The West Block – Episode 7, Season 12

THE WEST BLOCK

Episode 7, Season 12

Sunday, October 30, 2022

Host: Mercedes Stephenson

Friends:

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency

Dr. David Carr, Emergency Doctor, College Well being Community

Erin O’Toole, Conservative—Durham

Bruce Moncur, Afghanistan Veterans Affiliation of Canada

Debbie Lowther – VETS Canada 

Location: Ottawa, ON

Mercedes Stephenson: Are we heading for one more well being care emergency as wait occasions in ERs throughout the nation soar?

And veterans in disaster: The pressing name for Ottawa to do extra.

I’m Mercedes Stephenson. Welcome to The West Block.

Youngsters’s hospitals have joined the ranks of ERs overwhelmed by surging instances, placing extra pressure on an already stressed system. What’s the answer? We’ll ask the docs.

Canadian veterans are ready months for advantages as they wrestle and feeling indignant over the federal government’s response to a veteran who was provided medical help in dying (MAiD) as a substitute for remedy. Is the federal government failing our vets?

Lengthy wait occasions and overflowing emergency wards are an issue all throughout this nation. Even kids’s hospitals are sounding the alarm, saying a nasty scenario is being made worse by chilly and flu season which is now upon us.

The premiers have launched a brand new advert marketing campaign geared toward getting the federal authorities to extend well being funding. So, the place are the issues and what are the options?

Becoming a member of me to speak in regards to the well being care disaster are pediatric emergency doctor Dr. Rod Lim and emergency doctor Dr. David Carr.

Docs, thanks each a lot for taking trip of your very busy schedule treating sufferers, to talk with me and our viewers about what’s occurring.

Dr. Lim, I’d like to start out with you as a result of I believe the scenario in kids’s hospitals is especially regarding and stunning to individuals. What is going on in your emergency room proper now?

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: Nicely it’s a troublesome scenario. The autumn/winter, all the time historically a time of excessive viral exercise because the climate cools and the viruses unfold simply inside indoors from colleges. We’re seeing fairly a surge in RSV sooner than we historically see it and actually, because the pandemic, the virus has actually type of damaged all the conventional timelines. We’ve had RSV really over the summer time as properly, which is remarkable. So on the present time, there’s an amazing pressure on each the emergency division, in-patient wards and ICU capability, throughout the nation.

Mercedes Stephenson: Now how lengthy would the typical pediatric affected person, do you suppose be ready on a nasty day?

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: It actually varies throughout the nation, however I believe, you recognize, anyplace from two to seven hours, relying on which emergency division you’re going to. And at the moment, I’ve seen wait occasions throughout the nation even approaching 18 to twenty hours.

Mercedes Stephenson: Wow, 18 to twenty hours. It’s an extremely very long time and I do know the scenario will not be higher for adults both, Dr. Carr. You’re with the College Well being Community. That’s lots of huge hospitals in Toronto for folk from exterior the GTA space. What’s the scenario within the emergency rooms within the hospitals that you just’re concerned with?

Dr. David Carr, Emergency Doctor, College Well being Community: We’re seeing super difficulties and actually the principle difficulties stem from the truth that we’ve had important shortages of nursing, coupled with an amazing change in respiratory viruses after which poor entry to individuals to get into their major care practitioners. So it’s nearly an ideal storm so to suppose by way of getting individuals the suitable care in well timed fashions. And I believe emergency departments are the barometer of the well being care system, and proper now in Ontario and throughout the nation, there are some alarming alerts.

Mercedes Stephenson: Dr. Lim, why do you suppose that is occurring? Is that this kind of COVID pushed an already pressured system to the brink and it began to fray and now we’re seeing the implications of that. Is it longstanding systemic issues and that’s why we’re seeing it throughout the nation and never simply in a single province, however not one other? What do you attribute this disaster to?

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: Yeah, I imply it’s the entire above. We all know that previous to the pandemic, we have been already sounding the alarm in emergency drugs of hallway drugs, mattress lock, actually having a tough time flowing sufferers by way of the emergency departments. The pandemic has been a troublesome expertise for your entire group and the general public, and we’re no exception. So we had a really exhausted well being care group that was actually giving it their all for 2 and a half years now, however after the pandemic has slowly waned, not less than inside the public’s, you recognize life, it has not been anyplace near regular within the well being care programs. And because of that, lots of people who have been contemplating retirement have left. Numerous nurses—the skilled nurses that we’ve got—have needed to resolve to vary areas, or change professions, or do journey nursing, or depart the nation and it’s left us in a fairly a tough scenario the place we’re already exhausted, we’re short-staffed and now we’ve got further stresses with the viral acuity, typically entry to well timed entry to their major care as a result of they’re overwhelmed as properly. It’s—it’s the good storm proper now.

Mercedes Stephenson: It’s robust to get into emerge. It’s additionally usually robust to get in to see your loved ones doctor, if you happen to’re even fortunate sufficient to have one. Lots of people don’t. What are the implications Dr. Carr for each workers, nurses, and docs like your self, and sufferers once we discover ourselves in this sort of a situation?

Dr. David Carr, Emergency Doctor, College Well being Community: And I’m not attempting to pin blame right here, however I believe individuals have to comprehend the significance that nurses are by way of the glue within the well being care system. And I believe individuals don’t notice that once I come to an emergency division shift, and let’s say there are seven or eight nurses down on the inner drugs flooring or the surgical flooring, which means these sufferers within the emerge division can’t get entry to a mattress upstairs as a result of these beds are closed as a result of nowhere and nobody is to take care of them. After which the externalities of that result in emergency division overcrowding. EMS, our ambulance system, our offload, they’re delayed after which individuals can’t get to the emergency division. After which as soon as they get right here, they will’t be seen. And as soon as they’re seen, they will’t go upstairs for admission. So it’s an actual cascade and it negatively impacts sufferers and well being care suppliers. We used to speak as Dr. Lim talked about about ready room drugs and hallway drugs, prior. I believe we’ve now actually shifted to only seeing sufferers in ready room and in some instances, exterior of the ready room as a result of there’s simply no bodily house.

Mercedes Stephenson: It’s irritating. It’s scary. I imply, we’re all very happy with our well being care system in Canada, however if you happen to can’t get entry, or while you’re ready in ache, or very sick and typically with life-threatening circumstances. We heard a report of 1 demise in Quebec within the emergency room as a result of the affected person wasn’t seen in time. What’s an affordable period of time that we must be attempting to attempt to get to, Dr. Lim, for a affected person to be seen after they come into the emergency room?

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: Yeah, I believe it’s—there’s a distinction between comfort and medical necessity by way of a well timed evaluation. And there are pointers by way of—relying on triage code—when a affected person ought to be capable to be assessed by a doctor, and so they’re there for security causes. Sure complaints might be very exhausting to choose up and if they’re having to take a seat in a ready room, to nobody’s fault, however far longer than any of us would love, there’s actual hurt. And there have been research out of England wanting on the impact of the well being care system on general morbidity, mortality of the inhabitants and it’s a measurable affect when sufferers are unable to movement by way of the system. And that’s everybody’s worst nightmare. We need to do the very best for our sufferers. It kills us to not be capable to try this. And the considered anybody ready longer than they should in a ready room and one thing occurring to them due to that’s each well being care staff nightmare.

Mercedes Stephenson: I suppose I’m questioning who is ready to repair this. I imply the feds level fingers on the province. They are saying it’s a provincial accountability. The provinces say the federal authorities hasn’t upped well being care transfers. We’ve been begging them for years. Sure, they gave us cash for COVID, however the system was stretched earlier than COVID. Simply funding COVID doesn’t repair the underlying points within the system. Others say it has to do with accreditation for docs. It’s too exhausting for individuals who immigrate to this nation to work as a health care provider. It’s creating increasingly more of a scarcity. We’re shedding docs to america. The place do you see the options to this, beginning with you Dr. Carr?

Dr. David Carr, Emergency Doctor, College Well being Community: So I believe it’s vital to characterize appropriately the scenario, which is not any province is doing that nice. Our nation’s not doing that nice. And internationally, there’s a world disaster by way of emergency division wait occasions—this isn’t only a Toronto, an Ottawa, a Vancouver—we’re seeing emergency departments shut, and we’re seeing wait occasions attain harmful ranges throughout the nation. So neither Dr. Lim nor I are politicians, however what clear is to each of us, is that this can be a nationwide drawback and larger than that. These are usually not easy fixes. It is a a lot greater macro drawback than micro fixes. Clearly, issues like repealing Invoice-124 which freezing nursing pay. Clearly, making it simpler to extend our pool of physicians and nurse, recognizing international skilled graduates and growing class sizes for well being care professionals will assist, however let’s recall, this isn’t going to assist this winter. And this winter, is scary each of us, significantly.

Mercedes Stephenson: Dr. Lim, a closing phrase to you.

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: Yeah, you recognize I’ll enchantment to any father or mother on the market. Two children are blaming one another and pointing their finger and you recognize the issue is sufficiently big for all of us to just accept accountability for it. On the finish of the day, this can be a advanced drawback, and much past this winter, we’re going to have to essentially have a severe dialog about well being care and the quantity of assets which can be required and the quantity of planning that’s required, whether or not it’s well being human assets or whatnot. The earlier we will have an clever, a complete dialog round it, the higher the answer will likely be. And proper now, we’ve got a right away drawback that wants and rapid answer as properly.

Mercedes Stephenson: And hopefully we discover that. I do know there’s many, many Canadians watching this, frightened in regards to the winter forward. Thanks each for the time and care you give your sufferers, and for taking the time to talk to us and educate us this morning.

Dr. David Carr, Emergency Doctor, College Well being Community: All the very best.

Dr. Rod Lim, Pediatric Emergency Doctor, Canadian Affiliation of Emergency: Thanks.

Mercedes Stephenson: Up subsequent, they fought for Canada however now many say they’re struggling for assist. Why accomplish that many veterans really feel forgotten? And is the system failing them? We’ll discover out after the break.

Mercedes Stephenson: Canada’s veterans risked life, limb and their psychological well being to serve in Afghanistan, Iraq and extra.

During the last decade, extra Canadian veterans have died by suicide than have been killed in Afghanistan.

Veterans say they’re struggling to entry incapacity advantages and a brand new report by the Veterans Ombudsman backs up that declare, saying vets nonetheless wait, on common, 43 weeks for choices relating to their incapacity claims. The report comes similtaneously staff at Veterans Affairs Canada are literally calling for the minister to resign.

Becoming a member of me now to speak about that is Conservative MP and former Veterans Affairs Minister Erin O’Toole; Bruce Moncur, the founding father of Afghanistan Veterans Affiliation; and Debbie Lowther, who’s the co-founder and CEO of VETS Canada, a charity that helps veterans in disaster. So our viewers know, we’ve got additionally repeatedly reached out to the Minister of Veterans Affairs Lawrence MacAulay and he wasn’t accessible, however we’ll preserve attempting. It is a dialog that we’re going to have anyhow as a result of we predict it’s essential. Thanks all for becoming a member of us.

You already know, Bruce I need to begin with you. I’ve talked to lots of mates and contacts and sources who’re veterans in current weeks and heard of numerous deaths by suicides. It is extremely painful and really tough for the group, all the time and there’s an actual sense of despair and concern about vets points not getting consideration. What are you seeing as an advocate proper now within the veteran’s group?

Bruce Moncur, Afghanistan Veterans Affiliation of Canada: I’m seeing that, you recognize, that the present authorities has failed to grasp the issues, and even frankly, care, and the triple D coverage: delay, deny, die is alive and properly.

Mercedes Stephenson: Debbie, I do know that you just work with veterans who’re in extraordinary disaster. I’ve been out of the walks that you just do by way of downtowns, searching for vets who’re on the streets, attempting to assist them. What are you seeing in your place proper now with Canadian veterans?

Debbie Lowther, VETS Canada: We’re seeing veterans who’re very disheartened. You already know, lots of them have expressed that they don’t really feel valued. They don’t really feel vital. And, you recognize, to be fairly trustworthy, these—we’re listening to these complaints increasingly more usually, particularly with, you recognize, as you talked about earlier, the wait occasions and, you recognize, the growing rising costs of issues, veterans have gotten increasingly more in disaster like different Canadians. However, you recognize, these are women and men who put their lives on the road for our nation, so I believe we owe them much more than what we’re offering.

Mercedes Stephenson: Debbie, what’s the consequence for a few of these veterans if they’ve to attend 43 weeks for a incapacity fee?

Debbie Lowther, VETS Canada: It’s not good. You already know, we’ve needed to assist some veterans for lots longer than we usually would, to type of bridge them over that point interval. We’ve talked about to many case managers about having recordsdata purple zoned and what we preserve listening to is that that doesn’t make a distinction anymore. So previously, a file might be purple zoned and it could, you recognize, it could be slightly bit faster. However what we’re listening to now could be that’s not efficient anymore. So veterans are ready, they’re struggling and so they’re getting additional and additional behind and it’s having a larger affect on their psychological well being.

Mercedes Stephenson: That’s clearly, extraordinarily alarming and regarding you could be purple zoned and nonetheless not get an answer. Erin, you recognize, the Trudeau authorities’s taken lots of hits on this as a result of they promised veterans they’d by no means should combat in courtroom that they might do higher. The identical issues appear to exist. You have been a minister of Veterans Affairs. The Conservatives had their challenges too, however while you take a look at the situation now, what stands out to you as a former minister as one of many greatest issues veterans are going through?

Erin O’Toole, Conservative—Durham: Nicely two-fold, Mercedes. The primary is you all the time owe veterans and their households the reality. And the Trudeau authorities began by saying they have been going again to the outdated pension system. They didn’t try this. They haven’t been clear on lawsuits just like the Equitas lawsuit. They usually mentioned they might meet the 16-week wait time. And now you mentioned we’re at 43 weeks. So that you owe them the reality, first off. Don’t make guarantees you’ll be able to’t preserve. However second, the division, and actually the Canadian Authorities must broaden psychological well being providers extra, as a result of a lot of the delayed instances are advanced operational stress accidents and Bruce and Debbie know this as a result of they’re on the entrance strains. Should you don’t get that veteran and their household remedy or wellness, it might spiral into dependancy, homelessness, and Debbie and her group attempt to discover individuals who have already fallen by way of the gaps. So we’ve got to shut that wait time down and we want extra choices by way of psychological well being remedy as a result of bodily accidents typically have one remedy choice. Psychological well being, it might take two or three earlier than the veteran responds, so we have to ramp up psychological well being helps dramatically.

Mercedes Stephenson: Bruce, you and I have been talking about psychological well being earlier than the present. It’s one thing that we discuss continuously and it’s one thing that basically got here to the forefront partly, this summer time once we broke the information {that a} veteran had been provided medical help in demise, when he wished remedy for his traumatic mind damage and his PTSD. That had a really actual psychological well being consequence for him and for different veterans. It’s been the topic of parliamentary hearings that the minister appeared earlier than. The division says that this can be a one-off type of unintended case. It’s not imagined to be occurring. However I’m curious to listen to from you, lots of veterans felt that that was believable, and that struck me that they might imagine that the federal government would intentionally advance that coverage. There is no such thing as a proof that that’s what’s occurring. It seems to be this one explicit case. However the place are veterans at of their notion of how they’re being handled? And the way does one thing like that made supply have an effect on them?

Bruce Moncur, Afghanistan Veterans Affiliation of Canada: Nicely lifeless veterans price no cash and I believe it could be—it’s not the case supervisor’s job. They don’t seem to be certified to make these assessments by way of made. And admittedly, I imply the truth that it was provided, is disgusting, however the truth that the federal government had—how they’ve dealt with it since, is even worse. I requested—myself, I’m the co-chair of the Service Excellence Advisory Committee to the minister and requested for a gathering proper after it occurred and was denied, after which was informed to attend for the assembly that will occur. Sadly, the Queen’s passing occurred so that they determined to cancel that assembly. After which simply yesterday, they gave us 24 hours’ discover for a brand new assembly to occur yesterday and so they briefly touched on the MAiD matter and admittedly, known as your reporting into query with a few of their statements.

Mercedes Stephenson: And it’s been very tough to get solutions about this investigation. They are saying they’ve carried out it, however additionally they say there aren’t any recordings of the calls, that they’ve reviewed recordsdata however they’re not detailing how. They’re saying investigation’s nonetheless open. Debbie, I assumed it was actually fascinating that we heard the Union of Veterans Staff calling for the resignation of the minister. That’s fairly drastic. It appeared like he was blaming, at occasions, the staff throughout the listening to. He wasn’t essentially taking accountability because the minister, which I’m going to place to Erin as a result of he’s the politician, in a second. However out of your perspective, the place is the issue right here? Is it the division or is it the kind of machinations and bureaucratic purple tape behind the scene? Is it the minister and the federal government? The place does the work have to be carried out?

Debbie Lowther, VETS Canada: Nicely I believe there’s—it’s a really advanced subject, however I believe on the core of it, is coaching for the Veterans Affairs case managers. That’s who we cope with day-after-day. About 80 per cent of the referrals that we obtain do come from Veterans Affairs case managers and a few are excellent and so they know what they’re speaking about. After which there are others which can be simply—they’re baffled by their very own advantages. They will’t perceive them themselves and to allow them to’t clarify them to the veterans. So, you recognize, there’s a giant hole there with coaching in advantages, I believe, and now, clearly, a spot in coaching for, you recognize, issues like MAiD. As Bruce mentioned, you recognize, case managers are usually not certified to be discussing that, nor are they imagined to be, based mostly on the regulation. They’re not well being care suppliers, so that they shouldn’t be discussing it. However I believe coaching is—can be an ideal first step.

Mercedes Stephenson: Erin, while you have been watching these hearings on medical help and demise and, you recognize, type of felt like a little bit of a shrug on each the division’s half and the ministers as oh, it’s a one-off. Sure, it’s horrible. Let’s transfer on. What have been your ideas on that?

Erin O’Toole, Conservative—Durham: I discovered it horrendous. They—they’ve already failed one household as a result of they referred to 1 case employee, referring a veteran to MAiD and that they’re supporting the household. This must be not solely the cultural coaching and the sensitivity coaching for the case staff, I agree with Bruce and Debbie. We shouldn’t be having MAiD for individuals with treatable psychological well being circumstances. And significantly when a veteran seems like they’re a burden on their household and may’t entry helps, they’re weak. And the courts going again 20 years have warned that assisted dying for individuals with psychological well being situation, in the event that they really feel that they’re a burden, they are going to be compelled, or pushed, or pressured into accessing assisted dying, once we must be treating them. In order I mentioned earlier, Mercedes, the—the entire division, and as a former minister, I take blame, I ought to have moved sooner. We wanted to maneuver out psychological well being helps a lot sooner as a rustic. It’s solely been made worse by the pandemic, as a result of we have to get these veterans remedy and wellness, not have a case supervisor awkwardly referring them to MAiD. That’s going to trigger extra hurt than good. So I actually don’t suppose we must be having MAiD in these circumstances in any respect, actually not a division of the federal government encouraging it.

Mercedes Stephenson: Nicely and I do know like there’s—there’s a debate from individuals over whether or not or not of us who’ve psychological well being circumstances ought to be capable to entry if they will’t technically, proper now. I believe it’s March of 2023 that kicks in. The division can’t supply it, however nonetheless, this case work—it wasn’t even a case employee. She was similar to a cellphone financial institution worker at Veterans Affairs has this dialogue. Bruce what’s—what’s the impact of that type of a dialogue? Some individuals say properly what’s the issue with veterans understanding what their choices are? Why are you towards that?

Bruce Moncur, Afghanistan Veterans Affiliation of Canada: So I believe that is the place you’re going to start out having copycats. Like suicide begets extra—begots extra suicides and that’s—that’s a giant drawback. You keep in mind a few Christmas’s in the past the place it simply appeared like there was a brand new veteran taking their life day-after-day and admittedly, I imply we’re having, you recognize, many take their lives and just lately. I believe that that is indicative to a division that isn’t well-placed in Prince Edward Island and it’s the one division that’s exterior of Ottawa. I believe that must be addressed and introduced again into Ottawa. And I believe we’re—we’ve bought a minister doing his greatest Joe Biden impersonation. This isn’t Ronald Reagan’s second time period. We’d like a minister that, you recognize, the bar wasn’t set very excessive along with his predecessors and he appears to be not even be capable to make that. So I believe, you recognize, with the employees calling for his resignation, I believe it’s—it’s as properly, warranted and admittedly, as a member of advisory committee, I’d—I’d counsel the identical.

Mercedes Stephenson: So that you suppose the minister ought to resign, Bruce?

Bruce Moncur, Afghanistan Veterans Affiliation of Canada: A 100 per cent, sure.

Mercedes Stephenson: A fast closing phrase to you, Erin. Do you suppose the minister ought to resign?

Erin O’Toole, Conservative—Durham: This all the time must be a minister who’s very succesful, very hands-on and action-oriented and Mr. MacAulay will not be like that. So he’s bought to both step up or step out.

Mercedes Stephenson: Thanks to the three of you for becoming a member of us. This is a matter we’re going to proceed to comply with. It isn’t simply once we take a look at it close to Remembrance Day. However we very a lot recognize your time and your ideas right this moment.

Erin O’Toole, Conservative—Durham: Thanks.

Mercedes Stephenson: Up subsequent, what we’re watching: Finance Minister Chrystia Freeland delivers the autumn financial replace, and convoy organizers will testify on the Emergencies Act Inquiry. We’ll be proper again.

Mercedes Stephenson: As inflation soars and the opportunity of a recession looms, many Canadians are frightened about what all of it means for the economic system.

Finance Minister Chrystia Freeland will reveal the federal government’s outlook when she delivers the autumn fiscal replace this Thursday.

And key freedom convoy protest organizers are scheduled to testify this week on the Emergencies Act Public Inquiry. We’ll regulate that, too.

That’s our present for right this moment. Thanks for watching. For The West Block, I’m Mercedes Stephenson. I’ll see you proper right here subsequent Sunday, and I hope you’ve an ideal week.