Sending expecting families to Edmonton in the wake of Yellowknife’s obstetric unit closure is already forecast to cost more than $1 million in medical travel alone.
Health minister Julie Green said on Friday the territory was expecting to pay $12,500 for each person and one escort to travel to Edmonton and remain there for four weeks. The figure includes flights, accommodation, and meals for both people.
Yellowknife North MLA Rylund Johnson, performing on-the-fly math in the NWT legislature, concluded that means a bill of at least $1,125,000 if, as expected, 90 NWT families are affected between now and February. (A further 30 or so Kitikmeot families, whose medical travel is Nunavut’s responsibility, are also set to be affected.)
That cost does not include the fee Alberta’s healthcare system will charge the Northwest Territories for each birth handled, Green said. The size of that separate cost is so far unclear and may vary according to the complexity of each birth.
“I expect even one complicated birth can get very expensive, very quickly. This closure is becoming a million-dollar cost to us,” Johnson told the legislature, referring to the shuttering of Stanton Territorial Hospital’s labour and delivery service as too few obstetric nurses are available. Two have left their posts in recent weeks, and six of 13 positions on the unit are now vacant.
The obstetrics unit will now “not be able to provide birthing services outside of emergency or urgent situations,” the NWT’s health authority said on Monday.
A key complaint among obstetrics nurses, for years, has been that Stanton assigns three nurses per shift – a level some nurses say is dangerously low. They have requested four nurses per shift.
“This has proven that one closure is easily more than the cost of funding that staff position,” Johnson said, asking Green whether that fourth shift position can now be established.
“I don’t know where those discussions are at within the hospital,” the minister said in response.
“I do know the number of births at Stanton has been declining over the last three or four years.”
She added that the present staff shortage was such that agreeing, now, to a fourth position on each shift may for the time being be symbolic at best.
“I’m not sure that adding another position is actually going to bring them another body,” said Green.
“This is a conversation we need to have. Maybe the value of the fourth position over the long term is that people are more able to take their time off. It’s certainly something I’m interested in.”
Earlier this week, hospital chief operating officer Georgina Veldhorst told Cabin Radio she was not convinced a fourth position on each shift was needed.
“The staffing level needs to hit that sweet spot in terms of being able to navigate the normal swings that happen in obstetrics,” said Veldhorst, who, like Green, cited a declining number of births at Stanton in recent years.
“When the volume exceeds the number of staff that we have, we do make every effort to bring in additional staff. When we’re in this tight staffing situation and when staff are already picking up significant overtime, it becomes more difficult to call in additional staff when the number of patients increases.”
Nurses, though, say the current three-position system is exhausting and dangerous, often meaning one-to-one care for people in active labour is almost impossible.
“We were trying to prove with numbers and statistics and everything why we need that fourth nurse,” one nurse said. “We were not being told no but it was being pushed aside, pushed aside, pushed aside. To the point that our nurses are leaving.”
Asked by Kam Lake MLA Caitlin Cleveland how the hospital had fared in its most recent accreditation process – the means by which hospitals are measured against accepted standards – Green said some areas had performed well but acknowledged others had not.
“The lowest score compared to Canadian averages was received for the health and safety of the work environment,” the minister said, “so clearly there was a flag, in that survey, that work needed to be done in that area.”