Last week, Island Health (VIHA) issued a statement to explain their campaign, ‘use your ED wisely’ to reduce the volume of people going to the Nanaimo Regional Hospital’s emergency department.

According to Island Health, an average of 200 people a day go to the Emergency Department at Nanaimo Hospital.

200 people a day or 73,000 per year is probably the entire number of patients the hospital admits; not just the bunch of people with their minor cuts and stomach aches that come and go from the emergency department, as VIHA claims.

Compare this to the ED at Vancouver Hospital, one of the busiest emergency rooms in the province. At their peak shift  from 2-11pm, there are about 50 patients in the emergency department. In 2013 VGH had 84,000 patients passed through the emergency department and were funnelled to various parts of the hospital.

The real cause of the problem is that the emergency department is the entry point for virtually all patients who require any type of care. According to the Canadian Association of Emergency Physicians (CAEP) website, “Canadian hospitals gather few emergency department (ED) data, and most cannot track their case mix, care processes, utilization or outcomes.”

The gatekeeper system needs to be updated. Instead of slowing down the line of people to find out what insurance a patient has, there should be more emphasis on getting people the treatment they need.

It’s time for Terry Lake, Minister of Health, to look into these numbers and find a better admitting system.

VIHA (Vancouver Island Health Authority, a.k.a. Island Health) published the ad below in the local Nanaimo newspaper. Can you read it? It’s illegible. The ad says ‘use your ED wisely’. VIHA wants people to stop using the Emergency Department at your local hospital for ‘frivolous’ health concerns.

The emergency department at the Nanaimo Hospital is a good starting point for this discussion. Their admission process is presided over by a ‘gatekeeper’ who decides whether a person will be seen or not. How does she come to this decision? Does she take their pulse? Does she assess their injuries? No.  She looks a person up and down and decides like St. Peter whether they’re worth saving.

If someone has five star health insurance and claims to have received a minor cut on the job, then she will usher them through without a second to spare. Anyone else with a serious health concern and who falls into any of the following categories:

• old and living on a fixed pension
• LGBT
• First Nations
• Corrections inmate

are treated with complete disdain and put on the bottom of her priority list.  It doesn’t matter if a patient is brought in by an ambulance. She’s going to make them wait. Remember, the gatekeeper is god.

If you come to the Emergency Department on a holiday or weekend there is no one there except the gatekeeper.

Once a person gets passed the gatekeeper, you hope they’ll come across a student who might not know a whole lot but at least they seem to care. The regular ones treat patients like hogs in a factory farm. The only difference is that a factory farm is usually cleaner. Some of these health care workers are twitchy and irritated. Is that the result of being overworked? Perhaps some regular drug testing should be a requirement.  They shunt patients off from room to empty room. Sometimes they forget where they put someone.

Sometimes, one of these folks gets curious as to who is behind a curtain. Oh, the patient’s nearly dead, would you look at that. Time to call up the helicopter or the ambulance and cart them off to another hospital so they can’t be included in their list of daily death stats.

VIHA needs to shape up.

• Stop wasting taxpayers money on useless ads.
• Skim off the layers of management at the top.
• Audit doctor overbilling. Ontario is tackling this issue.
• Improve the gatekeeper/admitting process in the ED. The current situation creates a bottleneck.
• Treat everyone who comes into the hospital with respect.
• Enforce strict cleaning standards (ie bring back the regular hospital janitors before it was outsourced) Why do you think people have to come back? It’s so dirty that people keep getting infected.

Last week at the Nanaimo council meeting there was a presentation from the Newcastle Brechin Neighbourhood Association with concerns that their neighbourhood issues are being  ignored especially regarding pedestrian safety.

A pedestrian was hit and killed in a crosswalk at Estevan and Larch in December. The person who was killed was a member of the neighbourhood planning team.

Estevan Road was originally planned to be an arterial road with four lanes of traffic but now it is no longer needed as an arterial road. Unfortunately, drivers speed along the four lane section of Estevan which also includes a sharp curve at the south end.

Reducing the traffic to two lanes with curbside parking would slow traffic and make Estevan Road safer.

The residents spoke of a Comprehensive Pedestrian Connectivity Plan for the neighbourhood that needs to be implemented. They spoke about Terminal Avenue and the need for greater pedestrian and bicycle safety measures. Their questions were:

• How and where can we widen the sidewalk on Terminal Avenue between Stewart and  St. George so there is a “safety strip” style boulevard between the pedestrians and the cars?
• There were two locations identified in the neighbourhood plan for possible crosswalks across Terminal Avenue at Rosehill and at Mount Benson. The engineering RFP only refers to the Rosehill and Terminal crosswalk.  What is the rationale for ignoring  Mount Benson?
• How could we coordinate the current project on the Townsite and Terminal and Vancouver intersections with the Terminal Avenue project?

According to the residents, the Newcastle Neighbourhood Plan did not envision a “road widening project” along Terminal Avenue.

How many people are killed every year as a result of poor urban planning?

There were a number of presentations made to Nanaimo Council on Monday night from members of the public who had particular concerns about their neighbourhood.

There were two speakers who raised concerns about subdivisions of Departure Bay heritage lots. One resident spoke on behalf of the Departure Bay Neighbourhood Association and addressed the problems with the City’s subdivision approval process and how people feel shut out.

The problem  started when 10 out of 20 of these very large lots, about 0.8 acres to 1.1 acres, were permitted to be subdivided into smaller lots.

In 1954 a residential development called Lynburn Estates was created in Departure Bay.  A building scheme was placed on the entire development which stated that Lynburn Estates properties could not be used for commercial purposes and could not be subdivided. The building scheme was destroyed in an ugly court battle and basically the City stood by to watch the fight.

(Above, the map with blue dots indicates lots that can be subdivided into smaller lots, and the red dot represents an active permit for a subdivision at the corner of Lynburn Crescent and Sandringham Avenue.)

The City has approved 4 single family residences, and up to 2 duplexes where there currently is one single family home at the corner of Lynburn Crescent and Sandringham Avenue.

If the houses also contain a secondary suite, 12 dwelling units are possible. Considering the number of properties that can now be subdivided in a similar way the potential impact on the surrounding, established neighbourhood will be considerable. Overall it appears that there could be more than 40 single family residences and duplexes where there are currently now 10 residential homes.

The green gateway to Departure Bay provided by the large heritage residential lots along Departure Bay Road will be no more. Is this poor urban planning?  Comparatively, would the City of Vancouver consider creating small lot subdivisions in Shaughnessy?

The big question is will Departure Bay residents stay and fight or pack up and move?

Home Based Bakery

It was painful to watch Council struggle for one hour with concerns raised by two residents regarding a proposed production bakery to be operated as a home based business in a residential area in the 5400 block area of  Rutherford Road.

The residents brought forward a petition signed by 30 neighbours. It was clear that they had serious concerns on the topic.  Yet no one seemed to know how to help the residents.

Several Councillors tried to offer some suggestions:

Councillor Hong suggested for the residents to contact VIHA or if the home based bakery was approved by the City, to call a bylaw officer if the neighbours saw any regulations broken.

Councillor Fuller suggested looking at the Home Based Business Bylaw and seeing if it needed to be re-worded. He was shot down by the Mayor who quipped how many reports he had been requesting of late. The City Manager appeared to concur with the Mayor on the large volume of reports requested by Councillor Fuller and maybe he should re-think his request. Looking stunned, Fuller shrugged his shoulders.

Councillor Thorpe couldn’t understand the residents’ concerns with traffic if the bakery wasn’t going to have retail sales.

Councillor Bestwick made several attempts to try to get something rolling and each time he seemed to be stonewalled by the City Manager who couldn’t seem to see a way around the problem.  In total frustration Bestwick said, “we can’t do anything?”.  Finally, Bestwick with the help of the Legislative Services Manager drafted a motion to address the issue of the home based business at that specific address and it was approved by all except the Mayor.

Office Romance

In addition to signing a code of conduct, did Mayor and Council and City executive staff also sign a policy regarding romance in the workplace? This could protect the City from emotional workplace tensions, as many have witnessed, as well as any future lawsuits.

At the March 7th Council meeting, Council authorized a park land swap with a local developer to build a multi-storey parking facility and medical offices across from Nanaimo General Hospital at 1515 Dufferin Crescent.

Under the agreement, the City and the Developer are exchanging 82.7m2 (890 sq ft) of land.

The developer has plans for a new trail to Beaufort Park. Final approval of the land exchange is subject to an Alternative Approvals Process (AAP).

In order to proceed, Council is required to have approval of the electors prior to bylaw adoption, in accordance with the Community Charter. Approval of the electors may be received by way of an Alternative Approval Process (AAP), or assent voting (i.e. referendum). If 10% of the electors oppose the proposal by submitting a valid elector response form then the land swap cannot proceed.

The approval process applies to the whole of the City of Nanaimo which has 64,996 voters so 6,500 would need to sign petition forms and submit them to the City by Monday, April 25th.

The Beaufort Park looks like it has been nibbled away over the years, what remains is a very odd shaped park.  Previously in  2013 park land swaps were  common.  Another example of the City cannibalizing its own parks is the recent Georgia Park/Hilton Hotel land swap.