While details are scarce, the District of Tumbler Ridge and Northern Health have agreed to work together on “a new alternative overnight ER service,” according to a recent release.
The new alternative care approach “will rebuild a model of health care services that addresses the desire for an overnight ER service that can be sustained without compromising the stability of primary and community care services at Tumbler Ridge Health Centre,” says the release.
“We are pleased to have reached consensus on a way forward that recognizes concerns over how emergency health care services are accessed overnight, while also acknowledging the necessity for change in light of recruitment and retention challenges. We remain firmly committed to working collaboratively to provide the best possible access to emergency healthcare, while maintaining improvements in primary care capacity and mental health care support.”
It was announced on September 4 that beginning on September 5, the Tumbler Ridge Emergency Room would be closed evenings and weekends. The ER would remain open an hour early and two hours late—8am to 9am and 5pm to 7pm, said Northern Health, but close overnight.
The District has been in discussions with Northern Health since the closure, but, says Mayor Darryl Krakowka, at the start it was very confrontational.
“I’m going to be straightforward,” admits the Mayor, speaking to an audience at the recent Let’s Talk event. “[The first meetings were] hostile. Not only from their side, but from my side. I took offense to it. So, we actually didn’t go anywhere. I’ll be straightforward about that. I wouldn’t say it was held up by the mayor, but I do think that could we have come to something sooner possibly.”
Still, says Krakowka, it wasn’t a one-sided conflict. “I believe Northern Health dug their feet in as well, thinking that we would lay down, which I can tell you right now, the elected council members up here did not lay down, nor did our staff, nor did our community. And I think that’s what’s made the change, was the community standing up.”
Krakowka said this lasted all of September and part of October. Then he had a medical situation, which meant that the District and Northern Health didn’t start having productive dialogue until mid-November. Even then, it wasn’t until a meeting on December 8, when Krakowka and Dr Charles Helm made a trip to Prince George in a snowstorm—“we plowed snow with our vehicle,” says Krakowka—to meet with the Northern Health Board.
“I was going to go in there with a different concept. I expected them to chuck me out of the meeting, and then the other members of council that attended it as well as our medical adviser and staff could take over the meeting.”
But, he says, he had a change of heart. “The Sunday night before the meeting, I wasn’t sleeping, and I thought it would be the wrong way to go. When I talked to the minister of health that night, she just told me to be frank with the board. I thought about it a lot, and I went in with a different attitude that morning. I talked with the board chair and with (Northern Health CEO) Ciro Panessa before I sat down. I was frank. It’s too bad it wasn’t videotaped because it went very well. I believe the board listened. They are non-directional board, but I think they listened. And the board chair and the minister of health had an hour-long conversation after we left. Knowing we had to get back in dialogue for this community and not have that hostility and the anger, I think helped move it forward.”
Since then, he says, the two sides have remained actively engaged in discussions, with a focus on restoring constructive dialogue and “identifying collaborative solutions to reinstate after-hours emergency department services.”
This partnership and commitment predate the recent tragedy, says the District. “However, those events have only strengthened our resolve to address this issue while continuing to support the community’s recovery efforts. There is going to be some dialogue that has to take place on what that model looks like and how we move through it. But it’s going to happen.”
What’s the timeline on the ER re-opening? Krakowka says he doesn’t know. “I don’t have a time line. I don’t have all the concepts of what it looks like, but I expect that in a month from now, there will be some update. Maybe a month from now there’ll be another update. I would think that’s how fast this will go.”
He also warns people that how it works might change as time progresses. “It’s a pilot. The pilot does not mean that the ER will close again, but we may have to change things to make it actually work. I believe once it gets going in Tumbler Ridge, this model is going to be used for other places in the North. There’s other communities that are like Tumbler Ridge, with recruitment concerns and retention concerns.
While there are no specifics, the guiding principles will be focused on developing a collaborative overnight care service. “We will be exploring innovative options, including virtual solutions, with a goal of re-establishing overnight and weekend emergency department services in the community while also providing sustainable primary and community care,” says the District.
“This effort is about more than healthcare; it’s about rebuilding trust and strengthening relationships between community members, service providers, and leadership. By combining our strengths and working in good faith and in a respectful manner, we are confident we can overcome the obstacles before us.”
Still, there are obstacles. At the Let’s Talk meeting, Town doctor Tamara Pacholuk points out there are still only two doctors in town. “The doctors have not been involved in any of these conversations with the board, the mayor, the ministry of health and Northern Health. They are being excluded from this which means planning how the ER will run is honestly impossible without having input of those who are actually going to run the ER: the doctors, the nurses and the lab and X-ray technicians. Until then I honestly don’t think anything can be considered finalized when we don’t know if you’re going to have staff here.”
The mayor agrees, but he says it’s very early days yet, and he expects that Northern Health will reach out to the doctors (who work as contractors for the health authority) and to the nurses and other staff to have these discussions. “I’m not the employer. I’m an elected official for the municipality of Tumbler Ridge, but I do believe the engagement will happen.”
Dr Charles Helm, who has been negotiating on behalf of the district, calls it a huge step in the right direction.
“It’s not the final word but it’s a massive step. It’s not normally in the Northern Health playbook to reverse course, but they’ve reversed course. And that’s due to the relentless pointing out of what was wrong by so many people. It’s a team effort in this community, which eventually became unstoppable.”
Trent is the publisher of Tumbler RidgeLines.
