The Gerrard Report

Today, I write about a family who have been affected by the changes in our health care system.  The family wishes to remain anonymous but wants to make sure that there are lessons learned to improve our health care system.  The following is a first-hand account of their experience. On Sunday, October 22, an elderly woman living in the south east part of Winnipeg was found by her home care nurse to be doing poorly at an a.m. visit.   The nurse called her son to come and help with the care of his mother.   On arrival it was obvious that her health had rapidly deteriorated.   His first thought was to take her to Victoria Hospital which is five minutes from her home, but he knew the Emergency Room was recently closed.  He looked at his mother, seeing that only two days ago she was lively, walking and energetic, now she was responding very little while laying on the couch.  She could not get up on her own and he would not be able to lift h...

What should we be looking out for in 2018?   One thing to keep an eye on is Chronic Wasting Disease, a disease which is present in deer and elk in Saskatchewan and Alberta and in several states in the United States. It can also infect moose. To date, thankfully, it has not been found in Manitoba. It is related to Bovine Spongiform Encephalitis (BSE)  (Mad Cow disease) found in cattle and to Creutzfeld-Jacob Disease which occurs in humans.  BSE was found to be able to spread to humans and thus great care must be taken in detecting BSE in cattle and in preventing the prion which causes BSE from being transmitted to people. Until recently it was believed that Chronic Wasting Disease (CWD) was not transmissible to humans, but evidence, first reported in 2017, shows that it can be transmitted to primates (Macaque monkeys) and suggests it could be transmitted to humans.  Thus we need to be especially careful about the presence of CWD in deer and elk and the possibil...

I have been a passionate supporter of the people in Grandview who want to make sure their Emergency Medical Services station stays open.   As part of this effort, I wrote yesterday to the Minister of Health on behalf of the people of Grandview and area, including the people of Tootinaowaziibeeng First Nation.   My letter is below. Minister Kelvin Goertzen Minister of Health, Seniors and Active Living 302 Legislative Building 450 Broadway Winnipeg, MB R3C 0V8 December 20, 2017 Dear Minister Goertzen, I write to you with respect to the Emergency Medical Services station in Grandview. Currently, the Grandview EMS station has one ambulance and 4 paid paramedics who staff the station 70% of the time.   The remaining 30% of the time the station is covered by EMS personnel who are on call.   The population of the Grandview catchment area is currently estimated at 3,070 people.  This includes the nearby Tootinaowaziibeeng First Nation ...

The Wait Times Reduction Task Force brought forward its report yesterday.   While Drs Cochinov and McPherson have presented a lengthy report, much of the details are to be found in previous reports which have looked at the function of our emergency medical system and how to improve it.  The Brain Sinclair Inquest report of 2014, as an example, includes a thorough discussion of "patient flow" issues in Emergency Departments and the need to address these. The present report which repeats the emphasis on "patient flow" issues thus exposes the failures of the previous NDP government to implement earlier recommendations, and the failure of the present Pallister government to act in the 20 months they have been in office. One interesting example of a recommendation which has been talked about for years, with a complete failure of action by both the previous NDP government and the present Pallister government is found on page 60 of the Wait Times Reduction Task Force rep...

The KPMG report on Health Care  says the following about CancerCare Manitoba "Organizations like CancerCare Manitoba .... operate independently within the public system. .... There is not clear evidence that these organizations are more effective at delivering key management services despite leadership claims that they have more cost-effective or sustainable operations."   This statement by KPMG, is wrong, and is based on a lack of knowledge by those who wrote the KPMG report.  I will explain why. CancerCare Manitoba provides the best specialist network in Manitoba. - It has a clear provincial mandate which is recognized in legislation. - It has a province-wide network including 16 outreach centres in various parts of Manitoba.   Approximately one third of all cancer chemotherapy is given in these outreach centres.  Their impact is enhanced through the use of telehealth to provide a substantial amount of care and follow up.  This is very effi...

In a previous blog post on nitrous oxide , I have made the point that it is feasible to reduce production of the greenhouse gas nitrous oxide form agricultural sources by one third.   In this post I list eighteen studies in which nitrous oxide emissions have been reduced by 30% or more:  These studies illustrate the feasibility of reducing nitrous oxide by one-third.  It should be noted that the findings, when looked at carefully, suggest that approaches taken may need to be adapted to the particular local soil, crop and environmental conditions. The studies showing reduction of nitrous oxide by more than 30% are listed below: 1) Using a nitrification inhibitor or polymer coated urea can reduce nitrous oxide emissions by 35-38% compared to conventional fertilizer (reference 1). 2) Using fertilizer placed at a depth of more than 5 cm, compared to a depth of less than 5 cm, combined with reduced tillage resulted in reductions of nitrous oxide of greater than 30%....

Nurse Practitioners are a key part of ensuring we have an excellent health care system.  Some progress was made under the NDP government, but there was not a clear and continuing plan for the integration of nurse practitioners into health care delivery.   One step forward was the implementation of seven quick care clinics, five in Winnipeg, which were run by nurse practitioners.  There was also a gradual increase in nurse practitioners in access centres and a slow increase in nurse practitioners being involved in rural centres where there were no physicians.   Sadly, the Pallister PCs  are closing 4 of the 5 quick clinics in Winnipeg, have ended the Hospital Home Team, are closing the Corydon Primary Care Clinic and have terminated the positions of more than 20 nurse practitioners.  While some will get new positions, there will be a net  loss of nurse practitioner positions - the opposite of what it needed. While I have considerable concern...

November 19th in an article in the Winnipeg Free Press, Dr. James Bolton, medical director of the Winnipeg Regional Health Authority Crisis Response Centre admitted that " The treatment we have for suicidal people in the health system is abysmal.  There is no suicide specific treatment in Manitoba. " These damning comments came in response to a report " Toward Quality Mental Health Services in Canada " which shows that Manitoba is an outlier with far higher rates of attempted and completed suicides in our province than in Ontario, Alberta and British Columbia. This is an area where Judy Klassen (MLA for Kewatinook) and I have been very concerned for some time.  In 2007, a man who was suicidal went to a Winnipeg Emergency Room for help.   He was assessed and then sent home with a bus pass.  Soon after, he committed suicide.    In 2008, in response to this tragedy, Kevin Lamoureux and I introduced The Mental Health Bill of Rights - Bill 230, into th...

Under the former NDP government and now under the current PC government in Manitoba, our province has an extraordinarily high child poverty rate.   On November 21, Campaign 2000 released its latest report which showed that Manitoba has a child poverty rate of 27.5% - that more than a quarter of Manitoba children live in poverty.  We have, sadly, the highest child poverty rate of all provinces.  The average across Canada is 17.5%, a full ten percent below Manitoba.  The high rate of poverty has continued for so long that it is now expected.  The unconscionable has been normalized.  This in not acceptable. While federal policies are important to our national effort, the fact that Manitoba has the highest child poverty rate shows that Manitoba, compared to other provinces has poor policies with respect to reducing child poverty.   I have spoken out many times about the need for better efforts to reduce poverty in Manitoba.  In 2008, Kev...

The most potent of the three major greenhouse gases is nitrous oxide.   It is 300 times more potent than carbon dioxide.   It makes up approximately 15% of the greenhouse gases produced annually in Manitoba, when expressed as carbon dioxide equivalents.   It is produced primarily as the result of the application of fertilizer containing nitrogen onto fields in Manitoba to help the crops grow.  Especially under wet conditions, the nitrogen applied is converted to nitrous oxide which is a gas and goes up into the atmosphere.  The conversion of nitrogen to nitrous oxide results in a loss of the nitrogen fertilizer for farmers and the production of a potent greenhouse gas which warms the planet.  Its importance is even greater when one considers that its residence time in the atmosphere is more than 100 years - usually given as about 112 years. The NDP produced a climate change plan with a target to reduce greenhouse gases in Manitoba.  Th...

In Question Period November 22,  I presented a petition of 1,000 signatures of people urging the government to continue and to expand the Emergency Medical Services station in Grandview. I presented additional petitions of 500 signatures each on November 23 and 24th.   There are many reasons why it would be wrong to close the Grandview ambulance and emergency medical services station   There is tremendous community support for keeping it open.  I called on the government to keep the Grandview EMS station open and to keep their promise not to cut front-line services.  You can see the Minister of Health's response in the video by clicking on this link - video on Grandview EMS services   The written text from Hansard is at the bottom of this post.  November 25th, Naomi and I were in Grandview to meet with people in the community and to enjoy a community dinner together.  We were pleased to meet so many community members and to see the cl...

Sunday November 19th I hosted a Forum to explore the impact of the Pallister government cutbacks and to chart a course forward.  Three panelists joined me.  From left to right, in the photo above, they are Shelley Kowalchuk, Judy Walker and Alex Arenson. Alex Arenson, a Winnipeg lawyer and an advocate for the Corydon Primary Care Clinic, was the first of the panelists to speak.   He covered the history of the events since the government first announced that the Clinic would be closing in July 11, 2017.  According to the latest plans, the Corydon Primary Care Clinic will close in mid-January 2018.   As Mr. Arenson discussed, the closure of this clinic makes no sense either in terms of service for people or economically.   Just as people who went to the Misericordia Urgent Care are not going to the Victoria Hospital Urgent Care because it is too far away, few people from the immediate area around the Corydon Clinic will travel to near Bisho...

In my remarks to a panel on health care in April I spoke about the importance of patient-centred care.   A health care system needs to be founded on a number of operating principles.   One of these is the importance of putting patients first. While this may seem obvious, achieving care which puts patients needs first is often not in place.  Indeed, in many respects much of today's health care is organized around the needs of health professionals.   Hospitals and clinics are often designed using input from health care professionals, and they will frequently choose options which are most convenient for health professionals, not always thinking of the need to put patients first. The book " The Putting Patient's First Field Guide - Global Lessons in Designing and Implementing Patient-Centered Care " edited by Susan Frampton and her colleagues should  be required reading for people looking at the organization of patient care.  One of the po...

This evening, I spoke in the Manitoba Legislature on Bill 24: The Red Tape Reduction and Government Efficiency Act.  My speech is below: I rise to talk in opposition to Bill 24, and also to clarify several issues: In the Manitoba Liberal Party, we support the reduction of red tape and making things simpler for c itizens and for businesses to deal with government.   There are many ways of doing this – for example - improved coordination between provincial and federal governments.  I recall when I was the federal Minister responsible for Western Economic Diversification it was routinely much easier to get federal and provincial governments working together to help businesses in Alberta than it was to work with the then PC government in Manitoba.   Mr. Speaker, things have not changed, the current PC government is always ready to criticize the current federal government but rarely ready to try to work together to solve the issues that citize...