February 11, 2021—Ha-Shilth-Sa—Page 11
First Nations rely on ER due to lack of primary care Turpel-Lafond’s report stresses the need for be•er access to general practitioners for preventative treatment By Eric Plummer Ha-Shilth-Sa Editor Victoria, BC - A follow up report on discrimination in B.C.’s health care system is stressing the need to improve access to primary treatment, as too many Indigenous people are forced to seek help in the emergency department due to little access to a family doctor. Mary Ellen Turpel-Lafond delivered the report today, after being commissioned by the province to investigate allegations of racism against Indigenous peoples in health care. Her 240-page follow up report is filled with data collected from nearly 9,000 people who helped to inform In Plain Sight: Addressing Indigenous -Specific Racism and Discrimination in B.C. Health Care, which was released on Nov. 30. The Feb. 4 follow up includes numbers on the high volume of Indigenous patients who rely on emergency services for conditions that often should be treated earlier during routine check ups, said Turpel-Lafond. “First Nations, on average, are 75 per cent more likely to visit the emergency than anyone else - and the reason for that is that they are not attached to primary care,” said the former judge and provincial child advocate during a Feb. 4 press conference. “Their needs get more acute because they don’t get primary care. And when they go into emergency, it may not
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On Feb. 4 Mary Ellen Turpel-Lafond pointed to the failure of B.C.’s primary care system to adequately serve Indigenous patients, thereby causing a reliance on hospital emergency departments to treat a variety of conditions. be the place to do the referral, to do the communication, to provide the culturallysafe care, because at times emergency departments themselves are in a state of crisis.” Preventative treatment is being missed, noted Turpel-Lafond, citing pap testing for cervical cancer as an example. Although Indigenous women have a cervical cancer rate that is 1.6 times higher than the rest of the B.C. population, testing for this disease is significantly lower among aboriginal females. “The health care system in B.C. is a much different experience if you’re an
Indigenous person than if you’re a nonIndigenous person,” said Turpel-Lafond. “Instead of having routine health care, we don’t have the continuum; we have the emergency department.” The lack of access to a general or nurse practitioner is particularly concerning for Indigenous people over 65, according to the follow up report. “These elders are not attached to primary care at a rate 89 per cent higher than non-First Nations people in British Columbia – and that, in fact, is quite a staggering finding of this data report,” commented Turpel-Lafond. “Poor access
to primary care may be driving the lower screening rates for treatable cancers.” The investigation that informs In Plain Sight began in June, after allegations surfaced that a discriminatory game was being played in at least one B.C. emergency department at the expense of Indigenous patients. Reports claimed that a “Price is Right” competition was being played by emergency room staff, guessing the blood-alcohol content of aboriginal patients as they entered the hospital. Although Turpel-Lafond did not find evidence of this particular game, in her initial report she found that racism is an “undeniable” problem in B.C. health care, stressing the need for “fundamental changes to beliefs, behaviours and systems” that guide the current services. In Plain Sight has 24 recommendations, including the establishment of an office of the Indigenous health representative and advocate, as well as improvements in the complaint processes facilities use. During the Feb. 4 press conference Health Minister Adrian Dix spoke of the current overreliance on the ER, a dynamic that has no doubt challenged the province as health authorities struggle to contain COVID-19. “The fact that so many people around our province - Indigenous people - encounter the health care system through the emergency room and not through primary care is a challenge to our health care system,” he said.
VI’s intercity bus service at risk of permanent closure By Sam Laskaris Ha-Shilth-Sa Contributor Vancouver Island, BC – Countless members of First Nation communities on Vancouver Island’s west coast will have to start thinking of new ways to get around. Perhaps permanently. That’s because the Tofino Bus, which provides services to 29 communities as well as 21 First Nations or organizations on Vancouver Island, will not be resuming service as previously scheduled this Friday, Feb. 12. The Tofino Bus is currently Vancouver Island’s only intercity bus service. Earlier this month officials with The Wilson’s Group of Companies, which operates the Tofino Bus, announced it would not start up its service again on Feb. 12. The announcement also stated that without a significant subsidy from the provincial government, there is the risk the Wilson’s Transportation service could be suspended forever. Samantha Wilson, the brand manager for The Wilson’s Group of Companies, said a proposal was sent to Minister of Transportation and Infrastructure Rob Fleming seeking a $3 million subsidy for the next year in order for the Tofino Bus to continue operating. “Looking at our numbers, we can’t start this up (without the subsidy),” Wilson said. Back in 2019, the Tofino bus provided a total of 82,500 trips. Because of the COVID-19 pandemic and various travel restrictions, however, since March of this past year revenues for the Vancouver Island routes have been down 95 per cent. “We had to cancel more runs than we were running,” Wilson said. Bus service was shut down entirely from mid-March until July last year. B.C.
health regulations shut down the service again in December. A resumption of service in January was pushed back until this Friday. Company officials believe that they would not be able to even cover their costs of running any sort of service with the current rate of passengers. On Monday, Feb. 8 Wilson said discussions with provincial officials have been ongoing in recent days. “They have said we are working on something but we are not sure what that will be,” she said. Wilson said if the provincial government does indeed provide The Wilson’s Group of Companies with the $3 million subsidy it is requesting, it would not take long to start providing bus service once again. “We could be up and running pretty quickly,” she said. Wilson added if the provincial government does provide less than the $3 million subsidy request, then bus service could potentially still resume. But if that is the case, Wilson said some number crunching would have to be done and that might result in fewer buses on the road or possibly no buses on certain days of the week. “It would be dependent on the details of the funding,” Wilson said. “We know what we asked for and what we need.” Officials from Wilson’s Transportation have been in contact with various First Nations leaders, as well as local and provincial government representatives, to keep them informed of the seriousness and potential loss of bus service to their communities. “It could have a very negative effect on our community members,” said Ahousaht First Nation’s Chief Councillor Greg Louie. But Louie believes those from his First Nation would find ways to cope if there
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Samantha Wilson, the brand manager of The Wilson’s Group of Companies, said a $3 million government subsidy is required to resume bus service to Vancouver Island’s west coast communities. was no bus service from his community. what kind of infrastructure they have.” Michael Lee, the B.C. Liberal TransporHe believes Ahousaht members would rely on family members or friends to help tation and Infrastructure Critic, is among get them the necessities required, either those who have urged Fleming to take quick action. by offering a ride or picking up goods themselves. “If the minister does not act soon, thou“We are a forward-thinking communisands of people who live in these communities will be left without vital transty,” Louie said. “We’d survive somehow and I’m sure we’d find ways to be able to portation routes, becoming increasingly get to the city or cities somehow.” isolated,” Lee wrote in a letter calling on But not all First Nations, including some Fleming to respond to the potential crisis. Lee added that the issue is not only a remote Nuu-chah-nulth communities, would be able to find easy alternatives. concern for the present. “Communities need access to these Louie is unwilling to speculate what effects a cancelled bus service would have transportation networks now, and they need assurances that these companies will elsewhere. “I can’t speak for other First Nations be able to operate these services in the and I wouldn’t want to speak for other years ahead,” he said. First Nations,” he said. “I don’t know
