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Ripple effect

Regions are not only losing out due to the closure of Stanton Territorial Hospital's intensive care unit, but are facing waiting lists for specialists that are costing patients time and money.

Northern News Services

Yellowknife (Sep 30/02) - Patients in the Deh Cho region are hurting due to the crisis at Stanton Territorial Hospital in Yellowknife.

"Every time we medevac somebody (to Yellowknife) we're told, 'We're full. We don't have an ICU, send (the patient) to Edmonton'," said a frustrated Dr. Shane Barclay, who has been based in Fort Simpson for the past four years.

The waiting list for specialists has grown considerably longer, too, he noted.

In one case, delays for a colonoscopy resulted in a two- to three-month lag in detecting cancer. Another patient waited more than seven months to see an orthopedic surgeon when the typical interval from a referral used to be a month or two.

"There has been a difference of opinion between boards and medical staff upon the acuteness of the medical problem here," Barclay said. "Something needs to be done."

Hassles for Beaufort Delta patients

The shortages at Stanton translate into higher travel costs and more hassles for Beaufort Delta patients, says Dr. Braam de Klerk, medical director for the Inuvik Regional Health and Social Services Authority.

Like other centres, Inuvik has been sending all its critical patients down to Edmonton, where normally Yellowknife would have taken half of them.

The total number of patients affected averages out to be one patient every week or two.

Patients in the Mackenzie Delta are also seeing less specialists visiting.

Inuvik would normally get four orthopedic clinics a year, but so far in 2002 the orthopedic doctor has visited only twice. It's been a similar story with the other specialist clinics.

That means patients who can't wait to see specialists have to be flown out.

"Those things inconvenience the patients and obviously, flying one specialist up here is much cheaper than sending 20 patients down to Yellowknife or Edmonton," de Klerk says.

Besides the added hassle of travelling, he says, patients who fly out have to pick up the first $250 in travel costs, plus hotel fees while they're gone. All for a service that would normally be provided free in the community.

The local health authority ends up shouldering the increased travel costs, covering for a service Stanton is mandated by the government to provide, de Klerk says.

"I'm not blaming Stanton -- if they have no doctors there's nothing they can do.

"But if we don't get those visits, Stanton is still funded for that. If I have to send down five ENT (ear, nose, throat) patients out because the ENT guy isn't coming up, I have to pay that."

Concerns mirrored in Kitikmeot

Brenda Jenke, a councillor for the Hamlet of Cambridge Bay, says residents of the Kitikmeot share the concerns of other regions.

She says she doesn't believe the Kitikmeot region is being well represented at the Stanton table.

"It's a big worry," she says.

"Within the Kitikmeot we're all going to Yellowknife for medical treatment that is not offered in the region. Usually when a person needs to be referred to Yellowknife they have to wait.

"They have to do something. Not only does Stanton take care of the NWT, we have a lot of people from Kitikmeot region that rely on them," she says.

Waiting lists the biggest problem

In the South Slave the shortages are affecting patient care in a number of ways.

"As a territorial hospital, they do most of the specialist functions at Stanton," says Dana Rasiah, the CEO of the Fort Smith Health and Social Services Authority.

Not only do patients from Fort Smith see specialists at Stanton, but those specialists also visit the town on a regular basis.

"The waiting period is quite long because of shortages there in Yellowknife," Rasiah says. There is a list of 60 people waiting to see an orthopedic specialist who visits from Stanton.

Other specialists who make visit Fort Smith include experts in mental health, eye care, internal medicine and gynecology.

"There's a whole bunch who come down here on a regular basis," Rasiah says, noting some of those visits have had to be cancelled because of the shortages.

During August, six specialists from Stanton were scheduled to visit Fort Smith, he says. However, three of those visits were cancelled.

"It's critical we get those visits," he says, noting that, in August, 72 patients from Fort Smith were referred to specialists.

Rasiah explains it is also more difficult for a general practitioner in Fort Smith to make a referral to a specialist in Edmonton, noting such referrals are usually made specialist-to-specialist.

Fort Smith also relies on Stanton for birthing services.

Asked to describe how important Stanton is for health care delivery to Fort Smith residents, Rasiah says, "Under the current structure, where we rely on specialist services at Stanton, I think it's very critical."

Wes Drodge, the CEO of the Hay River Community Health Board, says specialists from Stanton also visit Hay River.

"Certainly when there's a shortage of specialists it affects the number of clinics they can attend," he says.

Drodge says health care in the NWT is an integrated system, and all parts have to work together to make the system function.

-- Paul Bickford, Derek Neary, Lynn Lau and Chris Puglia contributed to this story.