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Monday, July 9, 2012
A fight best held in public On paper, there’s room for Alberta’s 40 Primary Care Networks and the 140 family care clinics proposed by the province to work side-by-side. But so far, there’s only been a series of disagreements reported in the province’s papers on how this should be funded and managed — which is as it should be. The public airing of grievances from PCN supporters on its own has been informative for many thousands of Albertans whose only understanding of primary or family health care can be found in a hospital emergency ward. Not to mention the illumination provided by auditor general Merwyn Saher, who says there’s no mechanism in place to determine how much value Albertans are getting for the $170 million a year they are putting into the PCN network. Perhaps it’s uncomfortable for Premier Alison Redford, Health Minister Fred Horne, Alberta Medical Association president Linda Slocombe and others to read the back-and-forth of negotiations reported publicly. But
OURVIEW GREG NEIMAN for the public, this is a good outcome. We’ve had too much of secret meetings, and deals announced for which we have few details, and even less ability to understand the costs. If Alberta is going to have a fight over health care, let us have this fight in public. University of Alberta professor John Church recently told reporters that the time has come for Redford to “fish or cut bait.” “And the premier is willing to cut bait,” he said. That means upon the expiry last week of a temporary agreement between doctors and the government, there’s a whole new agreement to be made. So far, it’s reported that the province has proposed removing the language related to PCN from the agreement and killing a task force that was to study the system. You can read this as a proposal to end Primary Care Network, as some doctors fear — but so far, this is only
on paper. Right now, there are 40 PCNs scattered over the province and they get $62 for every Albertan in their region — even those Albertans who don’t even know a PCN exists in their area, much less how to contact one. Primary Care Networks are run by doctors and other health professionals. They co-ordinate individuals’ care and can refer patients to other providers, plus provide advice on wellness and healthy living to the community. They are for-profit entities, run under the authority of the doctors. Since they started about a decade ago, doctors report greater efficiencies, allowing physicians to carry higher patient loads, which means doctors who were not accepting new patients in the past are accepting new patients now. We simply know this as better access, for which $62 a year seems like a pretty good deal. The proposed family care centres would stay open late and accept walkins. You may not see a doctor — you may not need to. Other practitioners
would have authority to take a look at you and perhaps give you a shot you may need, or other minor things we now associate only with doctors. The clinic would be paid on a for-service basis. For families that cannot find a family physician, or for entire towns that don’t have one, this also looks like a pretty good deal. Employing greater numbers of nurse practitioners to do more of this team-approach health care appears to work in Europe, for instance. In the meantime, the AMA and the province have no agreement on pay and working conditions. Which should seem pretty obvious to the readers of newspapers. This is the system working in public. It’s our money on the table, and we can trust the participants to have our interests at heart. Of course, the actual negotiations should be private, but the issues need to be debated at length, in public. That’s what paper is for. Greg Neiman is an Advocate editor.
LETTERS Why put bike lanes at schools? On June 28, the last day of school at Eastview Middle School, I received an email from the school asking parents to read important information from the City of Red Deer regarding traffic changes that were going to occur over the summer. I opened the attached document and was surprised to read that the city was planning on putting in bike lanes on 39th Street and 40th Avenue and that these lanes would change the current four-lane traffic in front of Eastview Middle School, Maryview School and St. Thomas Aquinas Middle School into two-lane traffic. If you are a parent of a child at any one of these schools, you can understand the panic I felt when I read about this change! The traffic in the mornings and afternoons at these schools rivals the local high schools, the malls on a busy day and even the Westerner after a hockey game. There is so much traffic around the corner of 39th Street and 40th Avenue that Eastview School is committed to sending a teacher out every morning and afternoon to be certain the children can get across the crosswalks safely. I can’t even begin to imagine what chaos will occur if there are only two lanes of traffic; can you see parents that drop off or pick up their little ones in the parking lot of Maryview School getting blocked in because westbound traffic on 39th Street is backed up past St. Thomas Aquinas Middle School? That is a very likely scenario. The article gave an email address that could be used for comments and questions to the Engineering Department at the City of Red Deer so I sent them an email that same day asking them how this particular area was selected for the pilot project and how traf-
fic was going to flow. I am a daily reader of the Advocate and listen to and watch local news and this was the first I had heard of the project in the Eastview area. You guessed it — no response! So if there are other parents out there who are concerned about what the traffic will look like come this fall in front of Eastview Middle School, Maryview School and St. Thomas Aquinas Middle School, send an email
or call the local Engineering Department of the City of Red Deer for an explanation on how this site was chosen for the Commuter Bike Pilot Program and what is going to be done to address traffic issues. The information on the document was Engineering Department, City of Red Deer, engineering@reddeer.ca, 403-342-8158. Kim McCallister Red Deer
Carbon capture technology on shaky ground What can we do with wastes from our industrial pursuits — from fossil fuel extraction, agriculture, chemical and pharmaceutical manufacturing? We’ve been spewing lots of it into the air, but that isn’t a good plan. Carbon dioxide, ozone, mercury, and other emissions harm human health and contribute to global warming and holes in the ozone layer. We’ve dumped it into the oceans. But that compromises marine life that billions of people rely on for food. We could bury it: Out of sight, out of mind. But we’re learning that hiding it below our feet isn’t the best solution, either. DAVID Several scientific reports SUZUKI have called into question everything from injection wells to carbon capture and storage. The latter is a key component of the federal and Alberta governments’ climate change strategies and budgets. According to a recent study, little is known about leaks from the 680,000 waste and injection sites in the U.S., but structural failures are common. That’s not surprising when you consider that close to 130-trillion litres of toxic liquids have been pumped underground there over the past several decades. ProPublica, an investigative journalism website, reports that “the idea that injection is safe rests on science that has not kept pace with reality, and on oversight that doesn’t always work.” Researchers say wells often leak, contaminating groundwater and sending waste and toxic chemicals to the surface. According to ProPublica, “From late 2007 to late 2010, one well integrity violation was issued for every six deep injection wells examined
SCIENCE
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— more than 17,000 violations nationally. More than 7,000 wells showed signs that their walls were leaking. Records also show wells are frequently operated in violation of safety regulations and under conditions that greatly increase the risk of fluid leakage and the threat of water contamination.” Carbon capture and storage is another plan to hide our industrial wastes underground — in this case the carbon dioxide from operations like coalfired power plants and tar sands that would otherwise be sent into the atmosphere, contributing to global warming. The federal and Alberta governments have pinned much of their climate change mitigation hopes on the strategy, ponying up close to $3 billion to test the technology. One early venture ended in failure when the main company behind it pulled out. The Alberta and federal governments had committed close to $800 million for the $1.4 billion joint project between TransAlta, Capital Power, and Enbridge, which would have taken carbon from a coal-fired power plant west of Edmonton and either stored it underground or injected it into wells to recover oil. Even with generous government support, TransAlta spokespeople said the market for carbon sales and the price of emissions reductions were not good enough to justify going ahead and the plan didn’t make economic sense without a federal price on carbon through a cap-and-trade system or carbon tax. The economic difficulties with carbon capture aren’t the only challenge. The U.S. National Research Council concluded that storing carbon underground can trigger earthquakes. And researchers at California’s Stanford University say that could fracture surrounding rocks, allowing carbon to escape. A Greenpeace report notes that the technology, which has yet to be proven effective on a large scale, is energy-intensive, expensive, unlikely to get emissions down quickly enough to avoid dangerous climate change, and undermines funding and research into cleaner energy solutions.
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In Alberta, taxpayers are on the hook for any problems that might arise once the carbon has been stored. By law, the Alberta government assumes liability for any maintenance, cleanup, or other costs. That the industry demanded this provision makes one question its confidence in the safety and reliability of the technology. On top of all that, we don’t really know what effect pumping millions of tonnes of CO2 into the ground will have on bacteria and other organisms below the surface. We need to consider many solutions to deal with waste, pollution, and global warming, but not risky and expensive schemes that serve only to enable our continued addiction to fossil fuels. Our best bet is to reduce waste and emissions. And rather than dumping money into schemes like carbon capture and storage, we should invest in renewable energy. Online: Waste underground: ● http://grist.org/news/stuffing-the-ground-full-oftoxic-fluid-turns-out-to-be-a-bad-idea/ ProPublica report: ● http://www.propublica.org/article/injectionwells-the-poison-beneath-us TransAlta and feasibility of CCS: ● http://www.thestar.com/news/canada/ article/1208558--carbon-capture-and-storage-an-uncertain-future-in-canada Carbon capture risks: ● http://www.newscientist.com/article/dn21954earthquake-risk-for-carbon-capture-and-storageschemes.html Greenpeace CCS study: ● http://www.greenpeace.org/usa/en/media-center/ reports/false-hope-why-carbon-capture/executivesummary-false-hope/ Scientist, author and broadcaster David Suzuki wrote this column with Ian Hanington. Learn more at www. davidsuzuki.org.
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