Members of the Bonnyville Health Centre medical staff and local politicians held a public rally outside the health centre last Thursday, expressing concerns and discontent at the impending elimination of the pathology positions in Bonnyville by Alberta Health Services (AHS).
Dr. Leonard de Freitas, president of Bonnyville's medical staff, who submitted a letter to the Nouvelle two weeks ago, contesting the plan to shut down the pathology department, was on hand to speak to individuals about his concerns.
“The biggest issue for us here is focusing on getting support from the community and making them aware of the fact that AHS is planning on eliminating all pathology services in Bonnyville effective Oct. 1 this year,” de Freitas said. “The pathology department is such a vital part of us providing good quality care to patients and we feel very strongly that this is a service worth fighting for.”
De Freitas was joined outside the health centre by retiring pathologist Dr. Bob Davey, Roy Doonanco, chair of the Bonnyville Health Centre Board, Bonnyville Mayor Ernie Isley and town councillors Gene Sobolewski and John Irwin.
After Davey announced he would be retiring this year following 25 years of service, AHS concluded it was necessary to terminate the program in order to “ensure patients continue to get the care and treatment they need” according to a written statement by AHS released Aug. 9.
The release stated neither AHS or Covenant Health consider solo pathology practices to be an “optimally safe or effective way” of providing pathology services, a message echoed by AHS North Zone Medical Director Dr. Kevin Worry.
“The biggest concern for us here is patient care. The retirement of one of the two Bonnyville pathologists means changes have to be made in the local pathology service model in order to make sure patients get the same level of care and treatment they need,” Worry explained in an interview with the Nouvelle last Friday.
For the past 25 years, Davey has been charged with recruiting pathologists when a position opens up, but Worry said there are a number of things AHS considers before recruiting for a vacant position.
“When we look at anybody retiring we always look at what the local health service needs are,” Worry said.
In its statement AHS clarified, “Onsite pathologists are only mandatory and absolutely required when cancer surgeries that require an immediate intra-operative on-site consultation by a pathologist are performed. While biopsies of many types are performed in Bonnyville, such cancer surgical procedures are not undertaken at the health centre making the decision whether an on site pathologist is required in Bonnyville is dependant on a number of other factors.”
De Freitas refuted those claims and said he's worried about what the Bonnyville Health Centre stands to lose in the future if the public is not made aware of the planned cuts.
“The concern for me further away from this issue is what we stand to lose down the road,” de Freitas said. “The next thing to follow will probably be microbiology, which focuses on such things as throat cultures and blood cultures which are vital for a number of things.”
He added, “I'm just worried about being left with only basic lab services. We live in a community that is rapidly growing, I see it in the clinic and the emergency department every day. There has been a huge escalation of the amount of patients in this area and I feel this is a step in the wrong direction. I don't think it's about the quality of care being provided and that's why we feel so strongly about this and felt the need to stand up and protect our patients, because that's what we're trained to do.”
Brian Storseth, Member of Parliament for Westlock – St. Paul, said he was in staunch opposition of the cuts AHS plans to make and said it should be looking at improving services rather than taking them away.
“First of all, I feel like the decision made by AHS to terminate the pathology program in Bonnyville goes along the lines of centralizing these types of services. It's not a positive for rural health care delivery and it's not a positive for our communities,” Storseth said.
According to Storseth, the federal government has bulked up its spending on improving rural health services, investing millions of dollars on encouraging graduating medical students to work in rural areas. He believes that to be a reason AHS should reconsider its current position to cut rural healthcare.
Storseth said, “Hopefully they see the level of opposition this has received and change their mind, because we in rural areas rely on this level of service and it would be very troubling to see it go.”
Bonnyville Mayor Ernie Isley, who helped generate funding for the construction of the Bonnyville Health Centre as MLA in 1986, said he was unhappy with the approach AHS has taken.
“I've always taken pride in our health facility and have been impressed with the staff and level of service they provide to our residents,” Isley said. “I can't say I'm surprised to see AHS make these reductions, but I am disgusted with they way they have approached it. I was assured through AHS and through the VP of Covenant Health that everything was on hold until late September and we would be consulted about any changes. That clearly hasn't been the case.”
He admitted that losing the pathology department would be a blow both to the hospital and the residents of the 15 communities it services, and said it seems the province is making an added effort to centralize rural health services.
Retiring pathologist Dr. Bob Davey explained some of the duties the pathology department carries out and expressed both his surprise and sorrow at the decision to close the Bonnyville lab.
“The pathology department at the Bonnyville Health Centre runs a full spectrum diagnostic lab that is basic and extended in microbiology, basic hematology, basic coagulation studies, blood bank, and chemistry testing and analysis,” Davey said. “We usually do between 500,000 and 600,000 procedures in a year and service communities from Provost, north of Cold Lake, west out to Lac La Biche, Athabasca and Boyle and then into Vegreville, so we're seeing a lot of people.”
Davey said he doesn't believe claims by AHS that this service reduction is to maintain quality of service.
“I don't accept AHS claims that this is about quality of service and recruitment issues. I think their concerns are maybe valid, but we as a health centre have always succeeded when it comes to recruiting. In terms of quality of service issues, we've had the key factors of the provincial quality improvement program in place now for close to ten years, long before the province even conceived the idea.
“On a personal basis, it's an extremely sad time to see the pathology department potentially close, but looking at it as a burgeoning senior citizen who may need these services at some point, it's a little more threatening knowing local doctors won't have the support they may need.”
Worry said AHS has never had any problems with the quality of service offered in Bonnyville and commended Davey for the job he and his fellow pathologists have done in the area over the past 25 years.
“There won't be any change in the level of pathology service that Bonnyville patients will see. We're looking at making a transition so it is more consistent with the Alberta Quality Assurance Plan,” Worry said, adding all pathology services will be reverted to Edmonton.
He said initial discussions began in June and that AHS had met with Bonnyville Health Centre officials Aug. 2 and plan to hold further discussions this week.
De Freitas maintains there have so far been no notable discussions and once again emphasized his hope that AHS reconsider terminating the pathology program in Bonnyville.
“I would love to sit down with AHS just to get a clear indication on how they propose to go about making these changes…So far that hasn't happened, but I'm hopeful,” de Freitas said. “The emphasis should be placed on enhancing the health care service and system here in Bonnyville, not breaking it down.”
