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Category "Health"

14Oct

B.C. school districts target vaping, call for increased regulation

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https://vancouversun.com/


Vaping products are battery-powered devices that heat a liquid solution to create an aerosol and typically contains nicotine or THC, the active psychoactive ingredient in marijuana.


Ranta Images / iStock/Getty Images plus

KELOWNA — A British Columbia school board says it has “serious concerns” about the risk of vaping and is asking all levels of government to take action.

In an example of how school districts are grappling with the new products amid shifting regulatory frameworks, the Central Okanagan School District outlined in a letter to parents on Friday how it is working to curb the use of e-cigarettes by students.

Since May, the school district says it has met with local municipal governments to encourage the development of bylaws to prevent advertising and targeting sales to minors.

It also says it supports proposed new provincial regulations, and the school board voted to write to local federal candidates asking how, if elected, they would address the “serious danger” posed by the electronic devices.

The board specifically asked how candidates would address the marketing of vaping products to children.

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Vaping products are battery-powered devices that heat a liquid solution to create an aerosol and typically contains nicotine or THC, the active psychoactive ingredient in marijuana, but Health Canada has warned people who vape to monitor themselves for symptoms of pulmonary illness.

“The Central Okanagan School District continues to have serious concerns about the impacts of vaping on human health,” the letter from Superintendent Kevin Kaardal says to parents.

School staff are focusing education on middle school students and will continue to enforce a “no-vaping zone” on school property, it says.

School principals have been instructed to confiscate any vapour products they see on campus.

“If staff see vaping products on school property, they may confiscate them and turn them over to the RCMP,” the letter says.

In B.C., the rules around the sale of vapour products are the same as cigarettes and it is against the law to sell to someone under the age of 19.

Health Minister Adrian Dix said this month that a plan will be released in “the coming weeks” to deal with regulatory change and suggested licences would be required for vendors to sell the products.

The Central Okanagan School District isn’t alone in trying to address teen vaping.

The Sooke school district said vaping is becoming an “epidemic” among teens, ahead of an information session it held in May.

In August, the Vancouver school district issued information handouts to teachers and parents.

“Teachers are in a unique position to provide unbiased information about the adverse health effects of vaping to students and their families,” the package for teachers says.

The parents’ handout says the long-term health effects of vaping remain unknown.

“As caregivers, you can connect and discuss issues around vaping products with your child,” it says.

Two teenagers filed a lawsuit in the B.C. Supreme Court Sept. 30 against popular vape brand Juul alleging they suffered “adverse health conditions” after using the company’s e-cigarettes beginning in 2018.

Juul has not yet filed a response with the court.

3Oct

Vancouver surgeon’s I’m a HIPpy program helps kids around the world

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Six-year-old Mattias Thompson loves to play hockey, but he was born with a rare hip disease that is keeping him off the ice. However, thanks to early intervention and surgery, the Grade 1 student from Chilliwack may just have a chance to get back in the game one day.

Mattias is a major Pittsburgh Penguins fan, and loves sports, says his mother Nikki Thompson. While it may be years before he can play hockey, the family is hopeful he will be able to play baseball next year.

Dr. Kishore Mulpuri, the orthopedic surgeon at B.C. Children’s Hospital who performed Mattias’s surgery, said it’s too soon to comment on his long-term prognosis, but said he has a much better chance of a full recovery because of early treatment.

“We caught it very early and that will help him. If he was older he would be more at risk for arthritis. So we want to get it to as normal as we can,” said Mulpuri.

Mulpuri was recently awarded a $450,000 research grant from the federal government’s Canadian Institutes of Health Research program for his team’s project, I’m a HIPpy, which he started three years ago to help children here and in other countries receive early screening and treatment for hip dysplasia and other hip conditions.

Mattias was diagnosed with Legg-Calvé-Perthes disease, which restricts blood supply to the femur, eventually killing the bone. He spent weeks at B.C. Children’s in April having a full hip reconstruction. Preparation for that surgery included five days where for 23 hours a day he had to be in traction with his legs splayed apart.

In the summer of 2018, Mattias starting limping severely and so his family took him to the local hospital in Chilliwack. At first doctors told the family it was a virus that would go away in six weeks. After his limp got worse, they went back to the hospital and a paediatrician took X-rays and then diagnosed him with juvenile arthritis. They went to B.C. Children’s for an MRI and on that night the radiologist called the family to say he doesn’t have arthritis but instead had Perthes disease.

His journey is documented on a Facebook page called Mattias’ Perthes Journey.

He really wants to be able to run and play with his friends, but otherwise he is doing so much better, said Thompson.

“Early detection can really change the outcome for these kids,” she said.

She said the family’s steel business recently held its annual softball fundraiser and raised more than $32,000 for I’m a HIPpy to helps kids like her son benefit from early detection. On Oct. 5, the annual I’m a HIPpy fundraiser gala will take place at the Vancouver Convention Centre.

Mulpuri says if hip dysplasia goes unchecked, many adults develop arthritis and will need hip replacements.

“People don’t realize that every single child around the world should be screened to see if their joints are loose,” he said, adding that roughly 40-50 people per 1,000 people are born with loose hip joints. “If it is picked up early on then they could have a normal life with an early brace treatment. So the key message is we need to get to them early.”


Dr. Kishore Mulpuri, an orthopedic surgeon at B.C. Children’s Hospital, with patient Neko Wong. Mulpuri wants to help kids around the world get screened for hip dysplasia.

BC Children’s Hospital handout /

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Overall in B.C. the mean age is three months for detection, he said, but in other countries like India and China the age is two to three years, so that means the kids at nine to 12 will be having 15 to 17 surgeries.

“Their entire childhood goes to just surgery after surgery. It affects their mobility and takes their childhood away,” he said.

Mulpuri and his team created the International Hip Dysplasia Registry, which is the largest research and patient registry in the world. The registry is funded by HIPpy, with the goal that this research will help children worldwide.

While early screening is the best method to prevent the burden of hip dysplasia, Mulpuri said there are still other risk factors that need to be addressed like baby swaddling, for example.

“A lot of people wrap the babies tight for comfort, but that puts them at risk of hip dysplasia,” he said,

Other conditions that put kids at risk include being in a breech condition or having unequal leg lengths.

“As soon as we figure out they have a dysplasia or dislocation based on the severity we then treat with a brace treatment, which has over 90 per cent success rate if you treat early,” he said.

Mulpuri advises watching children for signs of hip dysplasia including if they’re having knee pain or walking with one foot turned out. He also says parents shouldn’t worry about getting a hip X-ray or asking their doctor if their baby was screened. At birth, all newborns in B.C. are tested for hip dysplasia, but there is currently no standardized testing and in some countries, little testing at all.

When not properly diagnosed, children can go on to have numerous surgeries and physical limitations that will impact them for life, causing much suffering and significant costs to medical systems, said Mulpuri.

Mulpuri said thanks to the CIHR grant, the support of B.C. Children’s Hospital, donors and volunteers, they are expanding their network, building data and statistics into the database “at an extremely fast pace.”

The financial impact of missed hip-dysplasia diagnosis to Canada and U.S. health-care systems is about $625 million a year, according to Regina Wilken, executive director of I’m a HIPpy.

Mulpuri works with doctors in Canada, the U.S., Europe, China and India sharing the database knowledge and assisting with hip-dysplasia patient surgeries.

He says the ultimate goal is to help all children improve their quality of life.

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25Sep

Physicians need to do a better job of protecting patient files: B.C. privacy commissioner

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https://vancouversun.com/


BC Information and Privacy Commissioner Michael McEvoy.


PNG

Doctors’ offices regularly breach patients’ privacy so clinics across B.C. must do more to protect the information in their possession, says a report released Wednesday by the Office of the Information and Privacy Commissioner for British Columbia (OIPC).

The audit and compliance report is based on 22 randomly selected medical clinics where at least five doctors worked. The audit sought to find out whether clinics and their staff are meeting legal obligations under the Personal Information Protection Act (PIPA). The act dictates how private organizations collect, use and disclose personal information.

Medical clinics were chosen for the review because of the massive amount of sensitive personal information they collect and because relative to other private sector organizations, physicians’ offices, medical clinics and labs “account for the largest number of complaints and breach files received by the OIPC over the past five years.”

The scope of the review did not entail a physical inspection of electronic medical records systems, patient files storage systems or actual visits to the clinics. Rather, designated staff at the clinics answered questions and provided written material.

Even without a physical inspection of such clinics, the review discovered numerous problems with the way clinics handled patient information. Many lacked a designated privacy officer, put insufficient resources into privacy procedures and failed to stay abreast of technological advances that would help protect information.

The compliance review report says although there’s an inherently strong bond of trust between doctors and patients, the “troubling reality” is that privacy issues occur regularly in the medical field and the privacy commissioner routinely hears complaints about privacy breaches. Such breaches include accidental disclosures by email, files stolen from doctors’ vehicles, and computer systems that are compromised.

“The harms caused by these breaches can be very serious, leaving victims vulnerable to everything from damaged relationships to humiliation, financial loss and more.”

Michael McEvoy, B.C.’s information and privacy commissioner, said the compliance audit focused on medical clinics because of the large volume and sensitivity of the personal information they collect.

“The results show that while some clinics were complying with their obligations, many have work to do when it comes to improving their privacy practices. There is no question about the intense demands medical professionals face. However, respecting and protecting patients’ private information is critically important.

“Doctors and staff at clinics not only owe it to their patients to do their utmost to build and maintain strong privacy programs, but they are also legally obligated to abide by privacy legislation. I hope that the focus of this report underscores the need for clinics to address gaps in how they protect this sensitive personal information and my office’s willingness to assist them in doing so.”

The report has 16 recommendations aimed at helping clinics address the gaps in their privacy management programs, building better policies and safeguards, and ensuring they provide adequate notification about the purposes of collecting personal information online. The report recommends that clinics develop more robust privacy protocols, better responses to breaches, improved monitoring to ensure compliance and prevent breaches, provide more training for staff, and use more caution when collecting and sharing information online.

More to come.

[email protected]

Twitter: @MedicineMatters

5Sep

B.C. government expands biosimilar drug program to Crohn’s, colitis patients

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https://vancouversun.com/


B.C. Health Minister Adrian Dix in a file photo.


Francis Georgian / PNG

The British Columbia government says it’s expanding its substitute drug program to include 1,700 patients with diseases such as Crohn’s and colitis.

Health Minister Adrian Dix says biosimilars, which are cheaper alternatives to name-brand drugs, have worked well in other countries and the province will be saving about $96.6 million to be put back into health care over three years.

Biosimilars are highly similar versions of bioengineered drugs known as biologics, and there are 17 such products approved for sale in Canada.

Bioengineered medicine is the single biggest expense for public drug plans; in 2018, B.C. spent $125 million to treat chronic conditions such as diabetes, arthritis and Crohn’s disease.

In January, the province made a three-year, $105-million investment to help low-income British Columbians get access to the drugs.

The initial program announced in May saw over 20,000 British Columbians move their prescription from the biologic to biosimilar drugs.

31Aug

Woman refuses to burn out her torch as she marks Overdose Awareness Day, crisis

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Tabitha Montgomery with free materials she’s distributing to B.C. libraries.


Francis Georgian / Postmedia News

It was during the International Overdose Awareness Day activities last year when Tabitha Montgomery really noticed it — events that had once been rallies had become vigils.

“There was a feeling that no one was listening. That it was not making a difference,” she recalled Saturday as she set up an information booth at the Vancouver Public Library.

Montgomery’s booth was one of several awareness activities happening in B.C. this weekend to mark International Overdose Awareness Day, a global movement designed to remember those who have died from drug overdoses. And to push for change.

However, some advocacy groups that organized activities in the past were noticeably absent from this year’s list of planned events.

Montgomery attributed that to burnout.

“It can be difficult to keep going,” she said. “I want to thank those who have been paving the path for so long.”

Montgomery’s father, her best friend and her daughter’s father all died from drugs. She believes the only way to end the overdose crisis is to remove the stigma and judgment around drug use and addiction and bring the issue fully into mainstream health care.

“This is a torch in my heart,” she said.

While she doesn’t represent any single group, the former director with From Grief to Action has had success asking B.C. libraries to display free books on grief and addiction in their community resources sections. She’s hoping to get the material into more libraries in the months ahead.

(Postmedia News photo by Francis Georgian)

In a statement, B.C. Minister of Mental Health and Addictions Judy Darcy recognized those who have died are “parents, children, co-workers, neighbours, partners, friends and loved ones.”

The politician said the B.C. Centre for Disease Control estimates 4,700 deaths have been averted by scaled-up distribution of Naloxone, more overdose prevention sites and better access to medication-assisted treatment, known as opioid agonist treatment.

“We have a responsibility to each other, our communities and the loved ones we have lost to keep compassion, respect and understanding at the forefront of our minds — and to continue to escalate our response,” she said.

In June, 73 people died of suspected illicit drug overdoses across the province, a 35 per cent drop from June 2018 when 113 people died, according to data collected by the B.C. Coroner’s Service.

But Montgomery said addiction is still treated like a “moral and criminal issue,” rather than a health issue.

“There’s so much misunderstanding,” she said.

Overdose awareness events were held around the world, including in many B.C. cities such as Vancouver, New Westminster, Kamloops, Kelowna, Powell River, Prince George and Quesnel.

In Vancouver’s Downtown Eastside, the Overdose Prevention Society supported the creation of a mural in the alley near its injection site. The project wrapped up with an art show.

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30Aug

Back-to-school is big business for B.C.’s lice busters

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Busy schedules, resistant bugs and, of course, the ‘ick’ factor.

B.C.’s lice busters say there are several reasons more parents are seeking professional help to deal with lice infestations — and as kids head back to school on Tuesday, they’re bracing for a busy month.

“By the end of September, we’ll likely see a few outbreaks,” said Rochelle Ivany, a Chilliwack nit picker who runs The Lice House with friend Ashley Wall. “Over the summer, kids have been off at camp, sleepovers and grandparents’ houses. When they come back to school, lice can come with them.”

Ivany entered the business when one of her kids came home with lice.

“I had no idea what to do,” she said. “Lice can be a taboo subject. No one wants to be the kid with it. Parents dread the letter coming home from school saying that there’s an outbreak in their kid’s class.”

After research and practice, Ivany set up shop in her home last year, offering people in the Fraser Valley an alternative to over-the-counter pesticides and hours of combing.

The key is to be “meticulous” while manually removing all lice and eggs with a special comb, she said.

Confidential sessions at The Lice House take between one-and-a-half to three hours depending on the severity of the infestation and the length of the client’s hair. Ivany charges $50 an hour — a lower rate than many of the services closer to Vancouver — and does comb-outs every three days until the client gets three clean comb-outs. She also provides treatment at cost for people who are referred to her through a social worker or community support worker.

“I get calls from a lot of panicked parents,” she said. “The message is that it’s OK, it’s going to be OK. We can help you.”

While it’s unclear if lice outbreaks are increasing — the B.C. Centre for Disease Control does not keep data on cases — more people are turning to professional lice removal services for help.

In Maple Ridge, Lice911 owner Barbara Pattison has been nit picking for 18 years.

“We’re the original,” she said. “When I started, there were four companies in North America.”

In the last decade, she’s expanded to provide mobile service in communities across Metro Vancouver and Vancouver Island. In addition to Lice911, there are almost a dozen other companies offering treatment in B.C.

Pattison said lice seem to be more resistant to chemicals, which have become weaker in the last 10 years, while people may be too busy, or unwilling, to spend hours combing out bugs. In the last few years, she’s also seen a shift toward more teens and young adults arranging treatment for themselves, which she attributes to selfies and people putting their heads together to look at phones.

“All it takes is three seconds of hair-to-hair contact,” she said.

The lice expert advises parents to check their kids’ hair regularly for lice, looking for sticky black, brown or grey eggs half the size of a sesame seed attached to strands of hair. Some kids may have an itchy head or a rash at the nape of their neck.

“If you can catch it early, when there are 30 or 40 eggs, it’s much easier to deal with,” she said. “An average infestation is about 500 eggs.”

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23Aug

Daphne Bramham: B.C. addictions minister targets province’s ‘wild, wild West’ recovery houses

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B.C. Addictions Minister Judy Darcy has no illusions about the current state of British Columbia’s recovery houses and the risk that the bad ones pose to anyone seeking safe, quality care.

Nor is she alone when she calls it “the wild, wild West.”

Anyone able to build a website and rent a house can operate a so-called recovery house. Like a game of whack-a-mole, even when inspectors try to shut down the worst ones, they spring up somewhere else.

That said, the regulations they’re supposed to enforce are so vaguely worded that it’s easier for bylaw inspectors to shut places down for garbage infractions than for failure to provide the most basic of services like food and a clean bed to people desperate for help.

Even the most deplorable ones have never been taken to court by the province, let alone fined or convicted which makes the penalties of up to $10,000 moot.

It’s taken two years, but this week Darcy — along with Health Minister Adrian Dix and Social Development Minister Shane Simpson — took the first steps toward bringing some order to the chaos and overturning years of neglect.

In two separate announcements, what they’re offering is both the stick of tighter regulations and enforcement as well as the carrot of more money for operations and training staff.

The carrots announced Friday include $4,000 grants available immediately to registered and licensed recovery home operators to offset the costs of training for staff before tougher regulations come into force on Dec. 1.

On Oct. 1, the per-diem rate paid for the treatment of people on social assistance will be raised after more than a decade without an increase. Recovery houses on the provincial registry will get a 17-per-cent increase to $35.90, while recovery houses licensed by the regional health authorities will jump to $45 from $40.

The sticks are new regulations that for the first time require things like qualified staff, which common sense should have dictated years ago as essential. Recovery houses will have to provide detailed information about what programs and services they offer. Again, this seems a no-brainer, as does requiring operators to develop personal service plans for each resident and support them as they transition out of residential care.

As for enforcement, the “incremental, remedial approach” to complaints has been scrapped and replaced with the power to take immediate action rather than waiting for a month and giving written notice to the operators.

Darcy is also among the first to admit that much, much more needs to be done to rein in bad operators whose purported treatment houses are flophouses and to provide addicts and their families with the resources they need to discern the good from the bad.

More than most, the minister knows the toll that poor funding and lack of regulation is taking both on addicts who seek help and on their loved ones. She’s haunted by meetings she’s had with the loved ones of those who have died in care and those who couldn’t get the services they needed.

“It’s the most difficult thing that I have to do and, of course, it moves me to my core,” she said in an interview following the announcement. “People say, ‘Do you ever get used to it?’ Of course I don’t. If you ever get used to it, you’re doing the wrong job.

“But I try and take that to drive me and to drive our government to do more and to move quickly and act on all fronts and having said that, there’s a lot to do. There’s really, really a lot to do.”

Among those she’s met are the two mothers of men who died within days of each other in December under deplorable conditions in two provincially registered recovery houses run by Step By Step.


B.C. Minister of Mental Health and Addictions Judy Darcy shares a laugh with Scott Kolodychuk, operations manager of Surrey’s Trilogy House One recovery home where Friday’s news conference was held.

Mike Bell /

PNG

It was four to six hours before 22-year-old Zach Plett’s body was found after he overdosed and died. On Christmas Eve, a 35-year-old man died at a different Step by Step house. It was two days before his body was found by other residents.

Two years before those men died, the provincial registrar had received dozens of complaints and issued dozens of non-compliances orders. Both houses remained on the registry until this summer when owner/operator Debbie Johnson voluntarily closed them.

After years of relentless advocacy Susan Sanderson, executive director of Realistic Recovery Society, was happy to host the ministers’ Friday announcement at one of its houses. She wants to believe Darcy that these are just first steps since the per-diem rate is still short of the $40 she and others lobbied for and remains a small fraction of what people who aren’t on welfare are charged — charges that can run up to $350 a day.

Having taken these long overdue and much-needed initial steps, maybe Darcy and her colleagues can take another logical next step to support working people getting access recovery who — without access to employee benefit plans — can’t afford the cost of treatment.

They shouldn’t have to wait until they’re destitute to get care, any more than someone on welfare should be deprived of help.

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Twitter.com/bramham_daphne

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26Jul

Daphne Bramham: Recovery homes’ dilemma: Trying to comply with regulations that have yet to be written

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After three years of operating two registered recovery houses, in January 2016 Cole Izsak found what he believed — and still believes — is the perfect place.

But before taking possession, the owner and executive-director of Back on Track Recovery applied to the provincial health ministry to essentially grandfather his operation and transfer the registration of one of his houses to the new site.

Because Back on Track has never had any substantiated complaints, he didn’t expect any problems and, a month later, shut the registered house and opened a four-plex now called The Fortress.

The next month, Izsak closed one of the two houses that were registered by the provincial government and moved to the new compound with internal, off-street parking at 9889-140th Street in Surrey.

He still wasn’t concerned when in May, the ministry said it was putting a hold on his application while both the province and Surrey were formulating new regulations.

Since then, it is rare that any of the 40 beds — two per bedroom in each of the five-bedroom houses — are empty.

While Back on Track continues to operate the one registered house, The Fortress remains unregistered, with only two of four business licenses that it needs.

For the last 2½ years, Surrey’s bylaw inspectors have been telling Izsak that unless all four houses at The Fortress get their provincial registry, the city can’t license the houses until the registration from the health ministry comes through, certifying that services offered meet its standards of care.

In mid-May, Back on Track and its residents were told that the licenses were being revoked and the four houses would have to close at the end of July. It has since been given a reprieve, pending a decision from the provincial registrar.

“If Mr. Izsak’s registration comes through, we’ll be prepared to do our own inspections for renewal or issuance of the licenses,” bylaw services manager Kim Marosevich said this week.

In late May, after Maggie Plett first spoke publicly about her son Zachary’s death at another Surrey recovery house called Step by Step, Addictions Minister Judy Darcy told News 1130, “We’re trying to make up for lost time over the past many, many years since the scandal started to break.

“But I would expect that we will have new, stronger regulations and enforcement in place by the end of the year.”

Throughout all of this, the government has paid Back on Track the $30.90 per diem that covers the cost of room, board and recovery services for each welfare recipient living there — a rate that has remained unchanged for 16 years.

Izsak doesn’t know why the ministry has yet to make a decision on his application. The mental health and addictions ministry has not yet responded to my questions about it.

On Tuesday, Izsak gave me a tour of the four neatly kept houses. He showed me the well-supplied pantry where residents are free to take whatever food they want and as much as they want. There is also an open-air gym and smoking lounge. Every room has a naloxone kit in case of an opioid overdose, and every few weeks, residents are given training on how to use them.

The half-dozen residents that I spoke to privately — including one who said he had been in at least 20 such facilities — said The Fortress is the best. They talked about feeling safe, well-cared for, and even loved.

Izsak makes no apology for not having more set programming in the houses.

“People who are coming off the street or out of prison are not going to surrender to eight hours of programs per day,” he said. “But what they will surrender to is coming to a place like this where they are fed well, have a clean bed, a TV, and programming from 9 a.m. until noon.”

He acknowledged that there are no certified counsellors or therapists working there. He devised a recovery program called MECCA based on his own experiences in recovery that is delivered by others who are in recovery.

Izsak also said he cannot afford to hire certified addictions counsellors and specialized therapists, as they do at recovery houses where monthly rates are anywhere from $3,000 to $9,000 a month.

Right now, registered facilities don’t require that, according to the registry’s website.

What’s required is that all staff and volunteers “must have the necessary knowledge, skills, abilities and training to perform their tasks and meet the health and safety of residents.”

Far from bridling at more regulations, Izsak has a long list of his own that he would like the province to enact to weed out bad operators.

It includes random site inspections, manager-on-duty logbooks documenting what happens every two hours from 10 a.m. until 10 p.m., and a requirement that all operators provide their expense receipts.

After three recent deaths in recovery houses, Izsak is now a man on a mission.

“I want to close operations that are bad so that I’m not treated almost like a criminal because they acted unscrupulously.”

Of course, he first needs to save his own.

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Twitter: @bramham_daphne


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18Jul

Ian Mulgrew: Medicare expert, lawyer spar to end landmark trial

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The B.C. Government’s defence in the landmark three-year-old Medicare constitutional trial in B. C. Supreme Court is ending not with a bang but a testy, two-day courtroom sparring match involving one of its experts.

Dr. Gordon Guyatt gave as good as he got, repulsing a prolonged assault on his objectivity and left the stand Thursday having provided some last-minute fireworks but seemingly little insight on the key issue — wait-lists and the effects of constraints on access to private care in the provincial Medicare Protection Act.

“My perception is that there’s been a fluctuation of concerns with waiting lists and that governments have, to an extent, addressed things,” he said.

“Things can always get better … you have tensions — constant tensions — in every health care system in the world, and problems will never be solved.”

A specialist in internal medicine and, for almost 35 years, a health researcher at McMaster University, the argumentative Guyatt was assailed as more of an ideological warrior than a disinterested expert.

Robert Grant, lawyer for the two clinics and handful of patients behind the legal challenge over barriers to access to private care, portrayed Guyatt as a virulent opponent of the private clinics and Dr. Brian Day, the driving force behind the decade-old litigation.

Noting he had a duty to be impartial, Guyatt bristled at the broadsides aimed at impeaching his credibility.

“Given my, given that commitment, I do not see personally as relevant further pursuit of my opinions about issues beyond the issues that I’ve been asked to comment on in my deposition,” he complained.

“Thank you for that,” Justice John Steeves said. “In the meantime, just answer his questions.”

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Government lawyers vainly tried to halt the brutal cross-examination that battered Guyatt’s neutrality.

A self-described left winger who ran repeatedly as an NDP candidate, Guyatt has been a social activist for 40 years.

In 1979 he co-founded the Ontario-based Medical Reform Group, which disbanded in 2014 and was replaced by the Canadian Doctors for Medicare, which he joined.

He was also a director of the Ontario Health Coalition, an activist network, that along with its sister group the B.C. Health Coalition, is a member of the Canadian Health Coalition.

Doctors for Medicare and the B.C. coalition, under the banner of B.C. Friends of Medicare Society, have intervened in the challenge to support the government case.

Grant accused the groups of wrongly asserting Day seeks “U.S.-style health care for Canada, where people go bankrupt, lose their homes and life savings, or worse, because they can’t afford treatment when they need it.”

The B.C. coalition, he said, incorrectly claimed Day wanted a system where “international private insurance corporations run the show and patients foot the bill.”

Grant said the groups were fearmongering.

“It is an overstatement that this case could bring down single-tier Medicare,” Guyatt agreed, adding he also did not endorse the portrayal of Day and his supporters as “greedy, awful people.”

He maintained he was too busy to keep up with everything the groups did,  and distanced himself from the inflammatory rhetoric.

“The way I would put it is that we were advocates for equitable high-quality health care accessible to people without financial obstacles,” he said.

“So, specifically, as I have said previously, I believe that it is more appropriate to base care on the need — the medical need than on ability to pay — and I would like to work, continue to work, in a system where the patients I treat are treated on the basis of need rather than ability to pay.
”

“I understand,” Grant replied.

“But the point (of the trial) isn’t about what you want to do in your own practice; it’s whether or not increased private health care, and specifically private-pay surgeries, will be permitted or not. And you are opposed to increased private-pay surgeries. Isn’t that right?
”

“Yes,” Guyatt confirmed.

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Grant insisted Guyatt was a vocal opponent of Day within the Canadian Medical Association, seeing him as a “tragic choice” and “a complete disaster” as the organization’s president.

“I don’t recall active involvement in that matter,” Guyatt said, but again added such comments would be “hyperbolic.”

The Ontario specialist attacked the concept of using “benchmarks” to measure surgical waiting times — saying “not much” research has been conducted to establish what is acceptable and he suggested they were undependable tools set by “good old boys sitting around the table.”

But Guyatt has long minimized waiting lists and their ill effects — calling them “a problem that may be much smaller than we imagine” in 2004.

And he acknowledged he was not familiar with the circumstances in B.C.

“Certainly not in detail …. I do not know the details of the extent of waiting lists currently. I am sure that waiting lists remain a problem. … and that they’re not optimal … I do not know well enough to know whether it would be appropriate to characterize them as a serious problem or not.
”

The final witness John Frank, an expert on social determinants of health, took the stand later on July 18 and was to finish July 19 — day 179 of the proceedings.

“When this trial began I thought it would last up to 18 weeks (three times longer than the similar Chaoulli case in Que.),” said Day, founder of the private Cambie Surgery Centre.

“I am happy that — almost 3 years later — the witness phase is over. I am confident that the justice system will eventually grant all Canadians the same rights to protect their health that the Supreme Court of Canada granted to citizens of Que., and that the citizens of every other country in the world enjoy.”

Justice Steeves plans to hear final arguments this fall and begin deliberations in December.

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17Jul

572 British Columbians died by suicide in 2017, including 22 youth

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The BC Coroner has released its updated suicide report from 2007 to 2017. The report shows 572 people took their own life in 2017. Of those 22 were under 19.


The B.C. Coroners Service has released its updated report on suicides in the province between 2007 and 2017.

The report shows that 572 British Columbians took their own life in 2017, down slightly from 603 in 2016, 615 in 2015, and 644 in 2014.

Most were men and more than half were aged 30 to 59. Twenty-two youths under 19 years old died by suicide in 2017, up from 20 the year previous.

The coroner report shows the highest age-specific suicide death rate was among 40 to 49 year olds in 2017, and the three most common means of suicide were by hanging, followed by poisoning, firearms and falls. The number of SkyTrain suicides went up to four from three in 2016, while railway suicides in 2017 fell to four from six the year before. The number of CO poisonings also fell to 13 from 20 the year before, while the cause of 42 suicides was still under investigation.

The Fraser and Interior Health Authority had the highest number of suicides in 2017, with 157 and 130 deaths, respectively. The Northern Health Authority had the highest rate of suicide deaths at 18 deaths per 100,000 individuals.

Overall, the rate of suicide deaths in B.C. was 12 deaths per 100,000 individuals.

Suicide rates are highest in Northeast, Kootenay Boundary, Thompson Cariboo, East Kootenay, and Northern Interior Health Services Delivery Areas, according to the report.

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