Letters

The BC Rural Health Network is one of over 150 national and provincial organizations who have co-signed the Canadian Health Organization’s letter to the Honourable Bill Morneau, Minister of Finance, calling on all parties to work together to implement universal, public pharmacare within this government’s mandate.

 February 13, 2020 

The Honourable Bill Morneau, P.C., M.P. Minister of Finance 
Government of Canada 
Ottawa, Ontario, K1A 0A6 

Dear Minister Morneau, 

We are a diverse coalition of 150 national and provincial organizations representing health care providers, non-profit organizations, unions, workers, business, seniors and patients from coast to coast to coast. In November 2019, over 150 of our organizations signed a joint Pharmacare Now Statement calling on all parties to work together to implement universal, public pharmacare within this government’s mandate. We are now calling on your government to make the financial commitments that are needed in this year’s budget to make this program a reality. 

In the federal budget for 2019, the government provided $35 million over four years to establish a Canadian Drug Agency Transition Office. It also provided $1 billion over two years (starting in 2022–23) to develop a national strategy for high-cost drugs for rare diseases, with up to $500 million per year ongoing. 

As laid out in the report of the Advisory Council on the Implementation of National Pharmacare, an additional $3.5 billion is needed by 2022 to roll out the first stage of universal, public pharmacare. This stage would provide access to a national formulary of essential medicines by January 2022. Incremental increases in annual spending would subsequently be required to roll out a full, comprehensive formulary by January 2027.

The majority of Canadians voted for pharmacare in the 2019 election. We are counting on your government to fulfill its promise to Canadians by implementing the Advisory Council’s recommendations. Universal, public pharmacare would improve the health of our population and would save Canadians billions of dollars every year. Canada can’t afford not to adopt this program. 

In this year’s budget, we hope to see the necessary minimum commitment of $3.5 billion in total for pharmacare between 2020 and 2022, as well as maintained funding for a rare diseases strategy. Anything less would put us behind schedule for implementing this essential new program. 

We thank your government for its commitment to universal pharmacare. Only single-payer, public pharmacare will ensure everyone in Canada can access the medications they need. 

Regards, 

The Pharmacare Now Coalition

Cc: The Right Honourable Justin Trudeau, Prime Minister 
The Honourable Chrystia Freeland, Deputy Prime Minister and Minister of Intergovernmental Affairs 
The Honourable Patty Hajdu, Minister of Health 
The Honourable Deb Schulte, Minister of Seniors 
The Honourable Matt Jeneroux, Conservative Party Health Critic 
The Honourable Luc Thériault, Bloc Québécois Health Critic 
The Honourable Don Davies, NDP Health Critic 
Mr. Greg Malone, Green Party Health Critic 

Encl: List of Signatories 
Pharmacare Now Statement 

List of Signatories 

National Organizations: 

Action Canada for Sexual Health and Rights / Action Canada pour la santé et les droits sexuels
Alliance for Equality of Blind Canadians / Alliance pour l’égalité des personnes aveugles du Canada 
BloodWatch.org 
Broadbent Institute / Institute Broadbent 
Canada Without Poverty / Canada Sans Pauvreté 
Canada’s Building Trades Unions / Syndicats des métiers de la construction du Canada 
Canadian AIDS Society / La Société canadienne du sida 
Canadian Association for Retired Persons 
Canadian Association of Community Health Centres / Association canadienne des centres de santé communautaire 
Canadian Association of Emergency Physicians / Association Canadienne des Médecins d’Urgence 
Canadian Association of Retired Teachers / Association des enseignantes et des enseignants retraités du Canada (ACER-CART) 
Canadian Association of Social Workers / Association canadienne des travailleuses et travailleurs sociaux 
Canadian Association of University Teachers / Association canadienne des professeures et professeurs d’université 
Canadian Centre for Policy Alternatives / Centre canadien de politiques alternatives 
Canadian Doctors for Medicare / Médecins canadiens pour le régime public 
Canadian Federation of Medical Students / Fédération des étudiants et des étudiantes en médecine du Canada 
Canadian Federation of Musicians / Fédération canadienne des musiciens 
Canadian Federation of Nurses Unions / Fédération canadienne des syndicats d’infirmières et d’infirmiers 
Canadian Federation of Students / Fédération canadienne des étudiantes et étudiants 
Canadian Health Coalition / Coalition canadienne de la santé 
Canadian HIV/AIDS Legal Network / Réseau juridique canadien VIH/sida 
Canadian Labour Congress / Congrès du travail du Canada 
Canadian Medical Association / Association Médicale Canadienne 
Canadian Nurses Association / Association des infirmières et infirmiers du Canada 

Provincial and Territorial Organizations:

L’Alliance du personnel professionnel et technique de la santé et des services sociaux
AccessBC
AIDS Committee Newfoundland & Labrador
Alberta Community Council on HIV
Alberta Council on Aging
Alberta Federation of Union Retirees
Alberta Society for the Promotion of Sexual Health/Société pour la Promotion de la Santé
Seuelle – Alberta
Alberta Union of Provincial Employees
Alternatives North
ARCH Disability Law Centre
Association of BC College Pension Plan Retirees
BC Building Trades
BC College of Family Physicians
BC Federation of Retired Employees Association 
BC Health Coalition
BC Nurses’ Union
BC Poverty Reduction Network
BC Rural Health Network
British Columbia Government and Services Employees’ Union
British Columbia Teachers’ Federation
Canadian Association of Retired Persons – NL
Centrale des syndicats du Québec
Citizens With Disabilities – Ontario
Coalition des organismes communautaires québécois de lutte contre e sida
Coalition solidarité santé
Confédération des syndicats nationaux
CUPE Ontario / SCFP Ontario
Disability Alliance BC
Fédération des travailleurs et travailleuses du Québec
Fight for $15 & Fairness / Lutte pour 15$
Health Coalition of Newfoundland and Labrador
Health Sciences Association of Alberta
Hospital Employees’ Union
International Brotherhood of Electrical Workers – BC Provincial Council
Living Wage for Families Campaign
MacKilop Centre for Social Justic
Manitoba Health Coalition / Coalition manitobaine de la santé
Manitoba Nurses Union
Médecins québécois pour le régime public
New Brunswick Common Front for Social Justice / Front commun pour la justice sociale du Nouveau-Brunswick
New Brunswick Nurses Union / Syndicat des infirmiéres et infirmiers du Nouveau-Brunswick
Newfoundland and Labrador Coalition of Seniors, Pensioners and Retirees Associations
Newfoundland and Labrador Federation of Labour
Newfoundland and Labrador Public Sector Pensioners’ Association
Non-Academic Staff Association – Alberta / Association du Personnel Non-Académique -Alberta
Northern Territories Federation of Labour
Nova Scotia Health Coalition
Nova Scotia Nurses’ Union
OHIP for All / OHIP po Tous
Ontario AIDS Network
Ontario Federation of Labour / Fédération du travail de l’Ontario
Ontario Nurses’ Association
Pacific Aids Network / Réseau Pacifique de SIDA
Parent Support Services Society of BC
PEI Coalition for a Poverty Eradication Strategy
PEI Federation of Labour
PEI Health Coalition
PEI Nurses’ Union
Planned Parenthood – NL Sexual Health Centre
Public Service Alliance of Canada, BC / Alliance de la Fonction publique du Canada, Colombie-Brittanique
Québec Accessible
Quebec Association for the Defense of the Rights of Retered and Pre-Retired Persons / Association québécoise de défense des droits des personnes retraitées et prétraitées
Registered Nurses’ Association of Ontario / l’Association des infiermiéres et infirmiers autorisés de l’Ontario
Registered Nurses’ Union Newfoundland & Labrador
Saskatchewan Union of Nurses
Save Our Northern Seniors / Sauvez nos aînés du Nord
Sexual Health Nova Scotia
Sexual Health Options, Resources & Education Centre
Surrey Board of Trade
Table des regroupements provinciaux d’organismes communautaires et bénévoles 
United Nurses of Alberta
Workers’ Action Centre

 

Complicated gratitude: a letter to my mother’s physician

Rachel B. Cooper
CMAJ January 27, 2020

On the morning you administered medical assistance in dying (MAiD) to my mother, you kindly and gently explained what we could expect. You reassured us that she would feel no pain, but rather drift off to sleep quickly. You entered my mother’s room and greeted her warmly. You took in the scene: family members sitting in every chair that was permitted to be in the hospital room. You graciously turned down the glass of scotch we offered you — the scotch we poured to toast my mother. You knelt beside the bed, holding my mother’s hand, and asked her whether she wished to go ahead. She assented. You encouraged us to embrace her as she took her final breaths. When my mother died, you leaned down to the bed where my sister and I lay, holding our mother, and quietly informed us that she had passed. And at our request, you opened the window so that her soul could escape the hospital room. With utmost respect, you fulfilled my mother’s final wish — to die with dignity.

In the minutes, hours and first few weeks following my mother’s death, I could not help but think of you as her executioner. In the final days of her life, following her decision to formally request MAiD, my mother’s longstanding delirium cleared. The mother I remembered from childhood, with her sharp wit and hearty laugh, reappeared before my eyes. She was no longer the confused, paranoid, hostile and forgetful person I had come to resent over the last several months.

And here you were to help steal her away, once and for all. Your clinical offering to fulfill her last wish of dying with dignity — and its finality — brought her back to life. The irony wasn’t lost on me.

Six months earlier, our mother was in the intensive care unit on the brink of death. We discussed end-of-life care and planned a funeral. I stood by her bedside, held her hand, and told her I loved her and that I forgave her. I told her she could let go. But for better or for worse, she fought like hell to live, and we brought her home.

On the day you provided MAiD, as you arranged the supplies, I quickly flashed back through the last six months. My thoughts lingered on my mother’s final days spent recounting 69 years’ worth of memories and wisdom.

“Should we sing something?,” my sister wondered aloud.

I buried my head in the crook of my mother’s ankles, eyes clamped shut, and we began to sing “What a Wonderful World” — the same song my sister sings to my infant nephew before he naps.

I was entirely unaware of your presence behind me, and was reminded only when you put your hand on my shoulder. For an executioner, you have a gentle touch.

You relieved my mother of the endless breathlessness caused by her end-stage chronic obstructive pulmonary disease. You enabled her to rest and slumber peacefully for the first time in months, if not years. I took comfort in the fact that you fulfilled your professional duties ethically, within the parameters of the legislation. You allowed my mother to have a good death. An ethical death. A compassionate death, free of the suffering she experienced in life.

In the moments following my mother’s death, our family held one another and sobbed. You offered condolences. We bowed our heads slightly. I felt gratitude for the privilege of living in a country that provides for its citizens in life and until death.

My mother is gone, but you didn’t take her. Her illness robbed her of her stamina, strength, and dignity. She was riddled with pain and suffered immensely. You alleviated her suffering. But in her relief, we suffer the loss.

I conclude my letter to you, doctor, with deep gratitude — gratitude for your humanity, your compassion and your ethics. I no longer see you as my mother’s executioner. You were her saviour.

“”””””””””””””””””””””””””””””””””””

A POTENTIAL SOLUTION TO THE DOCTOR SHORTAGE

THE TIMES COLONIST
December 28, 2019

Letter to the editor

My doctor has retired and no one has taken over his practice. Given the current situation regarding physician production and the outflow of doctors due to their retirement age, it’s highly unlikely that I’ll ever have a family doctor again.

I consider myself to be a relatively healthy 61-year-old despite having completed 37 years of military service, including multiple operational deployments. Currently, I require little more than an annual visit to renew prescriptions as required by Veterans Affairs Canada.

Now, I’ll be another lost patient joining the queue at a local walk-in clinic to access primary-care services. Should I be successful in the patient-care lottery and “win” one of the available appointments, it will use up the valuable time of a highly trained physician, time that could be better used by much more acute or complex patients.

It’s long past time for B.C. to address this situation by adding physician assistants (PAs) to primary-care clinics along with physicians and nurse practitioners in a fully funded, collaborative practice setting.

The education and credentialing of physician assistants is not the issue that protectionist bureaucrats at the B.C. Ministry of Health once used as an excuse to block their integration into our rapidly failing health-care system. Physician assistants are employed in Manitoba, Alberta, Ontario and New Brunswick, while Canadian Armed Forces physician assistants, where the skill set originated, provide quality medical care in some of the most remote locations in Canada.

Data suggests that 70 per cent of patients could be appropriately managed by physician assistants. With physician assistants joining the currently overworked health-care team, this would greatly improve patient access to timely and appropriate care and no doubt restore the dignity to patients begging for access to the public health-care system.

So, the question becomes, when can British Columbians expect to see physician assistants added to staff of the urgent primary-care clinics?

Mike McBride, Colwood

“”””””””””””””””””””””””””””””””””””

February 26, 2019
The BC Rural Health Network sent a letter to the Honourable Adrian Dix, M.L.A. Minister of Health

April 10, 2019
Reply from the Ministry of Health
Joanna Richards, Executive Director – Primary Health Care

Joanna Richards 
A/Executive Director 
Primary Health Care

“”””””””””””””””””””””””””””””””””””

May 21, 2019
Powell River Voices set up a committee to organize a petition for Healthy Food in Healthcare. Their letter to the Vancouver Coastal Health Authorities can be found below.

“”””””””””””””””””””””””””””””””””””