The people spoke and IH responded: OR cuts at KBRH largely scrapped
By Andrew Zwicker
Monday evening, the people of the West Kootenay organized in a show of strength unseen in this area in recent years. An estimated 1,500 plus people lined Hospital Road in Trail with signs, drums and vocal chants protesting the proposed cuts to the O.R. at Kootenay Boundary Regional Hospital. The rally was timed to coincide with the meeting at KBRH between local surgeons, IHA and health ministry officials. Protesters lined the road to greet the meeting attendees and let them know what they thought of the proposed cuts as they arrived.
As 7:00 P.M. came around,most of the protesters made their way up to the hospital and parked themselves loudly outside the window where the meeting was taking place. At one point, attendees had to come outside to address the crowd and ask them to quiet down as they were having difficulty hearing one another over the noise.
The result? The people’s voices were heard. It was said by several members in the meeting that a key factor in the decisions to retain service largely as it was (without the cuts from 20 to 16 operating rooms as was proposed) was the voice and volume of the support shown by the protesters.
Last August, surgeons at KBRH proposed suggestions to IH as to how they could maintain the same level of service as well as achieve some cost savings, but over the past seven months they were not able to reach a deal. In the end, the deal reached at Monday night’s meeting was nearly identical to the one proposed seven months ago.
Following the meeting, The Telegraph talked to Dr. Andre Degreef, the head of surgery at KBRH about the process, the meeting, the result and the impact of the rally.
What was the deal that was ultimately arrived at?
Well, originally they told us they were going to cut us nine months ago. We decided that we didn’t want that so we should make some changes to avoid cuts. They told us they wanted to save $300,000 so we found ways to make up the savings. Then they still wanted to cut us, so we decided to make some more suggestions and that is now seven months ago. They proposed cutting our operating rooms from 20 to 16. What we ended up with was a deal to keep 19.5 operating rooms open. In other words they delayed this for seven months. They caused havoc, harassment , heartbreak and lots of wasted hours for seven months only to give us exactly what we proposed. They don’t want to say that what we got is what we asked for, but it is very very close to that.
So what are the changes that will be made?
We have got what we already had. The only difference is that some operating rooms are being shifted to more minor procedures. In every single formal senior operating room you need two nurses at any one time. In some cases, with ambulatory care or procedures where the patient goes home the same day, you only need one nurse in the O.R. So now instead of operating rooms that need two nurses, we are going to delegate to the operating room where you only need one nurse. So it’s going to be the same complex and offering the same services; it’s just going to cost them less.
I spoke with a number of nurses the day after the agreement, though, and a number of them are still being laid off.
What they’ve done is, nurses that were basically producing little results were let go. Those people lost their jobs. People that were really, really necessary to make the place run have kept their jobs.
Some of the nurses were saying that, even though it’s good news, the process is what has bothered them and some of them will be taking other jobs regardless of the deal because of the toxic work environment.
One guy yesterday said to me after the meeting, ‘Hey, we won! Let’s go have a drink!’ I said, ‘No way. This does not feel like winning’. If this in winning, then I don’t want to ever win again.
It really left a sour taste in our mouth. We’ve been at this for nine months. The thing that swung it was that the local people, politicians and business men got behind us and the Minister being harassed in parliament. It was the Minister of Health that told them, I’m sure, to do what they need to to make this trouble go away.
The guy we had been dealing with was the COO, Allan Sinclair. Rumor has it that he is not happy with the deal. It’s obvious he did not want to give us this deal, so we went to people more senior than him, and they solved the problem so it makes him look a little bit bad. The more senior guy than him came and solved the problem that he could not solve.
From our point of view, we just absolutely have to thank the local politicians. The mayors of Rossland, Trail and Nelson really played a big part. Without the media, I mean, you guys have been tremendous in reporting on this. That really kept it alive. If nobody had done or said anything, it would have just died a natural death and it would have happened and we’d be in a much worse position.
It almost sounds as if they made a deal with you, not because they thought it was the right thing to do, but rather to save themselves embarrassment.
Absolutely. They did not want to lose face, so they can’t say that we got the same deal we proposed seven months ago. The fact is, it does save money, but the bad news is that this should have happened seven months ago. They could have saved a lot of trouble and a lot of heartache doing things in proper time.
What do you take out of this going forward? Do you learn to use the media and public pressure more or find better ways to solve things next time an issue surfaces?
We started off by telling them that there is no line of communication between Interior Health, the Ministry of Health and the local doctors and that the system they have in place sucks. It does not address local problems when some bean counter decides we have to save money so we will cut in this section. That doesn’t work. They have promised us that a system will be put in place where the local and regional hospitals will have a say in what happens.
They didn’t say what they would do but they agreed that they have to put a system in place that is more productive when an issue arrives. In fact, there is a proposal that they are creating that will come back to us in a week or two to negotiate where we will set up some kind of committee of doctors to work with them.
It sounds like they really need to change their motivation for decision making to, ‘Let’s say first this is the standard of care we want–how can we fund it?’ rather than, ‘This is how much money we have. Let’s offer care that relates to those dollars’.
That’s exactly what we said to them from day one in August last year. We said, ‘How dare you guys make the decision from your side about what we need to do our jobs.?’ How can the general decide to send its army in to fight but take away their guns? How can a coach send his hockey players out to play without sticks? That’s what they were doing . They were expecting us to hang around, to sit around and be available for extra time for overtime because they wanted us to be on call at night but they weren’t prepared to give us an operating room during the day.
Are you optimistic looking forward that things will get better?
I think these guys have been taught a lesson that they must not wake the sleeping giant. With all of the media attention and politicians beating it up in parliament and being on radio and on the CBC, they realized that they pushed too far. It really made IH look bad and they learned from that. They cannot push around the local people and rule from afar.
It sounds like the real tipping point in the negotiations was the vocal crowd rallying outside the meeting?
We very clearly realize that it was the backing of the community and everybody around that made this work. In fact, when the meeting started the Interior Health people said that. While the meeting was on, there were a thousand people and guys with drums that came around outside the window where the meeting was. The crowd did not allow the Interior Health people to leave without sending a message and giving them a speech first. During the meeting, they realized that there is serious support from the community and that was a big eye opener for them. So I’d like to say a big thank you to the community. You saved the O.R.
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