nurses and will send patients waiting for a long-term care bed to a home not of their choosing.

Read more:

Ontario health minister looks to accredit international nurses faster amid closures

Prince Edward Island has been trying to adopt more team-based approaches to primary care called “medical homes and neighbourhoods” to reduce a significant number of patients without family doctors.

And Alberta has been investing significant funds and energy into reducing surgical backlogs.

Ronan Segrave, Alberta’s surgical recovery lead, says a task force dedicated to this work has made some welcome progress in streamlining referrals and intake of patients – embracing new technologies to do so – and ensuring operating rooms are operating as effectively as possible.

Major changes in any health system can be “disruptive,” he says, but he believes patients, health-care workers and government alike know that even disruptive change is necessary to make improvements, Segrave said.

“We’re starting to embed changes that are more transformational in nature, moving forward to a world where people waiting outside of recommended wait time simply doesn’t happen in the future,” he said.

“We’re changing processes, changing the pathways, changing how we deliver care, using the right technology and tools … We want solutions and changes that will be sustainable, not just in the short term, as important that is, but in the medium to longer term.”

Read more:

Could physician assistants help with Canada’s health-care staffing crisis?

For those on the front lines of Canada’s health care “crisis,” this kind of change can’t come soon enough.

Nurses in particular have been bearing the brunt of patient frustrations over long wait times and lack of timely access to care.

And it’s been taking its toll on the dwindling numbers of nurses who have not decided to retire early or leave the profession entirely, as many across Canada have been doing in recent months, says Jane Casey, a registered nurse and director of emergency at Humber River Hospital in Ontario.

“There have been times where the stress of the moment gets to people and they do raise their voice and are quite concerned,” Casey said.

“So I would say, pack your patience. We’re doing the very best we can.”

With files from Global News’ Jamie Mauracher 

© 2022 Global News, a division of Corus Entertainment Inc.

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Girl Guides of Canada announces two potential new names for Brownies program

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Girl Guides of Canada is asking its members to vote on two new name options for its Brownies program — comets or embers.

Last month the national organization told members it would be changing the name of the program for girls aged seven and eight because the name has caused harm to racialized Girl Guides.

Girl Guides says that some Black Canadians, Indigenous residents and people of colour have chosen to skip this program or delay joining the organization because of the name,  adding a change can ensure more girls feel like they belong in the program.

Members were invited to vote for one of the two new name contenders in an email sent Tuesday.

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The email says the name comets was chosen because they inspire as they travel through space, boldly blazing a trail, and the name embers were selected because they are small and full of potential that can ignite a powerful flame.

Girl Guides says members can vote until December 13 and the new name will be announced in late January.

This report by The Canadian Press was first published Dec. 4, 2022.

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Veterans’ cases raise fresh concerns about expanding assisted dying law

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Revelations that some Canadian veterans have been offered medically assisted deaths while seeking help from the federal government are adding to worries about Ottawa’s plans to expand such procedures to include mental-health injuries and illnesses.

Veterans’ organizations are instead calling on Ottawa to increase access to mental-health services for former service members, which includes addressing the long wait times that many are forced to endure when applying for assistance.

“Mental-health injuries can be terminal only if they’re untreated, unsupported and under-resourced,” said Wounded Warriors executive director Scott Maxwell, whose organization runs mental-health support programs for veterans and first responders.

“That should be where we’re focused: resourcing, funding and investing in timely access to culturally competent, occupationally aware mental-health care.”

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While medical assistance in dying was approved in 2016 for Canadians suffering from physical injuries and illness, the criteria for MAID is set to expand in March to include those living with mental-health conditions.

While that plan has already elicited warnings from psychiatrists across the country, who say Canada is not ready for such a move, Maxwell and others are also sounding the alarm about the potential impact on ill and injured ex-soldiers.

Those concerns have crystallized in recent weeks after reports that several former service members who reached out to Veterans Affairs Canada for assistance over the past three years were counselled on assisted dying.

Those include retired corporal and Canadian Paralympian Christine Gauthier, who told the House of Commons’ veterans affairs committee last week that she was offered an assisted death during her five-year fight for a wheelchair ramp in her home.

The federal government has blamed a single Veterans Affairs employee, saying the case manager was acting alone and that her case has been referred to the RCMP. It also says training and guidance has been provided to the rest of the department’s employees.

The issue has nonetheless sparked fears about what will happen if the criteria for MAID is expanded in March, particularly as many veterans with mental and physical injuries continue to have to wait months — and even years — for federal support.

Those wait times have persisted for years despite frustration, anger and warnings from the veterans’ community as well as the veterans’ ombudsman, Canada’s auditor general and others about the negative impact those wait times are having on former service members.

“My fear is that we are offering a vehicle for people to end their lives when there are treatment options available, but those treatment options are more difficult to access than medically assisted death,” Oliver Thorne of the Veterans Transition Network recently testified before the Commons’ veterans affairs committee.

And despite the government’s assertions that a single Veterans Affairs’ employee was responsible for proposing MAID as an option, Royal Canadian Legion deputy director of veterans’ services Carolyn Hughes said the reports have added to longstanding anger and fears in the community.

“Many veterans have been angered and retraumatized by this situation, seeing it as an extension of the perception of ‘deny, delay, and die’ from VAC to veterans,” she told the same committee.

Prime Minister Justin Trudeau said Friday that the government is looking at striking the right balance between providing access to assisted deaths and protecting vulnerable Canadians, including veterans.

But the Association of Chairs of Psychiatry in Canada, which includes heads of psychiatry departments at all 17 medical schools, is calling for a delay to the proposed MAID expansion, saying patients need better access to care including for addiction services.

The Conservatives have also called for a delay, with democratic reform critic Michael Cooper underscoring the need for more study and preparation.

“Many veterans who turn to Veterans Affairs for services and support are vulnerable,” he said. “Many have physical injuries and mental-health issues arising from their service. What they need is help and support. And it can be devastating to be offered death instead of help.”

NDP veterans affairs critic Rachel Blaney said it is essential that the government increase access to services for veterans.

“We should always make sure that there’s resources and services out there,” she said. “We don’t want anyone to feel like this (MAID) is ever the first option for them. “

This report by The Canadian Press was first published Dec. 4, 2022.

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‘Paris moment:’ COP15 conference in Montreal seeks hard targets on biodiversity

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If global biodiversity — the subject of a huge international meeting in Montreal this week — is too much of a mouthful, try thinking instead about the white-throated sparrow.

Their cheerful “Dear Sweet Canada, Canada, Canada” song brightens backyards and parks across the country. Except not so much anymore.

“It’s a classic case in point,” said Peter Davidson of Birds Canada, one of many groups that will be watching the upcoming two weeks of COP 15 meetings like, well, hawks.

“It’s a common and widespread bird, but they are declining at a rapid rate. It’s an indicator,” he said of the white-throated sparrow.

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That’s the kind of decline that 196 countries are hoping to halt at this week’s meetings by reaching a refreshed Convention on Biological Diversity that contains real goals and real money. Referring to the international deal that created the same for greenhouse gases, advocates say they’re hoping for a “Paris moment.”

“What happened in Paris was pretty much every country agreed there was a climate crisis and they had to take action,” said Mary MacDonald of the World Wildlife Fund.

“It was a moment that pulled everyone together and that is what we’re lacking for the convention.”

Evidence that such a moment is required is not scarce.

Davidson points out North America has lost about one-third of its birds in the last 50 years. That’s three billion birds not filling the skies.

The United Nations has concluded that one million species worldwide are threatened with extinction. The pace is increasing.

Canadian habitats from prairie grasslands to eastern woodlands are rapidly vanishing, says the Nature Conservancy of Canada. Studies suggest 90 per cent of ecosystems worldwide have been altered.

As nature thins, so does its ability to provide humans with everything from clean water to pollinated crops. So does its ability to help with climate change, something the federal government is counting on to help meet its greenhouse gas targets.

Ottawa is spending $631 million a year over the next decade to help forests, marshes, peatlands and pastures sock away up to four megatonnes of greenhouse gases annually. But they won’t if those environments aren’t preserved.

“You cannot have a conversation about tackling climate change without talking about the importance of biodiversity,” said Dawn Carr, conservation director at the Nature Conservancy of Canada and a member of the Canadian delegation to COP 15. “They’re really totally inseparable issues.”

Diplomats have thrashed out 22 different targets for the Montreal meetings. They include reducing invasive species and pesticide use, cutting food waste, ensuring fair access and sharing of genetic resources and ending government subsidies that harm biodiversity.

But federal Environment Minister Stephen Guilbeault said four of them would be enough for something Parisian.

“We want to halt and reverse biodiversity loss by 2030,” he said. “We need to protect at least 30 per cent of lands and oceans by 2030.

“There needs to be a real serious conversation about resource mobilization to help developing countries achieve their targets.

“And in the case of Canada, it needs to be done in partnership with Indigenous people, provinces and territories.”

That’s a lot, Guilbeault admits.

Last time he checked, there were 1,200 “bracketed” items — spots in the text where the wording isn’t settled.

“It is not a small feat to accomplish.”

Nor, he said, can negotiators pick and choose among those four items. They’re closely linked and dropping one affects the others.

“I doubt that we can have an agreement on protecting 30 per cent by 2030 without a robust conversation on resource mobilization,” he said.

Guilbeault said it would be just as hard to talk about protecting lands without including the Indigenous people.

The talks will be slow and painstaking, said Carr.

“They will literally go around country to country to country and they will wordsmith the draft text until there’s consensus.”

The stakes are high. Brackets where consensus isn’t achieved are simply removed and, among the bracketed items, is the crucial 30 per cent by 2030 point.

“If those brackets don’t get removed, the measurable aspect will be lost,” Carr said.

COP 15, which stands for Conference of Parties, will create a small city in itself. Organizers say there are 17,000 registered attendees with 900 reporters accredited to cover their deliberations.

Critics say such mammoth events are too unwieldy to produce results and deliver little beyond unenforceable feel-good communiqués. They point out targets set at such meetings are rarely met and ask if there isn’t a better way to respond to environmental crises.

But Guilbeault said there’s still value in bringing the world together to discuss shared problems.

He points out that 10 years ago, scientists said the world was on track for between four and six degrees Celsius of warming. Now, after a decade of COP climate meetings, that range is 1.7 C to 2.4 C — not good enough, but better.

“There’s no doubt in my mind that countries meeting year after year, comparing plans, comparing strategies … played a key role,” Guilbeault said. “We need the same type of international movement on nature and that’s what I’m hoping Montreal will be.”

Hope echoes through any talk of COP 15 like the song of a white-throated sparrow.

“I think there’s a lot of interest and hope around it,” said MacDonald. “Nature is very hopeful.”

This report by The Canadian Press was first published Dec. 4, 2020

— Follow Bob Weber on Twitter at @row1960

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