Ahead of the Heard
It’s an issue that never goes away for citizens living outside of the major urban centres of Alberta – and that’s the fate of their local hospital. Recently an urban daily once again tried to make a case that many so-called rural hospitals need to be closed because they serve only a small population. It’s not the first time the urban media has taken on the value and need for those facilities. Invariably the insinuation is that they are a waste of money which could be used to support health care in urban Alberta. That perception is simplistic and doesn’t provide much insight into the ramifications of closing those facilities. To be fair the rural hospital issue was just a part of the city newspaper’s series on the state of all health facilities in the province.
First off – it seems city reporters have little perspective of how critical the availability of local health services is to those living outside the main towns and cities. City folks take it for granted that they can get to an emergency hospital in twenty minutes or less. Rural residents in many cases are lucky to get to a hospital in two hours – city people would be out in the street demonstrating if they had to endure such a wait time. Those that rail against rural hospitals have no clue how that massive wait time creates real anxiety in rural society. I should say there are exceptions – those being city folks who get into out of town car accidents, or get injured whilst on outdoor recreational pursuits, or workers from cities who get injured on rural worksites. Those unfortunate folks are probably quite grateful that they were able to get treatment at those money-losing rural hospitals. I note no city reporter ever suggests that small hospitals near ski and vacation resorts be closed. But I digress.
Second off – and this seems to elude those that want rural hospitals closed – sick or injured rural residents, workers or travellers don’t just disappear when you close local hospitals. They end up exactly where you don’t need them - in big city hospitals – making their patient congestion problem even worse. Well duh! At times some big city hospitals are up to 30 per cent filled with out of town patients. Most folks with any common sense would surmise that figure would increase significantly once you start closing rural hospitals.
Third off – one has to be rather politically naïve to believe that any money saved by closing rural facilities will actually be used to significantly expand health facilities in big cities. Alberta Health Services, the bureaucratic monster octopus that governs health care in this province, could just as easily waste all the millions that would supposedly be saved. Keep in mind; those saved millions are a bit of an illusion, being rural patients haven’t disappeared as they will still incur costs for their treatment in overflowing urban hospitals. When bean counters start to evaluate the financial implications of closing rural facilities, they need to cost out those ongoing and extra costs that will still continue for patient care. I suspect no such honest cost study has yet occurred.
Having said all that – the situation can be made better, more efficient and maybe less costly if the approach was based more on positive innovation rather than arbitrary closings and taking away people’s security and rights. What about designing facilities that can provide a variety of health care services – such as long term care facilities for seniors along with doctors’ offices and a small emergency facility all in one building. What about expanding the emergency role of nurses where local doctors are not readily available. What about examining what’s been done in other countries like Australia and New Zealand – how do they provide services to their far flung residents – no point in reinventing wheel. What about an honest evaluation of how the STARS system of ambulance planes and helicopters can be expanded to replace rural facilities or provide better service.
In the end any real action on this issue will depend on politics. Rural hospitals and their fate depend on what political price is involved – if it’s one thing rural politicians fear it’s the closure of a hospital in their riding. They will lobby intensely to stop a closure – which tends to forestall any hopes of some innovative concepts to make the situation more efficient but with less facilities.
One thing for sure – don’t expect any changes or new ideas until after the next provincial election.