Photo Courtesy of The National Post

How you doing? Sniffly? Sneezy? Got a frog in your throat or a crick in the neck? Do you feel, to use the vernacular, like you want to barf up a lung?

Nope. “Fine.” That’s good to hear. And on that account, I say told you so.

With spring springing and the arrival of longer, warmer days and the promise of fun and excitement in the great outdoors, it’s time to take accounting of the pandemic flu season that just past. Or perhaps that should be non-demic.

I was serving on the Community Editorial Board of my local daily, The Guelph Mercury, this time last year. As the coming swine-flu-pocalypse was starting to break, I waxed sarcastically about the media’s attention to hysteria, and how when all the beans are counted, common medical sense will bear out and all the worry will have been for not.
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It takes a special kind of political acumens for a regional Canadian politician to make news headlines both north and south of the border, but Danny Williams has done it.

The Blogosphere across North America lit up a few weeks ago with the news that the Premier of Newfoundland and Labrador was heading to an undisclosed American medical facility for a no-further-details-given heart surgery last week. Canadian progressives are chastising Williams for bailing on his at-home medical options while American opponents of healthcare reform get a new scapegoat for why a public option doesn’t work.

Simplistic? Probably. Williams’ people were less than helpful when the news broke, initiating what CBC reporter Janyce McGregor called a “cone of silence” about the matter.

What we do know is that after “weeks of consultation” with doctors, Williams decided to head stateside for the surgery which was apparently unavailable in his home province. This was according to Deputy Premier Kathy Dunderdale, for whom the odious duty of informing the media fell.
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Photo Credit: Vancouver Coastal Health

Lost in the shuffle amid the recent tragedy in Haiti, parliamentary drama and growing Olympic fever, a recent B.C. Court of Appeal ruling stands to reshape the way the Canadian legal system deals with addiction. On January 15, 2010 the Court of Appeal for British Columbia dismissed a federal government appeal to close InSite, Canada’s only supervised safe-injection site. The federal government is widely expected to appeal the decision to the Supreme Court of Canada, opening the door for a new approach towards Canadian policy in dealing with addiction and substance abuse.

In the 87 page ruling, Justice Huddart wrote that the court dismissed the federal government’s appeal “by reason of the application of the doctrine of interjurisdictional immunity”, which prevents a law from being applied outside of its constitutional jurisdiction. With health care professionals, academics, and courts recognizing InSite as a provider of legitimate health-care services – an area of provincial jurisdiction – the Court of Appeal found that federal drug laws prohibiting the possession of controlled substances were constitutionally unable to override the application of provincial health-care programs. The Court felt that attempts by the federal government to close InSite were an “indisputable intrusion of the federal government into the provision of medical services”.
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Last week I found an interactive map on the Globe and Mail website that provides a big-picture look at the number of confirmed H1N1 hospitalizations, ICU admissions and deaths by province/territory and for Canada as a whole. Today, I found another great resource courtesy of the National Post.

The image illustrates how H1N1 vaccines in Canada originate from GlaxoSmithKline, the sole provider of H1N1 vaccines in Canada, and ultimately reach the general population. The image also indicates the eligibility groups province by province and provides up-to-date information on the roll-out so far.

Here is a summary of the content provided:

British Columbia:

- 1.16 million doses received.
- Over 900,000 injections thus far.
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Over and over, I hear British Columbia’s Minister of Health Kevin Falcon tell us he is following “best practices,” when he explains why certain services, such as six community based crisis lines on Vancouver Island, have been dismantled. The term is held up as a rationale for cuts to an existing and responsive tried and true system of delivery of services, particularly in regard to the Nuu-Chah-Nulth on the west coast of Vancouver Island.

Under the guise of “best practices,” the existing crisis-line services that have direct ties in to each of the communities are being replaced with a central call centre. The easy to remember number 811, so goes the rationale, will make it more convenient for those in crisis to get through for the help they need. That the call centre will be staffed by the lowest bidder for the job will make for great savings in Falcon’s system. Anyone who’s paid attention to the abject failure of corporations such as Telus to deliver useful service to its customers through their outsourced call centres should quickly understand the fundamental differences in service that this shift by the Minister of Health implies. The difference is often inconvenient and frustrating when dealing with one’s phone or internet service; it can be a matter of life and death when dealing with a crisis line for those living in remote regions whose only contact is the person on the other end of the line. It can make all the difference for the individual in crisis if the voice on the other end of the line is familiar with the community, the situation, and the unique social narrative that defines small and remote communities.
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Ontario MPP and Mayoral hopeful George Smitherman with Toronto Mayor David Miller.

When David Miller announced that he would not be seeking a third term for mayor, much speculation arose as to who would dare take the role of what is seemingly the worst political job in the country. Almost right away, Ontario Liberal MPP George Smitherman – who was Health minister of Ontario from 2003-2008 until he was shifted to Energy and Infrastructure – put his name in the proverbial hat, though no official candidacy will begin until the new year. Smitherman is MPP for the Toronto Central riding and does have experience in municipal politics, as he was top aide to former Toronto Mayor Barbara Hall. Considering his likely opponents may include John Tory, Smitherman must think he is a shoe-in for the job and has even resigned his portfolio (though not his membership) in anticipation of the race.

Smitherman will be switching political domains on the heels of the red hot eHealth scandal, which saw the resignation of Smitherman’s health portfolio successor David Caplan. Smitherman feels there should be no correlation between himself or the scandal, because eHealth was not created until after he was shuffled to the energy portfolio.
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Perhaps now doctors will start reporting medical errors.

Recently Montreal’s Jewish General Hospital has released statistics saying that reporting medical errors made during patient care has reduced the occurrence of errors by as much as 50%. Health care officials are using these encouraging numbers to work towards the creation of a province wide registry of medical errors. It is my personal hope that every province (for selfish reasons particularly my own) adopts a similar registry system. Canada isn’t the first country to be suggesting that fixing mistakes might be more effective than covering them up. For years physicians and patients have been working towards full-disclosure policies in the US and the UK.

Understandably this presents an interesting problem for many people. Encouraging numbers may finally be the salve for doctors worried about malpractice litigation and the general public not really wanting to know how frequently our health care professionals mess up.

As someone who was the victim of a medical mistake once I am in full support of full disclosure and more than that, mandatory registries of any and all medical errors. In my case the mistake that was made caused me to live for almost two years with an untreated torn ACL tendon in my knee before I finally found another doctor who took the time to find the problem. My own story is nothing compared to patients who have lost their lives or paid dearly in other ways for medication mix-ups or surgery mishaps. Medical professionals are people, and as scary as that realization may be they make mistakes and often after one mistake they again make the mistake of not reporting the first mishap in a voluntary system. It’s just not quite cutting it. It certainly is understandable as admitting to mistakes that may have endangered a patients life is a scary thing for a doctor worried about losing patients, or even their career.
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A negative-stained image of the swine flu virus.

While searching the web for accurate information regarding the number of Canadians impacted by the Swine Flu, I came across a fantastic interactive map on The Globe and Mail site. The map provides a big-picture look at the number of confirmed hospitalizations, ICU admissions and deaths by province/territory and for Canada as a whole. Although the size of the rings surrounding each providence can be misleading, the facts are not. Here are some of the figures they’ve gathered:

Deaths per million people:

All of Canada: 2.76
Newfoundland and Labrador: 0.00
Prince Edward Island: 0.00
Nova Scotia: 1.07
New Brunswick: 0.00
Quebec: 3.48
Ontario: 2.09
Manitoba: 5.79
Saskatchewan: 4.92
Alberta: 3.35
British Columbia: 2.74
Yukon: 0.00
Northwest Territories: 0.00
Nunavut: 31.85
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The Canadian government’s response to the H1N1 virus has been widely criticized for its perceived lack of foresight regarding its ability to inform and inoculate an increasingly frightened public.

Although the actual logistics of providing the vaccine are largely being seen to by individual provincial health services, Steven Harper’s Conservative government has borne the brunt of attacks about their level of preparedness in managing what the World Health Organization has been calling a global pandemic of so called ‘Swine Flu’ since August 29, 2009.

On October 21, 2009, Health Minister Leona Aglukkaq and Canada’s chief public health officer Dr. David Butler-Jones hosted a joint press conference in Ottawa to urge all Canadians to ward against this new, highly virulent and potentially deadly strain of influenza.

“I’m happy to say that today Health Canada has authorized the H1N1 flu virus vaccine,” said a reassuring Aglukkaq, “This is a milestone in our efforts to fight H1N1 flu virus.”
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There are few topics that get my blood boiling more than health care – my beloved Montreal Canadiens is one of them. What once was a trademark of Canada and a symbol of Canadian goodwill has become a shadow of its former self, run down by too many people, not enough money and inefficient practices. Something I was once very proud of, I am now very ashamed of. Oddly, my feelings on healthcare seem to mirror my feelings on Les Canadiens. But my focus here is not on hockey, or on what I’m sure is the top quality health care the members of the Canadiens receive, but the health care we receive, specifically we Albertans, since that is where I am speaking from.

Growing up under the realm of King Ralph, i watched health care fall on Alberta’s priority list. Our hospitals became crowded and seeing people sleeping in hallways became common to the point where they were simply a reality, just like filling up on gas. Small town doctors became fewer and further between, MRI’s became harder to get and hospital triage areas became backlogged and neglected. Slowly but surely, and right before our eyes, our system became based on dealing with emergencies rather then preventing them. And if you had the money, privatization was introduced as an answer to all of your problems; all of this when ironically our province was doing the best it had been doing since health care was introduced. And now, under Steady Eddy, it seems the only thing that is steady is the poor decision making streaming out of the Legislative building, beginning with the LPN vs RN debacle.
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