Alberta’s rural health-care system needs more public funding, more efficiency and much more local autonomy, residents and esteemed panellists said at Pincher Creek’s health-care forum in late April.
Upwards of 150 people came for a one-hour discussion that saw residents, politicians and one riding candidate engage local doctors and public health policy researchers from the University of Calgary.
Between panellists who said the status quo isn’t holding and residents who said they felt ignored by the province, the conversation registered an uneasy mix of frustration and hope for the future.
‘If you want to find someone who can fix this, find a mirror’
Drs. Gavin Parker and Kristy Penner, both of whom practise family and emergency medicine in Pincher Creek and neighbouring Crowsnest Pass, repeatedly called for more community involvement.
“If anybody can help solve this, or at least start to work on this, it’s the people in this room,” Parker started off.
“I do think there is hope,” he continued, qualifying in the next breath that “Clearly, what I’m doing and what we’re doing isn’t working.”
Penner’s prognosis was no less sparing.
“If we keep doing the same thing, we’re only going to be waiting longer” for routine medical services, she told the packed forum, painting graver implications for women and the elderly.
“You’re going to have to leave [home] to have a baby — you won’t be able to get surgery in Pincher Creek or Crowsnest Pass. You won’t be able to get home care or long-term care in your community. And as a senior, you’ll have to move out of your community to access long-term geriatric care.”
The College of Physicians and Surgeons of Alberta is working to fast-track foreign-trained doctors’ credentials, while licensed practical nurses are picking up the slack at Pincher Creek’s medical clinic, according to Parker.
But the system can’t build capacity when there aren’t enough doctors to train med school graduates, much less foreign doctors.
“Our voice is stronger when it’s collective,” Parker said, acknowledging the residents on Pincher Creek’s Attraction and Retention Committee, the citizen/council body that helps settle incoming doctors within the community, among other functions.
Parker also noted that Albertans who work outside of medicine make up a significant proportion of the CPSA’s board of directors.
“So, if you want to find someone who can fix this, find a mirror. That’s who,” he said.
It’s Friday night: Do you know where your MLA is?
Audience speakers questioned how civic participation could reverse the Government of Alberta’s concentration of authority in a sclerotic Alberta Health Services, the provincial health authority that executes government policy.
“I’ll vote for any party that starts taking that system apart and returning power to the community so that we can make a difference with some of the things you’re asking us to make a difference on,” one speaker said.
Another speaker noted that United Conservative MLA Roger Reid, who represents Livingstone-Macleod, was conspicuously absent.
“Where’s our MLA?” the speaker asked, drawing groans from the crowd.
“Is anybody from the Alberta government here?” another speaker asked. “Maybe that’s part of the problem,” the speaker suggested, drawing thunderous applause.
In the crowd were town Coun. Sahra Nodge, MD Coun. Dave Cox and Reeve Rick Lemire, and a host of doctors and nurses from Pincher Creek Health Centre.
The NDP’s Kevin Van Tighem, the only riding candidate to show, suggested that Pincher Creek has the talent and the grit to restore the health centre to a model of rural health care.
“Do we have to change ourselves? Or can we change medicine so it fits into our community without the community changing?” he asked from the mic.
The UCP’s 2023 provincial budget funds public health care to the tune of $24.5 billion, a roughly four per cent annual increase. This year’s budget includes $105 million for capital projects under the UCP’s Rural Health Facilities Revitalization Program.
Don’t expect a quick fix
Funding and educational programs need to deliver a robust, “team-based” rural health-care model that empowers Indigenous and rural learners to practise medicine, Dr. Penner explained.
More immediately, Penner said, doctors-in-training have complained about a lack of affordable housing and limited child-care options in Crowsnest Pass.
Melissa Fredette, a registered nurse at the health centre, vice-chair of the town’s Attraction and Retention Committee and mother of three, implored the community to promote Pincher Creek as a career destination for young health-care providers. But Fredette and her colleagues need more local support.
“We’ve just come out of a pandemic. We’re tired in health care,” she said. “We would love to have more help from the people here.”
Once it’s gone, it may never come back
Aaron Johnston, associate dean of rural medicine at the U of C, warned after the forum that many rural health-care teams are on the verge of collapse.
An under-resourced team “works until it doesn’t work — until there’s the loss of that last one person,” he said. “Lose a rural anesthetist and say goodbye to that town’s surgical team. Lose a team, and good luck restoring the services it was designed to provide.”
“Imagine how difficult it is to recruit 10 highly-trained medical staff at the exact same time,” he suggested, “because that’s what it takes to reboot these services once they’re gone.”