HomeMy WebLinkAboutThe Citizen, 1994-06-15, Page 6PAGE 6. THE CITIZEN, WEDNESDAY, JUNE 15,1994.
Emergency service not new issue, says Grier
The following is a verbatim transcript of an interview between
Ontario Health Minister Ruth Grier and Signal-Star Editor, David
Greenberg on the occasion of the inaugural meeting of the Huron/Perth
District Health Council, in Seaforth,
GREENBERG: Emergency
service is a big issue around here;
at least one hospital has lost - or
almost lost it. What is the
government planning to do about
it?
GRIER: It's not a new issue. For
a long time small hospitals have
had to top up the salaries of
physicians from their budgets, and I
think the solution is finding a
different way of compensating
physicians.
The fee-for-service system,
especially on emergency where
there may be only one or two
patients in a night, doesn't make it
worth their while to work, and
that's why they haven't been willing
to staff emergency rooms.
The Ontario Medical Association
could change the schedule of
benefits in order to compensate
them more appropriately for
emergency hours. We want to sit
down and negotiate a way of
paying them, not on the basis of the
number of patients seen, but on a
salary basis.
GREENBERG: For emergencies
only?
GRIER: For everything, so then
they could schedule themselves,
and not be dependent on the fee for
service for that.
GREENBERG: Has the OMA or
anybody responded to the notion of
salary?
GRIER: Well, as part of our
agreement with the OMA, we
established a committee with the
OMA and the Ontario Hospital
Association last November to talk
about this. In February the OMA
pulled out. I'm delighted now, since
the end of May they have now
indicated a willingness to come
back and continue discussions on
this issue.
GREENBERG: Is the amount of
salary a problem?
GRIER: I don't think we ever got
to that point. We have an
agreement with the physicians for
$3.8 billion that we will pay the
province's 20 000 physicians.
Within that, we have to re-allocate
within the OHIP billings for the
physicians in rural or remote areas
and I think we can do that.
GREENBERG: Do you
Volunteers
to clean
manse
Continued from page 3
Camp Menesetung.
Clean up at the manse will be
next week so volunteers are
needed.
Melanie Bearss gave a report on
the weekend at Westminister which
she really enjoyed.
Graduation dinner is Monday,
June 27 and on Wednesday, June
29 the Huntley family will arrive.
There will be a bake sale
Thursday and Friday, Sept. 8 and 9
and a used clothing sale Oct. 14 &
15.
Next meeting will be Sept. 15 at
2 p.m.
A delicious lunch was prepared
by Janet Laurie, Ollie Craig, Myrtle
Vodden and Bonnie Shannon.
• Over 100 Canadians die each year
from bike injuries. Children aged 5
to 14 account for one third of these
deaths.
last week.
recognize a difference between a
big city doctor and a rural doctor
and their different emergency
requirements?
GRIER: The OMA could do that
if they wanted to - today. That's the
schedule of benefits.
Rural doctors have been asking
them to do that for a while and the
OMA hasn't agreed. So now we
have the OMA and the hospitals all
sitting down to try and work out a
way.
It's not a problem I can wave a
magic wand and solve, or that the
OMA can or that the hospital can.
It has to be the kind of co-operative
effort that we see here with a DHC
(District Health Council).
GREENBERG: What if the
doctors just outright close
emergency rooms down. Are you
prepared to let them close?
GRIER: I cannot stop a doctor
from deciding where he will
practice. And I think that if a doctor
has privileges at a hospital, then the
hospital and the physician have to
work out an arrangement where
there is coverage for emergency
room service.
GREENBERG: Do you think the
hospital should be able to deny
privileges to a doctor who does not
stand emergency room service?
GRIER: I think they should
certainly talk very seriously to
doctors who have privileges about
responsibilities that go with those
privileges.
GREENBERG: But the Ministry
does not appear to be interested in
getting into the fight, elbows up.
GRIER: Well, the Ministry just
hires the doctors. They are
independent practitioners, they are
part of a self-regulating profession.
They cannot, under their oath,
deny emergency service to
anybody.
I believe that because they have
the privilege of being self
regulating and of having the use of
the publicly funded hospitals of this
province, with that goes
responsibilities and we're simply
talking to them about that.
It's only since 1991 that there has
ever been a formal agreement
between the Ministry and doctors.
Our government signed that and
we're taking our responsibilities
COALITION FOR
HURON COUNTY MEETING
June 23rd, 1994
8:30 am to 12:00 pm
Hensall Community Centre
• Auditorium
tr Groups and Businesses interested in
community and labour market
issues are invited to attend.
Co-sponsored bp jobsOntario Training
and the
Employment Training Committee
of Huron Community Services Network.
very seriously.
GREENBERG: I've heard that
the Ministry would like to see 3,000
to 5,000 family physicians leave the
province and then replace them
with nurse practitioners...
GRIER: I think that all health
planners, and it's not just in
Ontario, as provinces across the
country have looked at the future,
have realized that we have to for
the first time, get into some human
resource planning.
We have too many general
practitioners in some parts of the
province who are depending on the
population, such as the Toronto
area; we have too few in Huron and
Perth and parts of northern Ontario
and parts of downtown Toronto; we
have too few physicians servicing
clients with AIDS for example.
So we've never had a mechanism
for looking at how to appropriately
distribute physicians. So we believe
that we have to have some way of
doing that and not just allowing
everybody to just come in and set
up practice where they want to set;
which is what's happened in the
past.
And I also think, and the
Regulated Health Professions Act
acknowledges the important role
that other professionals have in
some parts of the province.
A team approach with nurse
practitioners working with
physicians to provide coverage,
works. It's proven to work in some
areas. And I think there is room
there to look at what needs do we
really have to meet in our
community and how best can we
meet them.
GREENBERG: I'm a little
puzzled trying to understand the
financing of the midwife program.
As I understand it, a family doctor
gets around $300 for a delivery
and midwives get somewhere from
$1,200 to $2,000. Flow does that
save money?
GREER: I don't know where that
figure comes from. Midwives are
on salary. Midwives deal with a
woman from the moment she
discovers she is pregnant, through
pregnancy, through birth and for
six weeks afterwards.
GREENBERG: Don't family
doctors do that as well?
GRIER: Not in the same kind of
intensity and relationship that a
midwife has. A midwife is on call
around the clock all the time, and
during the period before a birth is
available there.
GREENBERG: Aren't doctors as
well?
GRIER: A lot of general
practitioners don't attend births
anymore and won't deal with
pregnant women. And specialists
and obstetricians do. But we're
talking about a very different kind
of care. We're talking about care
for’ the 80 per cent of women who
are having an entirely normal birth
and don't need a medical
intervention.
GREENBERG: Do you think it
will save money in the long run?
GRIER: It wasn't begun to save
money. And we had midwives in
this country years ago, before we
had doctors. Births became very
medicalized over the past 50 or 60
years and about 10 or 15 years ago
women began to say, we want a
choice. We want a choice in the
kind of care we get if we're having
a normal delivery, and we want a
choice in not having it in a sterile
medical setting.
We want a birthing centre.
It doesn't mean we don't need the
obstetricians and the gynecologists
and their incredible skills for those
births where they're required and
we have to compensate them for
that.
GREENBERG: Sounds like it's
just the GP/obstelrician you are
trying to get rid of.
GRIER: I'm not trying to get rid
of anybody. I'm trying to give
women a choice, which is what
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they have demanded.
In my own family, one of many
grandchildren was born at home
with midwives and another needed
the most high tech expertise that a
teaching hospital in Toronto could
provide.
Every birth is different. The vast
majority of them are normal events
in a woman’s life.
And women are saying I want to
keep it normal with my family
around me and I don't want the
kind of medical intervention that
my mother had.
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