By Lyonel Doherty
The chief of staff at South Okanagan General Hospital is resigning over concerns about the continued erosion of patient care in the facility.
Dr. Peter Entwistle said Interior Health is planning to decrease the actual number of hospital beds in Oliver from 24 to 18.
“On average we have more than 18 patients,” he told the Chronicle in an exclusive interview.
“That means that patients will be forced to be left on beds in the emergency department in Oliver; that is really not good patient care.”
Entwistle said these latest cuts are a “financial” decision that will significantly impact patient care at the hospital.
But Carl Meadows, health services administrator for SOGH, said the perception that beds are being reduced in the hospital is false.
“It’s not true.”
He said the hospital has 18 physical beds that have been funded by the taxpayer for the last five years, and that “will not change.”
He noted the average capacity at SOGH during the past three years has been 18 beds or less. He did state there are some extra beds in the hospital that Interior Health hasn’t determined what to do with yet.
Meadows said SOGH will continue to have a chief of staff, noting the interim plan is to have Penticton’s chief of staff step in to fill the void left by Dr. Entwistle.
When asked about SOGH’s struggling ER department, Meadows said there is no intention of closing it. He pointed out that some new physicians have recently been recruited to work in Oliver, and some of those will be covering emergency room duties.
“It looks like we’ve got a full complement of physicians,” Meadows said.
Entwistle has been chief of staff at SOGH since 2009 and has been practicing medicine for more than 30 years.
When he settled in Oliver in 2007, he became part of a “cohesive” group of doctors who all shared emergency room duties equally.
“Everyone had a doctor at that time; there were no orphan patients (in Oliver).”
Entwistle said SOGH used to be a self-reliant, self-contained hospital, but the re-organization of health care made things “fragmented,” he pointed out.
The physician said it has been more difficult to staff the emergency room (ER) department, particularly on weekends. In the past, this has prompted the temporary closure of the department.
Because Entwistle is chief of staff, he has a responsibility for patient safety, which is why he has done everything in his power to keep the ER open. This has meant working many extra shifts while still maintaining his own family practice and doing the “addictions” work in response to the fentanyl crisis.
“It’s wearing on me, covering gaps in service is truly exhausting,” he admitted.
He said one solution to the ER staffing problem is fair and equal pay for Oliver doctors.
“If they are doing the same work with the same qualifications and skill as other doctors in other hospitals (Penticton, for example), they should get paid the same.”
But he said Interior Health’s solution instead is to close the department temporarily. “Either they think we need ER or not.”
Entwistle said working in ER can be the hardest job.
“It’s harder then your family practice, and it pays less. All doctors who work in the ER take a pay cut to work there.”
Entwistle said if things were done differently, ER wait times would be reduced.
Currently, there is only one doctor and two nurses on duty at SOGH at night, he pointed out. During the day there is one doctor and three nurses, he noted.
Entwistle fears that if health care cannot be properly funded at SOGH, patient care will be further eroded – from 18 beds to 12 beds to no beds, and the ER will face more closures.
Entwistle attended last week’s all candidates forums in Okanagan Falls and Oliver and was “appalled” that MLA Linda Larson appeared to accept the decrease in beds and ER closures as the cost of doing business.
He is very concerned that both candidates were proposing cuts of $2 billion a year to health care (by eliminating MSP premiums) without credible suggestions about where the money was going to come from to fill the gap.
That immediately prompted him to consider running as an independent candidate in the upcoming election and basing his platform solely on health care issues.
He said hospital beds, emergency services, wait times for surgery, mental health, addictions, youth and seniors’ health must be front and centre and not allowed to be forgotten.
“Our politicians must be accountable, and if you care about health then you should vote for health care.”
At the all-candidates forum in Oliver, the candidates were asked about the plan to reduce the number of beds at SOGH from 24 to 18 despite the hospital running at over-capacity.
Larson said the hospital is doing a “revamp” by taking rooms that were previously two beds and transforming them into one in order to make them more comfortable.
“The mandate in BC is to try to move people out of those beds and back into the community . . . supporting aging in place is what we’re trying to do.”
Larson said they don’t want people sitting in acute care beds, they want them to be able to stay in their own homes with home support. “We have 1,500 more care aids to help make that happen.”
NDP candidate Colleen Ross said the province is starving its health care system by cutting back on staff and beds. She said the NDP have made a commitment not to let people live with pain and wait times.
“When you’re living in pain, somebody made a political decision to allow that to continue to happen.”
Larson acknowledged that sometimes there are not enough doctors to do the work that needs to be done. Therefore, it’s better to close the ER at SOGH for one night and send patients to where they can get care, she said.
“It has only happened twice I believe in the last year or so . . . no one who has an emergency is left untreated. Everyone is taken care of within the appropriate time frame.”
Dr. Alan Ruddiman, president of Doctors of BC, served as chief of staff at SOGH for four-and-a-half years preceding Dr. Entwistle.
He said it is very difficult to serve in this role because it is frustrating to advocate on issues or policies that are in direct conflict or opposition to the Interior Health Authority (IHA).
“For that reason I understand why Dr. Entwistle feels he has to resign if he feels he needs to take on an increasing political role advocating within the community, and perhaps more broadly, on matters that may not align with the IHA position.”
Ruddiman said hospital staffing levels, resources and beds are very important to medical personnel at SOGH.
“Physician leadership at a local and community level is very important, as is having a strong medical staff voice within our health authority,” Ruddiman said.
On Monday, Town council agreed to write a letter to Interior Health, MLA Linda Larson and the Ministry of Health to express concerns about these latest developments and the impact they are having on the emergency room at SOGH.
Councillor Larry Schwartzenberger expressed his fear that any cutbacks may result in the loss of specially trained nurses.
Councillor Jack Bennest said this is just another step to moving local patients to the new tower at Penticton Regional Hospital, relegating SOGH to a geriatric facility.