Following a large rally outside Kitsilano's Pine Free Clinic yesterday, the NDP MLA representing the area still wonders why Vancouver Coastal Health is so intent on shutting it down.
David Eby told the Straight by phone this morning that a report on urban primary care in this region declared that not enough "high-need patients" were getting into the health authority's urban clinics.
That's because too many "low-need patients" were accessing the services.
"The solution isn't to close the clinic," Eby said, "It's to find a better way to make sure the high-needs patients can get in more efficiently."
The report by Dr. Garey Mazowita of Providence healthcare and Vicki Farally of Praxis Management described the high-need 15 percent of patients as "not necessarily limited to...people marginalized due to poverty, mental health or addiction issues, or with complex and multiple comorbidities, the frail, the disabled, street youth, and refugees and new immigrants".
"The critical issue for the individuals commonly included in the 15% is time—their complex interplay of multiple health and social issues generally require more provider time, in terms of both duration and frequency of visits, than most FFS [fee-for-service] practices can afford," Mazowita and Farally wrote. "Their primary health care needs are often best met by interdisciplinary teams that include physicians and/or NPs [nurse practitioners] as well as RNs [registered nurses], counselors, social workers, translators, pharmacists, etc."
Eby said that Vancouver Coastal Health's response—closing Pine Free Clinic, and removing primary care from Pacific Spirit Community Health Centre, Evergreen Community Health Centre, and South Community Health Centre—and consolidating services at Raven Song Community Health Centre won't address the issues identified in the report.
He and Vancouver-Fairview NDP MLA George Heyman issued a news release this morning noting that 1,2000 supporters of the Pine Free Clinic have signed a petition to save it. The two MLAs plan to present the petition to the legislature.
“For many, Pine has become a symbol of this bizarre decision to close four public health clinics across the city, and dump 15,000 patients with chronic health conditions onto an already burdened system where more than 100,000 already don’t have a family doctor,” Heyman said in the news release.
Dr. Rolando Barrios, senior medical director for Vancouver Community with the health authority, has written a statement claiming that "changes to primary clinics will not compromise patient care".
"In order to refocus on our population target and spend our public dollars wisely, we chose to redesign our urban primary care services to better support our most high needs and complex clients," Barrios wrote. "To do this, we are consolidating our four existing primary care clinics at South, Evergreen, Pacific Spirit and Pine into a single, high needs primary care stabilization clinic site at Raven Song Community Health Centre, located at 8th and Ontario."
He added that the new clinic "will provide more robust and fully coordinated care to those who need it".
When asked how much of this might be about real estate, Eby replied that he didn't know the answer to that question.
"There are four properties in high-value areas," he noted.
Vancouver Coastal Health maintains that it's moving primary-care clinics from the three community health centres to Raven Song, but other services will remain. Funding for the Mid-Main Community Health Centre is also being shifted to Raven Song. The Pine Free Clinic is leased space, according to the health authority, which hopes primary-care physicans will start a practice there.
In the 2014–15 budget estimates, the B.C. government increased funding for regional health care by 3.6 percent.
Last June then-Vancouver Coastal Health CEO Dr. David Ostrow announced that the authority had a $1.7-million deficit less than a quarter of the way through last fiscal year.
That led to a bunch of cuts to nonprofit organizations that were funded by Vancouver Coastal Health.
The Pine Free Clinic was originally headed by Vancouver Coastal Health's former chief medical health officer, Dr. John Blatherwick.