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LETTER - Health care group responds to pathology discussion carried out at latest CSRHD board meeting

Comox Strathcona Regional Hospital District board supports calls for general pathology services
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Dear editor,

Re: ‘Bad Blood’ over pathology issue, says Island Health medical director

We would like to respond to the above noted article. We applaud the Comox Strathcona Regional Hospital Board, especially director Brenda Leigh, in passing a motion to reinstate general pathology services and exclude the CSRHB region from a contract with the Vancouver Island Clinical Pathology Consulting Corporation (VICPCC).

The North Island executive medical director is not able to comment without bias as she represents and works for Island Health. She needs to represent more than her own personal view when speaking in public. Even though she may prefer to talk to the clinical pathologists in Victoria, we believe the vast majority of family physicians and surgeons much prefer to talk to local pathologists about the kind of clinical pathology questions that they have. This is proven by 75 doctors in Campbell River who signed a petition to highlight this specific point. She seems to imply that having to talk to local pathologists is a roadblock to her providing whatever services she is providing - the fact is that the people in Victoria are not easily accessible - ask any local lab technologist who has tried to get in contact with them. We need to hear from doctors not employed by Island Health.

It is true that more complex tests are sent to specialists in Victoria as they always have been. However, the general pathologists have performed all the work they are well trained for extremely well for many years so there really was no reason to take services from them to a private, for-profit, pathology corporation in Victoria. Finally, she has lost sight of the fact that having locally based general pathologists is essential to support the infrastructure and integrity of a local laboratory – removal of local clinical pathology services erodes the lab as a whole. Smaller laboratories such as Comox Valley and Campbell River labs will become unsustainable if the services are broken down and moved away. As in this case, removal of clinical pathology from the CR laboratory has left Campbell River with no funding to hire a badly needed third pathologist, indirectly affecting anatomical pathology in addition to clinical pathology and has resulted in longer turn around times. That is dangerous for urgent/emergent cases and has caused delayed treatment and surgeries for other patients. (Turn around times are specific as to the time when the specimen is taken from the patient to the time the results are given to their doctor). When one pathologist is working solo, as the colleague is away, confirmation of serious malignancies has taken well over a month in some cases. As a result the lab is now dysfunctional and not sustainable into the future.

It is clear that the powers that be in Victoria do not recognize the magnitude or gravity of the lab situation which has become intolerable.

There was no response to a previous letter sent to the Ministry by this board. Responses from over 3,000 people in the form of a petition and letters, plus concerns from 75 local doctors have received either no response or identical letters saying everything is fine, when we have proof to the contrary. Our request for a meeting also fell on deaf ears. It is clear from the identical letters of response from the Ministry of Health, Island Health, the MLAs, etc. that there is no intention or plan currently to resolve the problems which are harming patients.

They also stated the College of Physicians and Surgeons have indicated there is no conflict of interest in rewarding the contract to VICPCC in April of 2014. We have serious doubts the college has ever rendered such a statement. Although we have provided all the authorities, including Island Health, with documents showing an obvious conflict of interest, IH failed to provide us with the document from the college proving their claim that there was no conflict of interest in awarding the contract.

There have recently been two replacement pathologists hired for the Comox Valley hospital while Island Health is in the process of inflicting the same procedural changes on that lab as well, eroding services, with turnaround times already getting longer. They will be doing anatomic pathology as clinical pathology is all being done in Victoria by VICPCC, which means there will be absolutely no backup in the North Island for clinical pathology.

The people of the North Island indeed have a right to be heard and heeded. Since Island Health has made false statements, shown an erroneous graph to make it look like the turn around times are as good if not better there and made promises in writing which were broken with no explanation there is a lack of trust in Island Health. There are several discrepancies and obvious problems so the only solution is an independent inquiry into the contract between VICPCC and VIHA and then a fair resolution created which is certainly warranted. Doctors and staff at the Campbell River and Comox Valley labs need to be interviewed without any fear of any retribution. The person who awarded the contract needs to be interviewed along with others.

It is the politicians who need to fix all the problems caused by Island Health since Island Health is obviously not going to. They have been dishonest and disingenuous to the public.

Lois Jarvis, Richard Hagensen and Joanne Banks,

On behalf of Citizens for Quality Health Care