These comments reflect my personal opinion and do not represent that of any of the other doctors in the Yukon, although I am sure most of them will concur with my feelings. Some dates and numbers may be slightly off but are generally correct.
After driving up the Alaska Highway in a microbus in 1974, I arrived in Whitehorse to start my medical practice and family. The vehicle was perfect for the time as was the medical facility in Whitehorse. The hospital had approximately 110 beds, 60 nurses, 2 orderlies and 18 doctors doing general practice, and we did hemodialysis at the Whitehorse Trailer Park. I believe the population then was about 16,000. My microbus is now too old and too small for my expanded family, as is the current hospital and staff for the Yukon. In this state, the hospital simply cannot facilitate acute medical and surgical challenges. At the last count we had just over 50 beds – half the number from the ‘70s – for almost triple the population which sits at around 45,000. There is no current facility for hemodialysis. The number of administrative staff, policy analysts, programmers and planners has exploded out of control. There are more bureaucratic eyes rolling than ears listening to the boots-on-the-ground worker bees to extract solutions. Now we are inundated with “consultants”. In the early days, decisions were coordinated with the guidance of our Nursing Director and medical staff representatives, and there was a far greater proportion of those doing medical service than administration. The decisions made with this structure were made easily and for far better benefit to the general public.
In the late 1990s, the Government of the day decided to halve the size of our hospital. We had no choice but to cram the hospital with chronic care patients. The Thomson Centre was built to fill patient needs, but alas became designated as office space for policy analysts, programmers, program directors, and doctors’ offices. We were losing staff and beds, and staff pleas were falling on deaf ears. Around that time, we wrote a letter to the paper after one of my mastectomy patients and an acute gallbladder surgery were cancelled for "no beds". I found a wonderful nurse, CH, weeping at the start of her shift, saying "Dave, can you write a letter or do something." That letter was well received by the public, however a nurse who wrote in to voice support for that letter was sadly disciplined by our hospital. I like to think we succeeded in purging the Thomson Centre of non caregivers which now fares well with patients, and subsequent development of Whistle Bend, etc. have been exemplary but it is still nowhere near enough.
We are now forced to play musical beds, robbing the emergency room and short stay beds and are in effect “robbing Peter to pay Paul,” to endless complaints from clinical units without beds. We are forced to admit patients in administrative offices with no bathrooms, oxygen, suction, etc. Despite the abundance of administrative staff, nothing substantial has been done to assess the surgical and medical needs which are presently far too old and far too small. We have record-breaking wait times and daily cancellations, and as I write this letter, we have a "planned slowdown". Part of the problem with staffing policy seems to be a reluctance to hire permanent staff versus casual and agency nurses, and now even army personnel. This has destroyed morale here, as it has across the country. In 2018, the surgeons and staff in Whitehorse contracted an architect and consultants and came up with a proposal and design of designated surgical beds and new operating rooms to allow consistent booking and lower the horrible cancellation rate. These suggestions appear to have fallen on deaf ears and their suggestions appear to have been put on the shelf. Yellowknife has a similar population to Whitehorse, at about 45,000 people, yet has a hospital three times the size of Whitehorse’s. It was incredible to me and my colleagues when a Ministry of Health representative years ago forwarded a proposed budget for medical care in the Yukon of 1 per cent at a time when inflation was at about 6 per cent per year, with population increasing it at about the same rate – “What were they thinking?”
Hiring hospital staff, doctors, nurses, and technicians is competitive across the country and we all know that at the end of the day we have to be competitive to attract and keep staff. Negotiations need to address fairness in sharing between staff with aims to pay and give benefits that are equitable. When a nurse who has been here for years looks across to see an "agency nurse" being paid significantly more, morale flags, and believe me, it has. In fairness, this is not just endemic to the Yukon; it is across the country and a national failure for Canada. I personally think that the doctors should all be salaried here as in the NWT to avoid inequities and adversity. The inequities between niche practices and general practices that have to pay overheads are unacceptable.
There have been some great things done for chronic care and emergencies in Yukon. However, just last week there were 14 admitted patients in our wonderful new ER facility that were hospital patients, not emergencies. For just 14 new patients, our minor procedure room had to put people in the hallway because the short stay beds were so clogged with in-patients, the cataract patients of the day had to be dealt with in the hallway and our cast clinic had to be moved to the emergency department because there was simply "no room”.
This opinion is from a self-proclaimed Elder and does not represent that of the hospital staff. It has been 50 years since I came to the Yukon and it is clear to me:
The hospital is too old and too small to accommodate medical and surgical needs. We urgently need to have newer and more beds designated for medicine and surgery with block booking to avoid delays.
The powers of administration in government and its bureaucracy need to listen to the "worker bees" who have dedicated their lives and give deference to them. There is a need for more permanent staff position availability and less focus on "casual opportunities without benefits"
There has to be equality in payment negotiations between the workers. You cannot demoralize one group with less pay and office overheads while watching niche practices and contract practices be supported differently.
We need a renal unit and dialysis facilities.
Inflation and population increase have to be recognized in the hospital needs. Thirty years ago, Yukon medical facilities and staff were the envy of Canadian medical professionals. Morale was great. Waiting lists were down and we had stability.
If we do not comply with the current wants and needs, we will be forced to establish private hospitals to accommodate the needs of the Yukon. Again, these are my own opinions and I acknowledge that similar problems have occurred across Canada, but we have in the Yukon gone from "the best" to at best the same as the rest of Canadian hospitals. Practicing medicine in the Yukon has been a wonderful life and privilege. I owe my life to the local medical facilities and staff for my personal needs in the last few years. I really hope that we consult on these problems. I urge you, readers, to insist on change.
Respectfully,
D. Storey, Citizen, Elder, and MD
