May 23, 2023 – At a recent Vancouver Island Health Authority Board Forum, when asked by a member of the public when an additional primary care clinic might arrive to serve local residents, Island Health CEO Kathy MacNeil dodged the question, suggesting only that everyone just sign up with Health Connect and wait for a call.
According to information obtained from people seeking a doctor in our area, that’s not working out as advertised.
In previous articles, Second Opinion QB examined the governance of health service delivery, noting the lack of transparency of the Vancouver Island Health Authority’s Board of Directors.
The VIHA Board is largely inaccessible to the public, as was vividly demonstrated by a Board Forum broadcast two years ago, apparently intended to serve as a local public engagement function, but which achieved no such purpose.
In April 2023, another regional Board Forum was held in Nanaimo, this time the meeting was held in person as well as on Zoom.
Halfway through the meeting Ms. Hollins stated, “I was hoping to introduce our Board member from Nanaimo, Diane Brennan, but she hasn’t arrived yet.” Ms. Brennan appears to have not attended this Board Forum at all, held (once a year) in the region she represents. No reason for her absence was given.
Again, Island Health staff, led by CEO Kathy MacNeil and followed by Dr. Sandra Allison (mid-Island Medical Health Officer), extolled the grand vision and accomplishments of their wonderful teams. Their effusive self-congratulation was offset by a sobering set of statistics related to mental health and substance abuse in our region that jarred with VIHA’s proclaimed “accomplishments,” and the reality of the “public health emergency” that B.C. declared seven years ago.
VIHA provided the Nanaimo audience with no expectation that anything VIHA is doing or plans to do will make any sizeable dent in these multi-dimensional crises.
They did acknowledge broader socio-economic contributors leading to illness, including inequities in wealth and education. No surprise there, poor and under-educated people do tend to bear an inordinate share of the illness burden. So what is VIHA doing to improve the socio-economic determinants of health in our Island communities? That would have been an excellent question to be put to the Board members at the Forum. Didn’t happen.
VIHA Board members – even those who attended were largely invisible
Oddly, at the beginning of the meeting, Board and meeting Chair, Leah Hollins, did not introduce the head table, which apparently included three of her Board colleagues. The video of the meeting is of such poor quality that the Board members are not recognizable (most of the presentation slides were also illegible).
Halfway through the meeting Ms. Hollins stated, “I was hoping to introduce our Board member from Nanaimo, Diane Brennan, but she hasn’t arrived yet.” Ms. Brennan appears to have not attended this Board Forum at all, held (once a year) in the region she represents. No reason for her absence was given.
So, CEO Hollins introduced the three other Board members who did attend the meeting. If you’re keeping score, four board members did not attend, and there are two vacancies on the 10-member Board.
The attendance of the Board members was token at most. Not one of the three other Board members spoke a single word during the entire meeting. Next time, it would be less embarrassing, and VIHA could save some of our taxpayer money, by simply placing cardboard images of the Board members in the empty chairs.
Questions from the public were invited, then quickly shut down
After two more presentations extolling Island Health – Community partnerships, it became obvious that the question period at the end of the meeting was going to be shorter than planned. Attendees wondered if this was intentional, or whether Ms. Hollins has a time management problem.
The first question was from a member of the Nanaimo Area Network of Drug Users (NANDU) who asked: Why isn’t the “CAR 54” mobile crisis response team (RCMP + Nurse) accompanied by a person with “lived experience” (a peer)?
Chair Hollins simply ignored the man’s question, and went on to the next person. This curiously disrespectful response appeared in stark contrast to Island Health’s professed desire to embrace public engagement.
Hollins and her team missed, or intentionally avoided, an ideal opportunity to discuss the Peer Assisted Care Teams (PACT) program that is currently in trial use in the communities of New Westminster, North and West Vancouver, and Victoria.
This service, funded by the Ministry of Mental Health and Addiction (i.e. we taxpayers), establishes two person mobile teams to respond to and support individuals during a mental health and/or substance use crisis. The team consists of “one peer with related lived and/or living expertise/ experience coupled with a mental health professional.” According to the Canadian Medical Health Association (CMHA) BC, “as a result of provincial funding, PACT expansion will see seven new communities identified for expansion by 2024.”
PACTs are neither part of nor managed by Health Authorities. This might explain why Island Health staff either know nothing about the PACT program or choose to ignore it. This is another glaring example of the dysfunctional B.C. government silos, unable or unwilling to work in collaboration with one another, failing Vancouver Islanders, taxpayers and patients alike.
The next question from the public also related directly to the earlier presentation by the recently created Nanaimo RCMP Officer + Island Health Nurse intervention duo “CAR 54.” The audience member requested clarification of Island Health’s protocol related to involuntary apprehensions under the Mental Health Act. She expressed concern about a person apprehended, taken to hospital for involuntary assessment, then released, but apparently without informing worried parents who, she said, “were freaking out.”
Island Health Nurse Amanda gave a sincere but unconvincing response that “hopefully” Island Health’s mobile community crisis response team would follow-up post-discharge if required. In this case though, that apparently did not happen. As the woman explained to the Board, after 24 hours held in hospital during which time no psychiatrist ever appeared, the person was discharged. Soon thereafter they were re-apprehended and jailed.
This experience is presumably the kind of information that insulated VIHA Board members need to hear about, and to be held accountable for resolving.
This experience is not rare. A few months ago in Victoria, where VIHA’s head office is located, a very similar example was reported to Second Opinion QB by a distraught family about their son who suffers from a brain injury. His family asserts that they were neither consulted nor informed nor supportive of the man’s release from hospital because their son’s condition had not been stabilized. Predictably, upon discharge, he was soon arrested and jailed, where he was allegedly refused his regular medication, refused visitors, and detained in jail for an extended period of time without anything resembling appropriate medical care. Instead of being in care, he is now in the prison system.
Chair Leah Hollins was having none of it, “One of the things I need to say is if you are going to talk about a specific situation, that’s not for here. We’re here to talk about programs of Island Health and issues you might have with that, but not about specific incidents.” Next.
A third audience member offered criticism, with no specific question, related to the recently introduced self-serve street-level machines that dispense the opioid hydromorphone (Dilaudid), intended as part of the harm reduction tactics and overdose prevention efforts that have proven insufficient, some would say have failed miserably, for over a decade, with no improvement in sight.
A fulsome discussion of the pros and cons of safe supply strategies got lost in the questioner’s allegations of profiteering by medical professionals.
The fourth and final question was from “Ken,” who noted there is only one drop-in clinic in the City of Nanaimo (population 100,000). He asked, “When is Island Health going to open another one?”
Chair Hollins responded: “Could you be more specific by what you mean by a drop-in clinic?”
Island Health and the provincial government appear to have put all their (our) eggs in one basket, the infeasible idea that everyone should have their own designated GP. The simple and popular concept of walk-in (no appointment necessary) clinics, with extended hours on evenings and week-ends, has now apparently been abandoned.
CEO Kathy MacNeil ducked Ken’s question by deflecting responsibility for the primary care physician supply issue to the provincial government, expressing her hope that additional practitioners might soon set up shop in Nanaimo, and suggested that in the meantime Ken could register with the Health Connect waitlist, acknowledging that the wait times are long, but with her assurance that, “those new physicians and nurse practitioners are pulling peoples’ names off that list.”
New local clinic obliged to recruit patients, in order, from the Health Connect waitlist?
Contrary to CEO MacNeil’s assertion, according to reports from sources in Qualicum Beach, when the new combo Pharmacy & Medical Clinic opened at 100 Lombardy Street in Parksville, their physician(s) were accepting patients who showed up at the door, first-come-first-served — regardless of where the patient might have been on our local waitlist, or whether they were even registered on the Health Connect waitlist.
The public has a reasonable expectation that new clinics must recruit patients in the order they were placed on the waitlist. To confirm this, Second Opinion QB reached out to Oceanside Primary Care Network who are responsible for the Oceanside area of the Health Connect Registry, but did not receive a response prior to publication.
According to the BC College of Physicians and Surgeons, there are two physicians practicing at this new clinic: Dr. Tark Mohamed Raslan and Dr. Adewale Bisiriyu Ganiyu (as in ABG Medical Clinic).
Dr. Ganiyu appears to split his time between the Southwood Medical Clinic in Courtenay and this new clinic in Parksville. When we stopped by to confirm details late on a recent weekday morning, we found a vacant reception area and the following sign:
There was no mention of Dr. Raslan, or any sight of his waiting room or patients.
Curiously, Dr. Ganiyu was also recruiting new patients three years ago. In early 2020, a sign at reception at the Oceanside Health Centre indicated that Dr. Ganiyu was accepting new patients at his Courtenay clinic.
In her closing words thanking those who attended the April VIHA Board Forum in Nanaimo, Chair Hollins said: “It is really important for us [Island Health] to hear what your issues are.”
But with only 15 minutes allowed for questions, and no Chat stream provided to allow people attending virtually to ask questions during the meeting, it really didn’t matter. Listening, let alone hearing, was demonstrably avoided by the VIHA Board and executive.
VIHA’s April 2023 Board Forum meeting in Nanaimo can be viewed on YouTube: https://www.youtube.com/watch?v=GH1XisHIcQc