Watson Lake’s social woes won’t be solved by building a new hospital, say the community’s health staff.
They worry the government’s plans to give control over their new hospital facility to Whitehorse General Hospital will put undue emphasis on providing 24-hour acute care.
Overnight acute care proved useful several decades ago, when Watson Lake tended to more car crash victims from the Alaska Highway. But now the highway is in better shape, Watson Lake’s population has shrunk, and the community faces a new set of problems.
The biggest health issues now are drug and alcohol addiction and mental illness. Offering an overnight hospital bed to a strung-out addict, a belligerent drunk or a beaten-up elder is, needless to say, no permanent solution.
That’s why Watson Lake’s health staff want to focus on community nursing that would focus on mending these problems.
Health workers outlined their objections in a nine-page letter sent to the government, dated December 2008.
It caused a stir.
The Yukon Employees’ Union and NDP are both backing the health workers’ calls for the government to rethink its plans for Watson Lake.
Meanwhile, the Health Department and Whitehorse General Hospital are dispatching officials to Watson Lake on Monday to address concerns at a public meeting.
The fracas appears to have divided some Watson Lake health staff as well. Petitions posted inside the health centre have been torn down by someone, said Loralee Kesler, vice-president of the Yukon Employees’ Union.
“We’re all concerned by that,” she said.
The letter to the Health Department, signed by head nurse Sue Rudd, says staffers have called for changes to the delivery of health services in Watson Lake for more than a decade.
They want to offer more health promotion, health education and counselling.
But it’s been an uphill fight, because, technically, the Watson Lake facility is considered a hospital.
As a result, “we are seen in a narrow focus as acute-care hospital nurses despite our interest and ability to participate more fully in client care,” the letter states.
Watson Lake’s health workers were never consulted prior to the territory’s decision to make these changes, stated Rudd’s letter.
She’s also unhappy with the community’s private clinic, which, the letter alleges, has refused to support public programs to help fight diabetes and the human papilloma virus. Rudd’s letter calls for beefed-up contractual obligations with the clinic’s doctors.
Dr. Said Secerbegovic, owner of the clinic, declined comment.
The territory sees several benefits to putting Watson Lake’s hospital under Whitehorse’s control.
A report on Yukon’s health care services, prepared in September 2008, states there are “obvious symmetries between the two facilities ranging from the staffing of acute-care nurses and other health professionals, through to the purchasing of hospital goods and services that both organizations need to procure.
“An alignment of the facilities would also allow for the sharing of beds in a situation that WGH was full to capacity.”
This is little comfort to Watson Lake’s nurses, who see themselves as the peers of the territory’s other community nurses, rather than that of Whitehorse hospital staff.
And the proposed change may make it difficult for Watson Lake nurses to share shifts between the community’s health centre and hospital, they worry.
Besides, Rudd’s letter argues, it makes little financial sense for Watson Lake to have a hospital. Money would be better spent on a health centre that closes at 6 p.m., rather than an overnight facility.
To make her point, Rudd compares the costs of running Watson Lake’s hospital to that of running Dawson City’s health centre.
Rudd estimates it costs more than twice as much money to offer health care in a community that is smaller by nearly 500 residents.
According to the government’s 2006 census figures, Watson Lake has an aging, shrinking population of about 850. Rudd estimates it costs about $2.25 million annually to run the hospital.
By comparison, the health centre of Dawson City, population 1,327, only costs about million annually.
Much of the difference in costs, Rudd suggests, is made up by the administrative burden of running the hospital. Watson Lake’s facility has about 20 permanent staff, compared to eight permanent staff in Dawson.
Hence Rudd’s conclusion that plans to continue running hospital services is a waste of money.
“A community the size of Watson Lake cannot sustain the kind of human resources that are required to run a hospital,” she wrote.
Then there’s the matter of collective agreements. Currently, all Watson Lake medical staff are employees of the Health Department. As such, they’re members of the Yukon Employees’ Union.
Some employees at Whitehorse General Hospital are also Yukon Employees’ Union members. But others are members of Public Service Alliance of Canada.
Switching some employees over would require tearing up existing agreements, says the Yukon Employees’ Union.
“Your government would either have to negotiate three separate collective agreements with the potential for drawn-out bargaining processes, or attempt to merge the employees under one agreement. The latter approach would encounter even more obstacles,” states a letter sent by the union to the Health Department.
“Is your government really prepared to develop and pass legislation that will override the negotiated terms of agreements which your own representatives approved?” the letter continues. “The ramifications of such an action would carry serious consequences during future negotiations by destroying all good faith in the process.”
The controversy is only the latest to involve the new facility, which was originally built as a long-term care facility for the elderly. Midway through construction, Premier Dennis Fentie announced last summer the building would become a new hospital, after it came to light the existing hospital would be too costly to renovate.
Todd Hardy, leader of the NDP, said Fentie could have avoided the latest mess by talking with his constituents.
“The government has really screwed up the building. And, to add to their problems, they haven’t talked to the public about what’s needed in Watson Lake, and are making a really backwards decision,” said Hardy.
“Who is he getting his advice from? This is his riding.”
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