Thursday, January 17, 2013

Save Our Medevac Services - and Some Thoughts on What Fort McMurray Deserves

It's an issue that has been simmering for some time, years in fact, way back when Edmonton City Council decided that the land under which the Edmonton City Centre Airport stands should be used for something other than an airport. That airport, a small inner city one, was the airport of choice for many of those who travelled into Edmonton from remote destinations in the north as it is so centrally located - and that is exactly why that airport became the destination of choice for medevac services from the north, too.

Last night I attended a session at MacDonald Island that was designed to inform local residents about the issues surrounding the closure of the City Centre Airport, particularly in terms of the impact on medevac services. In attendance were members from the SOS group, or "Save Our Medevac Services", a coalition of concerned physicians and medevac personnel. There are many who believe this is a dead issue, long decided and dealt with, and that no more can be done to change the outcome, but SOS disagrees. They believe that residents in the north should be deeply concerned about the airport closure, and last night they detailed some reasons why.

It's all laid out pretty comprehensively at their website, but what it boils down to is this: according to a study done in 2011 approximately 5000 people per year are medevac'd into the City Centre Airport. Of those about 58% are considered "time sensitive" - meaning that the outcome and prognosis can be affected by time, and that increased time before proper medical attention can mean the difference between life and death. That is deeply worrisome for anyone who lives in this community, or at least it should be because that has the potential to impact any of us at any time.

The current situation is that patients are flown by fixed wing air ambulance (using the Beechcraft King Air 200, a plane I know well from my days in a small northern airline in Ontario - they were the little workhorses of our fleet) into the City Centre Airport. They are then transported directly to Edmonton hospitals, some of which, like the Royal Alex, are just minutes away. This allows for minimal transportation time and improves patient outcomes in critical cases. As of February 15, 2013, medevac services are being relocated, however - to the Edmonton International Airport, a destination significantly further away from the hospitals critical patients require.

There is no doubt this is a worrisome development. There is grave potential for increased transit times, and according to SOS we will go from having some of the best patient transfer times in the country to the worst, and as a community advocate this troubles me deeply. I want to see our residents receive medical treatment in the most timely way possible, and anything that increases the time to access services concerns me as it can have a very serious impact on those of us who may one day rely on medevac. The issue isn't a simple one, though, because while health care is a provincial issue the airport belongs to The City of Edmonton, and is under their municipal control.

Now, SOS believes that at this point the Alberta government should step in and reverse their decision to relocate medevac services as of February 15th as they feel a solid and reliable alternative has not yet been found. The new plan will be to fly critical patients into EIA, and then transport them to local hospitals by ground ambulance (certainly adding to transit time, there is no arguing this), or from EIA to hospital helipad by helicopter in the most critical cases. The members of SOS express deep concern over the workability of this plan as they do not feel it will best serve those northern residents who may require these services, and I think those concerns merit some consideration as well. I do not feel the provincial government has made it entirely clear how this change will affect medevac transit times, and the potential impact on those who end up in those airplanes and ambulances (and their families). If doctors such as Dr. Pawluski from Edmonton and Dr. O'Connor from right here in Fort Mac are concerned, and if air ambulance pilots and staff are concerned, then I am too. Those individuals know a helluva lot more than I do about the issue, and if they express deep worry about the impact this will have on the patients for whom they advocate(and others) then this is something we need some answers about, and before the February 15th relocation of services.

There is a significant divergence on one point for me, though. One of the things SOS proposes is that the Edmonton City Centre Airport remain open to medevac services for the future by means of the provincial government expropriating the land from the city of Edmonton. Now, this concerns me on two levels. One, I am not sure we wish to see this kind of precedent set, as what then prevents the province from expropriating land right here in the RMWB for which we may have other plans? If we advocate doing that to another city what prevents other cities from advocating for land expropriation in our region? This is a troubling slippery slope to me, and one that we would need to think about very carefully before placing a foot on it - but my second concern is the more important, actually. Why are we relying on other cities for such vital medical services anyhow? Instead of advocating for or demanding expropriation why aren't we demanding a long term solution that better benefits our region? Why aren't we pushing for our own world-class hospital right here in the RMWB?

I am going to use those two words again: economic engine. It is quite clear we are the economic engine of this province, this country, and to some extent this continent. The oil sands industry has the potential to pour trillions of barrels of oil, and trillions of dollars, into our economy. We have a population of 100,000 that is expected to grow rapidly and with intensity. So why exactly are we medevacing patients out to another city for medical care that quite frankly should be available right here? Why shouldn't we demand a tertiary care hospital capable of dealing with trauma and other emergent health issues right here in our own community?

I believe we have every right in this region to expect timely access to medical services, including services of the sort you find in Edmonton and Calgary. I reject the idea of expropriating the land in Edmonton because in the end all that sees us doing is continuing to medevac our residents to their hospitals, which does not in my opinion have quite the same benefit as having those services right here in our own community. There is no reason that cannot happen, and so I am requesting two things:

1) The Alberta government needs to provide a detailed and coherent explanation of how they believe the relocation of medevac services will affect this region. If this explanation continues to raise concerns and questions I suggest medevac services at the Edmonton City Centre Airport be extended past the February 15th relocation date until such time as those concerns and questions are addressed. SOS has claimed this relocation was the decision of the provincial government and that the ECCA will remain open for an indeterminate period of time so perhaps we take the time required to do some work into the exact impact this relocation will have, and address ways to mitigate that impact.

2) The Wood Buffalo region advocates for a full-service tertiary care hospital right here. We begin to see ourselves in the future as the home of medical excellence, with all services available here and foregoing the need to medevac any patients to other communities. Instead of being one of the communities where you see medevacs leaving we become one where you see them arriving, bringing patients from smaller communities to our hospital for the care they need and deserve.

The clock is ticking on this issue. One month from today, if things do not change, medevac services will be relocated, and I do not believe this community or those in it currently have a full understanding of the potential impact. This is your clarion call. Get educated on this issue, and then decide what you feel is the appropriate course of action. SOS suggests emailing Edmonton MLAs and the Premier to demand action on this, and I would suggest also contacting Alberta Health Services to express your concern. Whether you choose to insist on a delay of relocation of medevac services, or land expropriation to preserve medevac services into the ECCA, or, like me, a tertiary care hospital right here in Fort McMurray, this is your opportunity to do something. There are no guarantees that your action will change anything, but I can guarantee inaction will change nothing.

I have a vision here, folks. My vision is of a Fort McMurray with a centre of medical excellence, a hospital facility that people are medevac'd into, and not away from. I envision a community that never needs to leave for other cities to seek medical care, emergent and otherwise, because it is available right here, in the region that is driving the economy of the nation. To me that is truly the only acceptable long term outcome, because I am tired of being behind, playing catch up, and having less than what we deserve and need. Our current hospital does an admirable job, so this should not be taken as a criticism of their role in this community. Rather I want to see that enhanced and brought up to world class standards, because that is our goal in this community. We believe we should be a world class community, with world class facilities, and a world class industry. I firmly believe that a fundamental part of that is having world class medical care. This is an opportunity for us to start advocating for exactly that, while also seeking a fuller understanding of the short term situation and solutions. And it is all about educating yourself.

At the end of this post I am providing a link to the Save Our Medevac Services website. From there you can find the link to email members of the provincial government to have your say. My firm belief is that knowledge is power - so here is your chance to gain some knowledge, people. Now go exercise your power.

1 comment:

  1. All good points being raised and I am in agreement every community in Alberta not only yours should have state of the art tertiary care facilities like the ones in Edmonton and here are some points to consider in this regard.

    1. State of the art tertiary care hospitals like the ones in Edmonton take time to build.
    2. The cost to build even one of these hospitals is exorbitant.
    3. Staffing them with the necessary doctors and related personnel trained in specialized care and treatment is another point that needs to be considered.(there are shortages in these valuable personnel now even with the hospitals and medical facilities currently in place)
    To arbitrarily close down timely access to greatly needed and timely health care is a bad decision on all levels of government and needs to be addressed with expediency. As of this comment by myself the move of the medevac services to the airport in Leduc has been moved to March 15 2013
    More Important points to consider:
    This move has been delayed first from December 2012 to February 15, 2013 and now has been delayed once more until March 2013.
    If this move was such a great idea why the delays in the first place.?
    Would it be because there are items still on the table to be mitigated in an acceptable manner?
    This move needs to be delayed indefinitely until this current Tory government can absolutely guarantee the safety and continued timely access to health care that is in place right now via the Edmonton City Centre Airport. I live in Edmonton and see the issues regarding this unmitigated move because I also travel the highways and byways of Alberta and expect timely health care access via medevac if anything were to happen while on the road. Speak up Alberta let your voices be heard loud and clear regarding this unmitigated move of timely services that have served northern communities for years.

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