Letters: January 21

Re: Rurality Changes Index will affect doctor recruitment, Lynn Wilson

Harper Eroding Democracy, Joanne Pickett

Re: Response to Open Letter to Scott Reid, Steve Duggan

X-Ray Machines in Airports, Ina Hunt-Turner

Re: Rurality Changes Index will affect doctor recruitment (Nov 14/10)

I read with interest the account of the effect the new RIO scores will have on the Rural Kingston Family Health Organization, and on many other small practices in smaller centres that lie in what we may term, "the near north", that is, the unfortunate belt of geography and population that lies between the "true" north as now defined by the Ministry of Health and the Ontario Medical Association (OMA), and the urban outermost boundaries.

Some minor corrections are to be noted.

First, the cut-off for the under serviced designation is now actually 45. For the purpose of physician recruitment and some other incentives, the eligibility score has been lowered to 40. So, while Sharbot Lake does not actually make 45 in the new scoring method, the Sharbot Lake site will be eligible to offer rural incentives to new physicians.

Second, in the last round of scoring (the 2004 index), through an error at the OMA, Sydenham was scored at 55, higher than Sharbot Lake. This was not corrected until very much later in the day.

Third, Verona was eligible for some rural incentives prior to the recent policy changes. It had the advantage of being able to qualify to offer rural incentives to new physicians. This was key to recruitment strategy for the solo practitioner how holding that site. A couple of other recruitment incentives were also available. Now that whole package has disappeared. For Tamworth, too.

Last, I note that your article singled out women physicians with small children as wanting smaller practices. As I recall, what I pointed to was the general trend among younger physicians as a whole group; larger practices do not appear to have an attraction for this group. Arbitrary figures provided by various agencies suggest that between 1,100 and 1,300 patients per physician is a reasonable practice size. That size, or smaller, is the practice size often selected nowadays by younger practitioners coming into the field. From some points of view, that's not a bad thing. It offers perhaps not a bad balance between reasonable practice size and quality of work and personal life for the practitioner.

This is not to extol the heroism of the practitioners out in the Rural Kingston Family Health Organization whose practices are over 2,000 patients; large practices are not for everyone, and, depending upon the demographics and comorbidity of the patient population, perhaps not an optimal way to provide care.

But, in the absence of practitioners with an interest in rural medicine sufficient to draw them to the country to practice, the current practitioner group has no recourse but live with the practice sizes, and to restrict practice intake of new patients to what is humanly manageable.

Where are the voices of political support for the rural populations and their service providers who are being sacrificed for the "greater good" of better public policy? The question now is how best to raise awareness in the practice populations affected, and to mobilize their voices as voters In Frontenac and Lennox & Addington.

What is not clearly understood is that if just one of the medical practitioners in Tamworth, and Verona, for example, were to go out of service for whatever reason, the neighboring practices would not be able to absorb the "orphaned" patients. There are 5,200 patients between these two practices. There are three physicians servicing this group. Two of the physicians have over 2,000 patients. I invite the readers to compute the consequences for themselves were this to happen in these communities where the sheer physical barrier of geography and economic costs of transportation already present significant barriers to access for many patients.

Interested parties should be hammering at the doors of their local and provincial elected officials and community associations to see what can be done for their communities. This is, among other things, a community sustainability Issue. For a community to remain viable and sustainable, core services are needed. Local primary health care is high on that list of core needs. This is a large piece of what the folks who design schemes such as the RIO scores need to understand. But, it is in the nature of policies based upon statistical modeling to shake off the outliers. And so populations such as the rural population of the "near north" become increasingly marginalized.

Lynn Wilson,
Administrator, Rural Kingston Family Health Organization

Re: Open letter to Scott Reid MP (Jan. 7, 2010)

I’d like to thank Helen Forsey for her letter (Open letter to Scott Reid MP, Jan. 7/10) to the editor. Stephen Harper and his ministers have been eroding democracy in this country since the day they took office, and the practice of sending greeting cards to constituents containing Conservative party propaganda is just another one of their cheap tactics.

Mr. Harper’s decision to prorogue government for the second time in just over a year in order to deflect public attention from recent scandals involving his party’s incompetence and questionable practices is both contemptuous and cowardly. It is obvious that Harper now presides over a minority government that can all too readily be characterized as a dictatorship.

Harper has maligned several senior and very competent bureaucrats who dared to question, criticize, or oppose his government's questionable policies - including former Military Police Complaints Commission chairman Peter Tinsley, RCMP complaints commission chairman Paul Kennedy, former Canadian Nuclear Safety Commission president Linda Keen, and parliamentary budget officer Kevin Page - just to name a few. The most recent casualty in Harper's dirty war against his political opponents is his government's attempts to destroy the reputation of former diplomat Richard Colvin. Why? A courageous Mr. Colvin revealed the truth about the Harper government's questionable policy pertaining to the treatment of Afghan prisoners of war handed over by Canadian Forces.

His plans to stack the Senate, after having derided that institution, is further evidence of his duplicity and unscrupulous nature.  

Joanne Pickett

Re: Response to Open letter to Scott Reid (Jan. 14/10)

It is disheartening to see the thoughtful clarity of Helen Forsey’s remarks responded to with insults and name-calling, ironic as they may be. Such language does not succeed in buttressing the logic that might be lacking otherwise. Let us hope we can encourage the exchange of political views while limiting insults to the public figures being discussed rather than our neighbours.

Stephen Duggan, Tichborne

X-ray machines in airports

Does anyone out there feel the same way I do? When I heard about the new X-ray machines that are to be installed at several airports I realized that we have gone completely nuts. I for one would not go through those machines so air travel is out of the question for me.

At a time that the air industry has such a hard time already, with the high fuel costs and other problems they sure don't need this extra burden added. It seems to me that if the CIA and the Canadian Security forces did their jobs there should not have to be a need for these outrageous measures. The young man who tried to blow up the plane on Christmas Day was supposed to be under surveillance and yet he was allowed to board a plane.

Wake up Canada. Slowly but surely more and more of your rights are being trampled on.

Ina Hunt-Turner