When you ask Leanne MacKinnon about the type of care her father received during the last days of his life, she’s quick to praise the efforts of the nurses, paramedics and home care workers.
But when you ask her about how the present health care system works and the effects of doctors withdrawing in-hospital care services in North Sydney and Glace Bay, she is not so positive.
In Cape Breton, upwards of 30 physicians have withdrawn from providing in-patient care due to a dispute over pay disparity and the effects are being felt. A number of those family doctors who have withdrawn are on the Northside and in Glace Bay. If there is no doctor available at those hospitals to provide care for a patient who needs to be admitted, the patients have to be sent to the regional hospital, no matter their condition.
Leanne MacKinnon’s father, Ernest (Ernie Slade) was one of those patients.
Slade was admitted to the Northside General at 10 a.m., June 6. Just over 14 hours later, he died 29 km away at the Cape Breton Regional Hospital, leaving behind a lot of questions.
“It’s not the people, it’s the policy - I don’t even know who to blame,” MacKinnon says now.
A family man
Ernie Slade was born in Florence in 1934. He worked for years with CN Marine in North Sydney as a stevedore. Besides working hard and raising a family with his wife Lena, to whom he remained married for 66 years, he served several terms as a councillor for the town of North Sydney.
“Everyone in North Sydney knew Dad,” says MacKinnon. “He was very optimistic and hopeful. He was grateful for every day of life.”
But eventually, rheumatoid arthritis took over his body. Macular degeneration took away much of his sight. Although excruciating pain took away his mobility, he never lost his interest in others and remained mentally sharp.
“He was always in good cheer and always concerned about everyone else’s troubles,” says MacKinnon. “As his world became smaller because he couldn’t get about, the visits of the wonderful caregivers and VON were important for social reasons as well as for the services that they provided.”
But on the morning of June 6, that all changed. His condition had quickly deteriorated and an ambulance was called. He arrived at the Northside General Emergency Room at 10 a.m.
“When we got there it was quickly determined that there was no stopping what was happening and some things were put into place, pain meds, oxygen and a few other things just to keep him comfortable,” MacKinnon remembers. “He was not long for the world. But we were told right from the beginning, ‘he can’t stay here, we’re closing.’”
There were no beds available in palliative care at that time in Sydney yet there were beds available at the North Sydney hospital – he just didn’t have access to them, MacKinnon disclosed in a recent letter to the editor of The Cape Breton Post.
“We were told very early in the day that the Emergency Department at the Northside General was closing at 6 p.m. and that Dad couldn’t stay. There were available hospital beds at the Northside General, just an elevator ride away, but he couldn’t have one because his family doctor, among others, is protesting fees for service by refusing to admit their patients to hospital. There would be no doctor available after the ER doctor left the hospital. The staff began an all-day search for a bed at the Regional, a place for Dad to die. The palliative care unit at the Regional was full. I asked that they please not send him to the Emergency Department of the Regional to die in a corridor.”
Being sent to another hospital because of the lack of physician inpatient coverage isn’t that unusual, says Greg Boone, director of issues management and stakeholder relations with the Nova Scotia Health Authority.
“Unfortunately, while we have some empty inpatient medical beds at Northside General Hospital, we cannot admit patients to many of those beds because some family physicians have chosen not to provide inpatient coverage for their own patients. That was the situation facing this patient and family and is an impact of the decision by some family physicians.”
Boone says it can be frustrating because it leads to more pressure on the Cape Breton Regional Hospital Emergency Department to move and admit patients.
“Patient flow is a balancing act at the best of times and when most inpatient beds are filled at the Regional, it increases the challenge. Having empty beds at two community hospitals and being unable to admit patients to those beds is a difficult situation. While the number can vary, there are times when we can have between 25 to 30 empty beds between two community hospitals (Glace Bay and Northside General). We regret that we cannot always admit people to hospitals closer to their home community. It does cause concern and hardship for some patients and their families.”
Arrival at hospital
Around 9 p.m. on June 6, EHS arrived at the Northside General to take Slade to the Cape Breton Regional Hospital, 29 km away.
Before they left, another family member, who was following by car, was told that if Slade died en route, the ambulance would have to pull over and the RCMP could be called because it would be considered an unattended death.
Even so, the ambulance began its journey. MacKinnon remained next to her father during the drive.
“He was in so much pain,” she said. “The ride was unbelievably rough. They’re like tin cans. Here he was being shook around - I thought he was going to be shook off the stretcher.”
An attendant told MacKinnon that Slade couldn’t fall off the stretcher since he was strapped in. That didn’t really make her feel any better.
“That’s how rough it was … he shouldn’t have been moved when he was that close to death.”
Eventually the ambulance arrived in Sydney and Slade was admitted to a bed on 4B.
He died three hours later.
Sharing her story
MacKinnon is sharing her story so people know how desperate things have become.
“It’s not about me - it’s about what he had to go through,” said MacKinnon. “This should not happen to anybody’s loved one, but I have no doubt that other Northside families can tell similar stories. My father was among the fortunate people who had a family doctor who he respected, liked and trusted with his life. He was lucky to live in a community with a hospital that has empty beds.
“In the end, this meant nothing.”
For Lisa Bond of Capers 4 Healthcare, MacKinnon’s story is becoming all too common.
“Most definitely we’re hearing more stories about people having to leave the Northside and lot of people are blaming the doctors which is unfortunate because when you look at the pay scale, you cannot blame doctors for pulling their services - our doctors are getting paid less anyway even to work in the Regional than they are in the rest of Canada.”
She encourages people to blame the health authority and the province for the current state of health care in Cape Breton and to attend a rally on Saturday, June 22, beginning at 1 p.m. at the Joan Harriss Cruise Pavillion, to get that point across.
MacKinnon wants to see Nova Scotia doctors and the province to resolve their issues so others aren’t placed into the same situation. In any contract and labour negotiation, compromise is needed on both sides, she adds because lives are the true cost in this dispute.
“I don’t have the solution but somebody needs to find one.”
Rally marks one year since initial announcement made
SYDNEY – A group formed to protest and question Cape Breton hospital closures is holding a follow-up rally this Saturday to protest a year since the province announced it was closing hospitals in North Sydney and New Waterford but beefing up the emergency rooms at the Cape Breton Regional Hospital and at the Glace Bay Hospital.
“We really want to mark that one year that we were promised that we would have answers,” said rally organizer Lisa Bond of Capers 4 Healthcare on Monday.
“We still have no answers.”
Bond says the event will begin at The Fiddle by the Joan Harriss Cruise Pavilion at 1 p.m. From there, people will march to city hall.
“We have a few speakers lined up and we’re working on more. Mainly it’s a way for everyone to get together. We’ll have an open mic part where people can tell their stories.”