N.L. doctors association accuses province of being too slow to resume health-care services

The association that represents Newfoundland and Labrador's doctors says the province was too slow to resume health-care services after the pandemic-fuelled shutdown, and it wants the health minister to publicly release the government's plan.

In a virtual news conference Monday afternoon, Newfoundland and Labrador Medical Association president Dr. Charlene Fitzgerald said the association was surprised last week when Health Minister John Haggie informed them the provincial government plans to have health-care services running at 85 per capacity by July 6.

"We were surprised by this revelation for two main reasons," she said. "First, we were unaware of the planning process, and that planning process hadn't involved physicians.And second we were skeptical that such a target would be achievable by July 6," she said.

Fitzgerald said Haggie told them of the plan after NLMA section heads presented data on their current capacityto Haggie data that the association says indicates medical services will not return to pre-COVID levels soon.

"Many parts of the health system remain significantly below capacity and will likely remain that way for many months. The issue is hospital rules and resources."

Fitzgerald said physicians who work in hospital settings rely on hospital resources such as operating rooms and clinic time, and can't control what time isgranted.

Regional health authorities control which services can restart, the allocation of resources, the rules for personal protective equipment, distancing requirements and the number of patients who can be seen, she said. The RHAs also require patients needing aerosol-generating procedures to be tested for COVID-19 ahead of their operation.

"These restrictions are in place for good reason. We don't argue with these restrictions. They are there to protect staff and to protect patients. We support these restrictions but they exacerbate the already existing wait lists," said Fitzgerald.

"Doctors are ready. We're ready to accelerate the volume of patient services now."

The NLMA provided Haggie with advice May 15 on how to reopen services, saidFitzgerald. But she said government transparency has been a problem with addressing the backlog of procedures, as well as keeping its "finger on the pulse" of the prevalence of COVID-19 in the province.

"There are other provinces that started to open up earlier that began to see that disease prevalence was low and that this was a time to sneak in before a second wave. As far as the timing, that would be one of the missed opportunities," she said.

Benchmarks

Fitzgerald said the NLMA also wants the provincial government to release benchmarks, by specialty area, so the public can see what progress is being made toward returning to normal.

In contrast with vague statements from N.L. public health officials, said Fitzgerald, the Nova Scotia Health Authority has been providing public updates with dataon volume and progress being made on procedures cancelled as a result of the pandemic.

"Nova Scotians can access those timelines for when their programs and services will resume and information on the programs their government is making," said Fitzgerald.

"We need a similar mechanism, and an accounting of the health-care system and the progress remaining."

Restriction challenges

Dr. Jerry McGrath, agastroenterologist in St. John's, said during the press conference that he has been operating at about a 50 per cent outpatient capacity in the last few weeks, gradually building since restarting in May. He said Eastern Health, the province's largest health authority, does plan to increase that.

McGrath does colonoscopies and upperendoscopiesat the Health Sciences Centre and St. Clare's Mercy Hospital, something he says there was quite a demand for before the pandemic. But inthe last few months, he said,there were very little to zero of those procedures taking place, and roughly 3,000 were cancelled as a result of the pandemic.

"The thing that worries me is that we've had two or three months where we've had zero or five per cent of procedures, and we need to catch up on those. Now we're looking at a situation where we're at 50 to 60 per cent of procedures, and even if we do get it up to 75 or 80 per cent, we still got this massive backlog of procedures that need to be caught up on," he said.

"My procedures are quite sensitive and invasive. If you're going to do an upper scope and look in someone's stomach you can't socially distance from them. I can't do that virtually and I can't do that from six feet across the room. That means there's a high level of PPE that's required to do endoscopy."

Before the pandemic,McGrath said, there were discussions on updating an outdated gastrointestinal unit at the Health Sciences Centre, which would have alleviated capacity concerns. He said the current unitis too small, and was over capacity before the pandemic.

McGrath saidcurrent public health restrictions make for a challenging work environment in the small unit, withpatients needing to be picked up after a procedure, patients under sedation needing an extra person to accompany them,physical distancing issuesand capacity problems.

"All these different factors need to be taken into consideration," he said.

"I'd love to be able to get to 80 or 85 per cent [capacity] and I'd love to be able to get to 100 per cent, because at 80 per cent our wait list will continue to grow. So those are my concerns as we move forward."

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