A recent public meeting put Northern Health Region (NHR) representatives in the hot seat to answer questions about last year’s suspension of birth services in Flin Flon.
For the first time since the suspension, members of the We Want Birth committee and concerned citizens met publicly with high-ranking officials from the Northern Health Region (NHR). The meeting took place on Feb. 26 at the Eagle Rose Holistic Healing and Teaching Lodge. A previous meeting was held shortly after the first announcement last November, but NHR representatives did not attend.
“We’re here to advocate for ourselves and many families who would normally give birth out of Flin Flon General Hospital,” said committee member Jan Unruh.
Fellow committee member Nikita Mackinnon added, “Our mission is to advocate for our whole community and surrounding areas to reinstate quality obstetric services.”
Officials from the Northern Health Region, including CEO Helga Bryant and regional administrative officer and executive director of medical administration Scott Hamel shared background information behind the suspension, including the departure of Flin Flon’s last full-time obstetrician in 2017, the program’s reliance on locums, the resulting gaps in service between 50 and 75 per cent of the time for obstetrics and the external review that led to the suspension last year.
“We really all want the same thing. We want the best possible care,” said Bryant. “The fact that we can’t do deliveries in Flin Flon at this point in time is just as distressing to us. It’s really hard to make those decisions as health care leaders and we’re just as concerned about this as the community.”
Bryant read a letter sent to her from a physician before the obstetrics closure in November. In the letter, the unnamed physician expressed concern over the state of obstetric care at Flin Flon General Hospital.
“Physicians and nurses have been put under extreme stress and even had their licenses put at risk because of this situation. This is very serious,” the letter stated.
Bryant said NHR administrators have spoken with the board and Manitoba Health about the potential for a “critical incident” occurring due to the situation.
“We are going to have a critical incident. Something bad is going to happen, if we don’t organize a plan to make this as safe as possible,” Bryant said. “We can no longer, under current circumstances, provide safe, high quality obstetric care in Flin Flon. We need to tell the community that and we need to declare that we can’t do this anymore in our current situation.”
“It was probably one of the most difficult decisions I’ve ever had to make, as a health care administrator.”
According to the NHR group, one woman has presented at the Flin Flon General Hospital emergency department in labour since the shutdown. Five ambulance transfers between Flin Flon and The Pas have taken place, as well as nine births from Flin Flon mothers in The Pas. Other births outside of NHR-administered facilities were not included in the numbers. Between 40 and 55 women are currently being supervised through the prenatal clinic in Flin Flon.
Once the discussion was turned over to the crowd, attendees shared their thoughts on the obstetrics suspension and their own birthing experiences in Flin Flon
Vanessa Unrau, a music teacher and new mother, voiced concerns with the suspensions, wondering aloud if it would be practical to have a second child under the current situation.
“I want the freedom to choose to have a second baby, based on my wages and benefits, not based on... whether or not I can afford to live in a hotel for up to four weeks,” she said. “I want control of my reproductive rights and to be able to exercise those rights in the comfort of not only my own home, but with my birth partner and my children’s support system.”
Another new mother, Noelle Drimmie, also shared her experience with the group. Drimmie gave birth to her daughter 11 weeks premature in Winnipeg last fall, around the time of the obstetric suspension in Flin Flon. Drimmie has sent letters to the provincial health ministry and provincial and federal politicians advocating for Flin Flon obstetrics to be restored.
Drimmie praised staff for how they handled her health when she presented to Flin Flon General Hospital after her water broke unexpectedly.
“It should not have been a fluke or good luck that there happened to be an OB on staff the day my water broke,” she said. “I settled for having a rotating doctor throughout my pregnancy. I settled for not having regular birth classes offered to me. I settled for not having a choice of midwife and I settled – for years – for not having a family doctor. I will not settle anymore and my daughter shouldn’t have to settle either.”
Drimmie also mentioned potential ideas for how Flin Flon could help recruiting efforts, citing a program from British Columbia that gave doctors and specialists a $100,000 bonus if they based themselves in rural areas.
“They had to stay for three years or they couldn’t keep the money. It was only a stopgap measure to be sure, but desperate times called for some degree of carrot dangling,” she said.
Hamel discussed challenges faced by health administrators in recruiting medical professionals and specialists to northern and rural areas.
“Recruiting full-time specialists is a major challenge for northern and rural areas across Canada. This isn’t just an incidence for us, especially when it comes to obstetrics,” he said, adding that hospitals away from population centres have relied on locum specialists to provide care.
“Permanent specialists in northern and remote areas across Canada are happening less and less. You’ll see that the type of practice a lot of specialists want to have now is out of major centres, both for the type of work that they’ll see there and the lifestyle. They’ll then have shorter-term, part-time contracts with other areas to support.”
Hamel said that discussions with Manitoba-based medical students to take on obstetric care in Flin Flon on a temporary basis had not been fruitful.
“We approach that group and say, ‘We know that a lot of you guys don’t want to do full-time work up here, we get that. What would part-time work look like? What would it look like if we gave you an opportunity of a plus-one, an extra year of education to do some obstetrics, some family practice obstetrics, and come up and provide that service as a group?’ There were no takers there,” he said.
Under the current contract with provincial authorities, Hamel said the NHR can currently offer some medical professionals up to 25 per cent higher wages than they would receive in Winnipeg. However, he said throwing money at the issue of doctor recruitment would not solve everything.
“The contract for the north is 25 per cent more. When we’re talking well into the hundreds of thousands of dollars, 25 per cent is already provided. They get 25 per cent more here than they do in Winnipeg. That exists,” he said.
“The pay, at a certain level, it creates backbending. It means someone can say, ‘I can make this much money if I work this hard. If you pay me more, that doesn’t mean that I’ll work more - it might actually mean I’ll work less.’”
The fate of whether or not full obstetric care will be restored in Flin Flon may be decided by a province-wide clinical services plan, set to be released later this year.
“I think people have to be aware that the other result of this clinical resources plan could be that we don’t have obstetrics. It could be that,” said We Want Birth member Kristen Fritsch.
“We’re talking about this grand release of a plan, but it could also be very disappointing for our community as well.”
“I think we all have to prepare ourselves for that. It’s not what we want,” said Bryant.
Cal Huntley, in attendance as the mayor of Flin Flon, mentioned his own frustrations with the situation as a civic leader.
“We’re trying to do whatever we can do. It’s very frustrating. It really is,” he said. “My daughter is pregnant and she’s going to be having a baby in June.
“I don’t want to normalize having to travel to Saskatoon [to give birth]. I want the service to be provided in Flin Flon, but given the comments and the statistics, we’re not unique in the situation we are presently in.”
