Trouble in Health Care in Flin Flon - under the Norman Regional Health Authority (NRHA), and Why is the NRHA going after Dr. Krishnan Sethi?

On Wednesday December 1, I went to Flin Flon for a Community Meeting concerned about the state of health care in the region. The Calm Air plane was late and I arrived shortly after the meeting started in the R.H. Channing Auditorium. It was packed with about 400 people there. When I entered, Dennis Ballard, former Mayor of Flin Flon was expressing the anger and frustration that residents of Flin Flon are feeling.

The health care situation in Flin Flon has been a concern of residents for many months. The NDP have not been listening and the problems have gone from bad to worse and as the Flin Flon Reminder reported people in Flin Flon are furious. In short some of the major issues brought up by people at the meeting and to me afterwards are the following:

1) The moving of the medical clinic into the Flin Flon hospital. Based on a presentation to the Board of the NRHA which suggested that the move was necessary because it was a cheaper location even though in many respects it was less convenient. The existing clinic has easy parking access and is readily accessible for those with disabilities being on the ground floor. The clinic in the hospital is on the third floor and to get there people have to go through the Emergency Room waiting room, and have a winding route and need to go up an elevator which is heavily used. At the forum, information was presented that the cost of the clinic in the hospital was understated because revenues from fee for services were exaggerated and renovation costs used were less than the real costs. Meanwhile the costs used for the existing clinic were overstated. Residents of Flin Flon were left wondering if the move to the clinic in the hospital was in fact to a more expensive as well as a less convenient site, and some residents felt that the use of the existing clinic should be continued.

2) Concerns over the mismanagement by the NRHA in handling physicians and physician resources and specifically in the treatment of Dr. Krishnan Sethi
Dr. Sethi is revered by people in Flin Flon. He has been looking after people in the Flin Flon area for 30 years as a family physician who also provides obstetrics and anesthesia services. He is a remarkable doctor. In 2005, he was awarded recognition as the Family Physician of the Year for Manitoba. Two people came up to me after the forum to tell me how Dr. Sethi had saved their lives, and I have had more such stories in letters since. Dr.Sethi has stood up to the Norman Regional Health Authority administration and called for improved quality of care in the Flin Flon area. Perhaps in retaliation, the CEO of the Norman Regional Health Authority has moved to remove Dr.Sethi's hospital priviliges on what appear to be very weak grounds.

In my view, when you have a high quality physician working in your RHA you should be doing everything to work with him or her to get the best quality health care for people. Instead, in Flin Flon, where they have a physician who is a star (Dr. Sethi is to health care in Flin Flon what Wayne Gretsky is to hockey), he is being attacked. This is wrong, and only serves to undermine the system and the quality of health care. Why would young doctors go to work in Flin Flon when they see how distinguished doctors like Dr. Sethi are being treated? Indeed, I have heard of one doctor in training who wants to practice in rural Manitoba who said she would never go to Flin Flon when she heard of what is happening to Dr. Sethi. Why would the NRHA act to make recruitment of doctors to Flin Flon more difficult?

By the way, Dr. Sethi was honoured this past summer by people in Flin Flon for his community work when the Flin Flon Station Museum added his name to its Wall of Honour. For many years, Dr. Sethi has volunteered in the Museum's Teddy Bear Clinic. Dr. Sethi even gave the museum a teepee where the clinic is now held! At the Forum, there were many, many people who came to support Dr. Sethi.

3) Concerns over the quality of health care being provided in Flin Flon, especially in the Emergency Room. A number of speakers at the Forum raised their concern over misdiagnoses and other problems of poor care in Flin Flon at the present time. The Operational Review ordered by the Minister of Health needs to do an audit of the quality of care being provided in Flin Flon.

4) Intimidation: As reported in the Flin Flon Reminder, one woman at the Forum spoke of the Flin Flon General Hospital as a "place of high intimidation." She indicated staff are afraid to speak out for fear of losing their jobs. This also needs to be investigated as part of the Operational Review of the NRHA.

All of the above speak to the poor management and mismanagement by the NDP of health care in Manitoba. When added together with problems in the Winnipeg Regional Health Authority and in the Burntwood Regional Health Authority in Thompson where the situation has reached the point where an investigative reporter has been banned from attending Board Meetings, it is not a pretty picture. Manitobans deserve much better stewardship of health care by their provincial government. The problem is that by being such poor managers, the NDP are undermining medicare in our province. We need to throw the NDP out of office and elect a Liberal government to preserve and enhance our medicare system in Manitoba.

A special thanks to Tom Heine for ably chairing the meeting.

Newborn Screening in Manitoba is in a shocking state - and major improvement is urgently needed.

The Newborn Screening in Canada Status Report which was updated Nov. 11, 2010 shows that Manitoba lags far behind most other provinces and is so far behind what is happening in most jurisdictions that our profile looks more like the screening profile of a third world country rather than the screening profile of a developed country.


Lets list the shortcomings:
1) Prince Edward Island, New Brunswick, Ontario and the Yukon have universal newborn hearing screening. Manitoba does not.
2) Ontario, British Columbia and the Yukon screen for Hemogobinopathies like Sickle Cell Disease, Sickle-C Disease and beta-thalassemia. Manitoba does not.
3) Ontario, Alberta, British Colombia, and Saskatchewan screen for Cystic Fibrosis. Manitoba does not. Also of note, all U.S. states screen for CF.
4) Among Core Metabolic Conditions, Manitoba only screens for Phenylketonuria, while Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick, Quebec, Ontario, Saskatchewan, Alberta, British Colombia and the Yukon screen for up to 20 conditions 5) With what are generally termed as Secondary Target Conditions including various Fatty Acid Disorder, Organic Acid Disorders and Amino Acid Disorders Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick, Quebec, Saskatchewan, British Columbia and the Yukon screen fully for at least one of these conditions while Manitoba does not offer full screening for any. In Saskatchewan, for example, there is full screening for 14 such conditions and partial screening for 6 more conditions.

To put the seriousness of the backwardness of Manitoba into perspective, please look at the Report of the Ontario Ombudsman entitled "The Right To be Impatient," an inquiry into whether the Ministry of Health and Long Term Care has failed to properly administer Newborn Screening in Ontario. For the full report see http://www.ombudsman.on.ca/media/3292/the_right_to_be_impatient_20050927.pdf

The Ontario ombudsman stated in his report of newborn screening in his Province, which was in 2004 where Manitoba's newborn screening program is today: "children have needlessly died and been rendered disabled."

I ask, "How many children in Manitoba have died or been rendered needlessly disabled because of the inaction, inattention and poor management of the NDP in Manitoba?"

I will quote more from the Ombudsman's Report: "Newborn testing is not just some impersonal, abstracted, bureaucratic question or an issue for another day. It is a matter about unnecessary illness, suffering and the death of real children. In spite of this successive governments have responded as though their decisions or inaction carried no human consequence or aided and abetted no suffering. Over the past years our process of decision-making on newborn testing, if it can be called a process at all, was not the march of progress that we in Ontario have a right to expect. Instead it was an ambling, staggering, distracted if not disinterested meander."

What happened in Ontario before 2004 was totally unacceptable and the Ombudsman recognized this. What is happening in Manitoba today is totally unacceptable. The situation in Manitoba needs to be corrected as fast as it possibly can be.

I am drawing attention to this situation in question period today so that action can be taken quickly to correct that major deficiency that exists in Manitoba today. I have also written to the Manitoba Ombudsman, Irene Hamilton, to ask her to undertake an investigation into whether the Ministry of Health has failed to properly administer Newborn Screening in Manitoba.

How many children have died or become disabled in Manitoba because of the poor management of the NDP? This is an important question. Confidential advice prepared for the Minister of Health in Ontario before Ontario improved its screening program provided an estimate of 25 disabilities and 25 deaths per year that could have been prevented in Ontario (from the Ontario Ombudsman's report). If correct, and since the screening program in Manitoba has been similar to the old, inadequate screening program in Ontario, this suggest that over the 11 years the NDP have been in power about 30 disabilities and 30 deaths could have been prevented. These are shocking numbers. Action should have been taken years ago. Action in Manitoba is urgently needed now.

How many conditions should we be screening for in Manitoba? If Manitoba were to move in the direction suggested by the American College of Medical Genetics, which is endorsed by major American health organizations including the American Advisory Committee on Newborn Screening, testing for 19 core conditions and 25 supplementary target conditions can detect problems in one our of 800 live births (from the Ontario Ombudsman's report).

What would be the cost to Manitoba of such screening? As the Ontario Ombudsman points out in his report "Successfully screening for very few children could, in the long run, pay the annual costs of the entire program."

[Update March 2011: I understand that Manitoba will start Cystic Fibrosis screening this year thanks to funding from the Children's Hospital Foundation of Manitoba. The province itself is not yet supporting CF screening in Manitoba, but it needs to soon because the Children's Hospital Foundation funding is only for one year. ]

The Red Zone Conference, The Lake Winnipeg Basin Summit - and the international environmental catastrophe that is Lake Winnipeg

Yesterday and Today Winnipeg has been the site of the Lake Winnipeg Basin Summit organized by Hank Venema and others at the Water Innovation Centre at our International Institute for Sustainable Development . Last night the Lake Winnipeg Foundation held the Red Zone II Conference featuring videos of Lake Winnipeg's situation and a Panel Discussion on the Lake.

I was particularly struck by the comments of Bob Sandford EPCOR Chair of the UN Water For Life Decade program and director of the Western Watersheds Climate Research Collaborative of Canmore Alberta. Bob Sandford has a broad perspective on water quality issues. He did not waste any time in calling Lake Winnipeg an international environmental catastrophe, and in saying that it is getting worse. Those of us who live in Manitoba and know of the algal blooms in the north basis of Lake Winnipeg already recognize the severity of the problem on Lake Winnipeg. The north basin algal blooms may be up to 160 kilometers long! This last summer, severe algal blooms near Victoria Beach and at other locations in the south basin of Lake Winnipeg brought home the severity and the extent of the problems Lake Winnipeg is facing.

The sheer size and scale of this environmental catastrophe on Lake Winnipeg - at 23,750 kms, the 10th largest lake in the world - makes it one of the largest environmental disasters on the planet. It is sad that our lake, Lake Winnipeg, is now becoming a symbol of the large scale ecological catastrophe which will occur when a government, in this case the NDP provincial government, abrogates its responsibility and mismanages the environment in its jurisdiction.

In question period today, I asked the Premier when he is going to set the targets for reduction of phosphorous and reduction of algal blooms. The interim target of a 10% reduction in phosphorous has not been met, and it was known as early as 2007 that this target was hopelessly and irresponsibly inadequate to achieve the reduction in algal blooms needed. I raised this in the fall of 2007, and it has taken three years for the NDP to acknowledge the inadequacy of their initial target. We need the real target and we need it soon so that we can all pull together on an effective plan to reduce the phosphorous in Lake Winnipeg and to reduce the algal blooms on our wonderful lake and to return Lake Winnipeg to health.

As Bob Sandford indicated Lake Winnipeg is becoming known as a global symbol of a very badly managed lake. It is very disturbing for me as a Manitoban to hear this, as I am sure it upsetting for other Manitobans. The fact is that under the poor management of the current NDP government action has been too little and too slow and the result has been worsening algal blooms and algal toxins in Lake Winnipeg. Indeed, so far there is no evidence that the situation of Lake Winnipeg has improved.