NWT doctors expressed concern over changes to Yellowknife primary care as they called for “urgent government action” to address broader problems in the territory’s healthcare system.
In a Friday news release, the NWT Medical Association – which represents the territory’s physicians – said it had written to ministers about “the critical need for government intervention to prevent disruptions in primary care and emergency services.”
The NWT’s healthcare system has been the focus of concern for years but its instability has increasingly taken on crisis proportions.
This week, after the auditor general released a damning report into mismanagement of the Stanton Renewal project, regular MLAs voted to have the same office inspect management of the NWT’s health authority.
The doctors’ letter to ministers was not made public but the accompanying news release summarized its contents.
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“It is evident that without swift action, we risk further compromising the quality and sustainability of healthcare services in the North,” physicians’ association president Dr Kate Breen was quoted as saying.
The association picked out the recent transformation of Yellowknife primary care as a key area of concern.
Previously, Yellowknife residents were placed on one of 10 different healthcare teams or on a 2,000-person waitlist that was years long.
Since the start of the summer, staff have been redeployed into four larger teams. Every resident can be assigned to one of those teams rather than left on a waitlist.
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Healthcare bosses have said doing so was intended to create a “medical home and a team” for every Yellowknife resident, which in turn would help make the process of “navigating to primary care” easier. Residents have complained of a weeks-long process to get an appointment, if any are even available, or else a lengthy lineup each morning to get a walk-in slot.
Staff have spent months voicing their fears that the system is not working out as planned, the workload is growing and delays accessing care are as long as they’ve ever been.
On Friday, the NWT Medical Association said it was “concerned” about the commitment to assign every resident to a primary care team.
The association said it had no idea where the resources were coming from to make that work.
“There has been no communication of a plan to increase staffing to be able to provide acceptable care to the whole population,” the news release stated.
“Physicians have expressed concern that by increasing workload and responsibility beyond data-informed, standard panel sizes … they will be unable to provide safe and sustainable care.”
A panel size is the number of patients a physician cares for. They can vary widely. Depending on the institution you ask, a reasonable panel size might be 1,000 to 2,500 people.
More broadly, the association said it was alarmed by this week’s report by the auditor general into huge cost overruns and project management failings related to Stanton Renewal, and fearful that ongoing staff shortages won’t end soon as wait times increase while access to care gets harder.
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“Patients are paying the price for these failures,” the association said of some of the management decisions reported on by the auditor general and made since. It called for “accountability to address these missteps” without specifying the form of accountability it sought.
In a series of recommendations to the GNWT, the association asked for:
- “adjusted” locum rates and better physician contracts;
- more work to retain existing northern-based doctors;
- more staff at Stanton’s emergency room, which the association noted “cannot close when it is understaffed” unlike many in the south, where other hospitals are within reach;
- less admin for staff; and
- more investment in front-line healthcare, especially primary care and public health.
More: Read the NWTMA’s news release in full
Regular MLAs have spent day after day cycling through a catalogue of issues with NWT healthcare. The premier himself acknowledge on Thursday that he takes many of the same calls from residents who have concerns.
Earlier in the year, healthcare managers had pledged the troubles ailing Yellowknife primary care would improve over time as the new system bedded in.
At the time, territorial medical director Dr Claudia Kraft acknowledged that the reshuffle into four teams did not “solve the problem of how many total appointments are available to us in the system,” nor how many staff are available in total.
“But it does really help us to take those next steps” of identifying where more work needs to happen, she said, “and then we can figure out what’s the best way to resource it.”
“We are going to be in a much better position week by week, month by month,” Kraft said.
