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Until the next boom floats us out to sea.

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The price of oil has fallen and it’s taken the sky down with it.

The price of oil has been falling and projected to fall for some time. It was projected when Jim Prentice was on the leadership campaign trail. It was projected while Prentice, Gordon Dirks and Stephen Mandel were on the byelection campaign trail. While promises were made for new schools and to complete the new schools promised by two previous Premiers. While sod was turned for photo-ops in fields that will remain empty for some time, and when Gordon Dirks was flexing the electoral muscle of his Ministry with promises of new school portables in his riding. While all four candidates to be government MLAs were sending empty chairs to candidate forums.

But now oil has hit bottom, at least for now, and $7 billion or so is gone from provincial revenues. The Premier’s plan thus far is to remove 5% from budget for the coming year, while withholding the 4% that would normally have gone to compensating for inflation, population growth and uptake in services.

An early election will be called, and voters will give a massive majority to the Prentice government.

The Wildrose will be led into battle by a leader who won’t be seeking re-election. The Liberals? There’s a very good chance David Swann will be in Legislature once the spring session resumes after the vote. Even if he’s only a caucus of one at that point. The Alberta Party? Calgary-Elbow has every reason to put an end to Gordon Dirks’ embarrassing tenure by electing AB Party Leader, Greg Clark. However, not everything needs a reason in politics (see MLA Genia Leskiw not needing any kind of articulate, sensible or coherent explanation for withdrawing $250,000 from the Office of the Child and Youth Advocate).

The Premier says that the opposition has a duty to be ready for an election.

Do they have a duty to be ready for a fixed election-date? Absolutely.

But with a year left on a his government’s mandate, an early election, without a dramatic plan to shift away from the poor fiscal management of Alberta’s PC government, is pure opportunism.

A dramatic shift being a clear and defined plan to finally remove Alberta from the resource roller-coaster and establish a course to stabilize government revenue. But there’s no sign yet that the Premier is coming to the table with a platform for a progressive tax system, royalty reform, heritage saving and so on. We may not even see a budget tabled before an election call.

So why wait until spring of 2016 for the next election? What’s in a year?

A year for Jim Prentice to develop an actual, detailed platform. To show voters how “new management” handles the books on the downside of resource dependence. A year for two opposition parties to elect new leaders. Time for all parties to finish developing a set of policies, and a heck of a lot of time for candidates to hit the doors, and for those who don’t have the benefit of incumbency or well-timed Ministry announcements, to let voters know who they are.

Alberta is more than the petrochemicals we drill and frack out of the ground. Our Premier can do better than drawing the curtains closed, dimming the lights and taking to the podium time after time with tales of fiscal woe.

Yes Mr. Premier, we know we’re dependant on oil revenue. We know there’s a glut of it on the market, demand is down and prices along with it. So what’s the plan, besides bloodletting until fortunes improve?

What’s our place in the world outside of non-renewable resources? What’s the future for education and healthcare, agriculture and farming? What’s in store for our cities in a province where population growth is in urban areas? How can we grow our economy by feeding the world’s population? How can develop and export knowledge, technology and renewable energy?

Just as important, how do we engage citizens to get there? We have a government that treats ‘consultation’ like a silly word, or perhaps a dirty one. The Legislature is a difficult building to walk into, even if all you want is a tour. Budgets, policies and decisions are treated as things developed behind closed doors, then sold and marketed to you and I.

This election certainly won’t be based on any of those broad ideas. It won’t feature detailed policy or broad debate on our future. No, it’s about securing the next four years for those who are comfortably unchallenged. What do they intend to do with these years? I doubt most sitting government MLAs could begin to tell you, beyond ‘fiscal restraint’ for the year ahead. We won’t know until months after an election, what that will actually mean for front-line delivery in areas like health, education and human services.

Cutting 9% from spending isn’t a plan for the future or a beacon of light and strong leadership by Mr. Prentice. It’s the hand (gently?) guiding us to the rocks until the next boom floats us back out to sea (we won’t waste the next one, right?).

So when you pick up that sharp pencil at the polling place, have a debate with yourself. Do you want this government to be comfortable for the next four years, or can we challenge ourselves and those we elect to do better? Voting for a candidate that’s challenging the government may be the only way we find out.

Making it Easy

“I’m from the bureaucracy and I’m here to make things easier for you”. In a system that functions on meaningful consultation and two-way dialog, these could be comforting words, rather than ones that cause news articles, headaches and other pains.

Concerns raised over parking changes at Cross Cancer Institute – Global Edmonton

It’s my first blog post of the new year and a story I’ve been wanting to comment on for awhile now, as soon as free time allowed.

Last winter I volunteered to drive a relative to an appointment at the Leduc hospital. I’m not particularly experienced with medical facilities outside of Edmonton, so it was a new experience to me. Upon arriving I proceeded to do the first thing that any Edmontonian would do, ascertain where to pay for parking. This is the moment where one truly realizes that they’re not in the big city anymore, parking is free. No attendant to pass on the way in or out, no machine to pay, run up to, run back to the car, and then run into in the building.

Getting in was as easy as could be.

Whether or not you’re charging visitors and patients for parking at a major medical facility, as an operator you should have one particular goal in mind – making entry and egress for people who aren’t exactly there to have a good time, as easy on them as possible.

If you’re a cancer patient bravely facing a terrible illness, a scared and ill individual arriving at an ER, or a friend, family member, or caretaker of said person, the least we can do as a society and a medical system is make the process of arriving and getting inside, the least of one’s problem.

Alas, the administration behind the scenes at the Cross Cancer Institute has stepped in to show exactly how to make things harder in order to make them “more convenient”. In this case, with the removal of a parking attendant in favor of a kiosk system.

Where patients and/or their families had the option of simply dropping the deposit in the hand of another human-being and going about their likely stressful, painful and draining business, they now have the added stress of dealing with a kiosk and more than likely, having to overpay thanks to uncertainty over how long their stay is going to be. This, in addition to now having to park, visit the kiosk, run back to the car and then in.

You might say I’m going off over something that’s not exactly a terrible inconvenience, but I would strongly disagree.

I’m fortunate to be able to say that the Cross Cancer Institute is a building I’m not familiar with. Hospital visits for familiar reasons however, I’ve done my fair share of. A couple of times as a rattled and frightened patient but mostly as a worried and concerned relative. I can think of a number of scenarios where a situation like this, particularly at a major medical centre where patients can be found transporting themselves, can add unnecessary uncertainty and stress to the daily routine of someone who surely doesn’t need to bear anymore than they already do.

The obvious is, of course, not knowing the length of your appointment and overpaying to avoid having to worry about receiving a ticket or making your way back down to the parkade in the middle of things.

If you’re a relative or a caregiver, having a parking attendant to deal with at the end of the day relieves you from having to leave the patient alone in the vehicle or sitting in a wheelchair while you take care of this annoyance.

It adds more stress to the patient and their caregivers. It may be an easy task running to a kiosk and back again, or multiple times during the day. But if you’re ill, or exhausted, or physically run-down from the effects of facing illness or caring for someone who is ill, it’s an added and unnecessary burden.

To leave you with a personal example, on one trip to a scheduled appointment, a family member forget her purse at home. With a parking attendant on hand, it was a simple fix. They simply left their plate number with the attendant and paid later.

Finally, it’s simply safer for all involved to have a parking attendant on site. It’s a set of eyes on the site, not just for crime prevention, but to provide assistance should a medical incident, or a slip and fall occur within their line of sight.

The bureaucracy and facility administration can certainly study the issue, but in the meantime, put the attendant back in the booth and make these trips to the Cross Cancer Institute just a little bit easier for all involved.

Failing the Frail – Homecare reductions in Alberta

 Alberta Health Services cuts homecare services

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“…assessed by START (Short Term Assessment and Rehabilitation Treatment) to develop a treatment plan to improve her quality of life and allow her to continue living out in the community.”

Glenrose program keeps seniors active

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My headline for this blog post is, of course, recycled from when I wrote last year about the closure of the START program at the Glenrose Rehabilitation Hospital. The program, highlighted so well in the above quoted article from 2006, was shuttered last year. My father, thanks in no small part to the advocacy of some diligent and committed home-care staff, was one the last patients to benefit from the impressive rehabilitative care offered by the program, and the efforts of staff, a number of whom had been with the program since its very beginnings.

Alas, with little consultation, and wave of approved soundbites in the face of criticism (namely from former patients contacting any local media who would listen), START was quietly closed. Assurances followed that opportunities would be there to treat patients in the community, and that the level of care would not suffer.

Over the past two years, over 5000 additional patients, being treated in their homes, in their communities, have been added to rosters of the Edmonton area’s various home-care providers.

No one asks to suffer from, to endure, and fight to overcome the effects of age, illness, injury, etc. And it’s hard enough finding obstacles and barriers everywhere, and everyday, where healthy individuals may see little more than some steps to climb, a distance to walk, or a curb to step upon. What’s desired is a level of care that enables them to maintain some quality of life, to avoid complications that can lead to setbacks, and hospitalization, and some help for families that struggle to provide and care for a loved one in need.

None of this can truly be appreciated unless it’s been seen or experienced up-close. Unless you’ve witnessed and/or cared for a loved one with medical difficulties, unless you’ve been a nurse, or a therapist, or one of the many talented individuals in the medical field or provide these supports to individuals in their homes, it can be so incredibly easy to under appreciate the issues at hand.

And it would seem that our decision-makers, elected or otherwise, exist detached from the everyday struggles of many Albertans. Perhaps it can be seen in a government that allows a compassionate care bill to die on the order paper. Or maybe in the statement of an AHS official who seems to believe that there’s little connection between a level of care, and the time health-care providers have available to spend with a patient.

“”We are not reducing the level of care for any of our clients. We will be reducing the amount of time spent with them in some instances,” Williamson said.”

 

“I’m sorry Mrs. Johnson, we’re reducing your daily exercise program by 15 minutes, the program that allows you to stay mobile and active”.

“I’m sorry Mr. Jones, we don’t have time to treat all your diabetic sores today, we’ll do the rest tomorrow, or Monday”.

 

The day-to-day life of a homecare worker isn’t just time spent with the patient. Time seems much shorter when a worker new to a patient and unfamiliar with them and their care must deal with the situation. Time which is well used to do more than run through a prescriptive routine, but which can be used to fully assess a patient’s state and condition. Time which is also consumed by travel and the transportation of supplies and equipment.

AHS is once-again acting upon a decision made behind closed doors, without any consultation whatsoever with those affected the most, failing those whose care they have been tasked with.

I challenge AHS to do better. I challenge everyone from senior management to the Minister of Health to set foot in our communities, in our neighbourhoods – to book our community halls and events centres and discuss this issue and many more, face-to-face with everyday Albertans. Listen to those who receive home care, those who provide it to the highest of standards, those who strive to provide the highest level of care to their patients, and those who support and care-for a relative or a spouse in need. It’s called public consultation, it’s called stakeholder involvement, and it shouldn’t take digging by a political party or the media to break an issue out into the open. Transparency, consultation, and open decision should, as a principle, be the standard of this government, and in particular the department with which we entrust our health, our lives, and that of those we care about.

Park It

Going to the hospital sucks.  Being in the hospital sucks.  No, I’m not telling you anything groundbreaking here, but having been to and around hospitals many times over the past decade for family members, and having gone through the UofA ER myself this past fall, I just wanted to say it.  Getting in to see family, to see a doctor, to deliver something from home, to ask questions, and/or to make some attempt to calm nerves, these are the priorities upon arriving, and once you get in the building of course.Once you’re on hospital grounds you should be in a place where care and compassion come first – where site design and operating procedures maximize to the extent possible the conveniences and minimize the distractions on patients, doctors, families and caregivers.This week, Rajendra Kale MD, Editor-in-Chief of the Canadian Medical Association Journal, published an editor slamming parking costs and policies in Canadian hospitals:

Parking fees are a barrier to health care and add avoidable
stress to patients who have enough to deal with. They can and
sometimes do interfere with a clinical consultation, reducing
the quality of the interaction and therefore of care.

Dr. Kale also quotes from a 2008 press release from the Government of Scotland, announcing the termination of parking fees by their National Health Service:

“It’s simply not fair to expect patients or visitors to have to pay when they come to hospital, when they may be suffering personal anxiety, stress or grief. Put bluntly, a car parking charge is often the last thing people need.

The editorial can be downloaded in-full here: http://www.cmaj.ca/content/early/2011/11/28/cmaj.111846

The Edmonton Journal, quotes Health Minister Fred Horne in response:

“I can certainly sympathize with the plight of people, and when you’re looking after someone who is ill, perhaps a family member, it can be just one more thing that you have to deal with,”
Hospital parking fees here to stay, province says – @EdmontonJournal.com
http://www.edmontonjournal.com/news/Hospital+parking+fees+here+stay+province+says/5785543/story.html

The larger issue here is, I believe a need for an independent Patient Advocate who can provide an ego and personal agenda free objective outside look at the system, with the resources to lobby and press for adequate changes to address patient needs, concerns and access limitations.

On this issue, the response of the Alberta Government is that $55 million of $60 million in collected parking fees is used to maintain AHS’s parking structures, and cover maintenance and staffing costs..  Perhaps something for the Auditor General to look at in the near future.  I can’t argue the government’s $ amounts with the information available, or the validity and value of parking lot construction, maintenance agreements and so forth, and I’m not really sure if I want to spend several months fighting through with FOIP request on this.  So instead I’ll talk about the 21st century, and how while we may not have flying cars and cities on the moon, we can surely do better than a parking system that leaves patients alone in the car while the friend or family member bringing them to the ER runs off to pay for parking, or where time better spent concentrating on treatment or asking questions of physicians, or anything that focuses on the patient and their care, takes a backseat to staring at the clock and wondering how much time is left on the metre.  Even while typing this I can already hear the sounds of someone, somewhere in downtown Edmonton, typing up a memo featuring some depressing cost estimates for a smart parking system.  So how about this, I’ll park, go see my relative who’s undergoing treatment, you grab my plate # when I drive in, and when I drive out, and bill me later when I’m not sick with worry, and far from being in a mood to watch the clock.

Failing the Frail: The Shuttering of the Glenrose Rehabilitation Hospital’s START Program

Short Term Assessment, Rehabilitation and Treatment

The START Medical Day Hospital provides a comprehensive geriatric assessment and group-delivered rehabilitation within the framework of an eight-week program to seniors.  The START Medicine Day Program (Short Term Assessment, Rehabilitation and Treatment) was established to meet the needs of the frail elderly experiencing increased functional loss due to acute changes as a result of multiple and complex medical conditions.

This summer the Glenrose Rehabilitation Hospital’s Short Term Assessment, Rehabilitation and Treatment program will complete treatment on the last group of Edmonton seniors to have benefited from this now 30 year-old program.  Since being relocated to the Glenrose, cutbacks have reduced the number of patients who have been able to seek treatment.

The program, however, has never stopped providing hope to the individuals and families living with and coping with chronic medical conditions and disabilities.  I’ve seen first hand, treatment at the Glenrose free a loved one in my immediate family, from the confinement of a lift-chair and a state of near immobility.

Between the soundbytes and accusations, are the day-to-day lives of frontline staff and those in need of, or in the care of, health services in Alberta.  The most painful path an individual may take to become a prisoner isn’t to commit a crime, it’s to be inflicted with a chronic illness or disability and be unable to seek treatment.

With the closing of the START program, our seniors and those struggling with illness and disability are being separated from the treatment options which have been provided by its dedicated staff, staff who in the face of previous budget cuts have been forced to provide treatment and conduct exercises in whatever space was available to them, including busy hallways.

My family and I are providing this testimonial in the hope that the Alberta Government and Alberta Health Services will allow this program and its staff to continue to treat frail Albertan’s in need of help.