Closing rural dialysis costly and deadly: report

Teresa Wright
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Report argues longer travel time significantly increases patients' probability of death

Dialysis patient Nathan Bushey says he hopes a report commissioned by the P.E.I. Islandwide Dialysis Patient Support Group will be considered as government continues to mull over the future of dialysis in Souris and Alberton.

Closing dialysis service in Souris and Alberton is a more expensive and potentially deadly option for some patients, according to a consultant’s report.

The report, entitled Ensuring Access to Healthcare: Maintaining Local Dialysis, cites data from numerous medical journals and studies, making the case that consolidating dialysis services in Charlottetown and Summerside would cost Health P.E.I. more money, would not improve patient outcomes and would increase the likelihood of death in some of those forced to travel longer distances for treatment.

The report was commissioned by the P.E.I. Islandwide Dialysis Patient Support Group, which has been fighting to keep dialysis open in the Souris and Alberton hospitals.

It was written by Alan Buchanan, a former provincial health minister who now works as a private consultant.

The group’s spokesperson, Souris Mayor David MacDonald, said they wanted to present government with scientific evidence to support their belief that hemodialysis in P.E.I.’s rural hospitals should not be relocated.

“I think the report shows quite clearly that dialysis is much better delivered in a local environment,” MacDonald said.

“We still have no rationale from government for their decision to close our local dialysis unit. It was simply an announcement. Period. And we just didn’t figure that was adequate.”

Last spring, Health Minister Doug Currie announced a consolidation of hemodialysis services in the province from four locations to two expanded ones in Charlottetown and Summerside. This would shut down dialysis treatment currently being offered at Western Hospital in Alberton and in Souris Hospital.

The decision sparked uproar from these two communities and they immediately began to push back. A large protest was held at Province House last May.

Currie later agreed to delay this change for a year to allow for more consultation with the communities involved.

But several members of the P.E.I. Islandwide Dialysis Patient Support Group say Currie has not reached out to them at all.

“We couldn’t understand why government announced this closure. The evidence that we had seemed to indicate that it made no sense,” said committee member Alan MacPhee.

“We asked government for written rationale on the decision, but government didn’t provide any written rationale… they’ve provided no information.” 

That’s why the group commissioned their own analysis.

“We can conclude that the proposed consolidation of dialysis does not meet Health P.E.I.’s own test of fair and timely access to care." Ensuring Access to Healthcare: Maintaining Local Dialysis

Their report looks at the viability of dialysis services in satellite locations and how this would apply to the stated objectives and policies of Health P.E.I.

It points out the health agency’s vision statement says P.E.I.’s health system is focused on ‘meeting needs in the most appropriate setting, by the most appropriate provider in the most cost effective manner.’

“In the instance of hemodialysis services and the decision to discontinue local dialysis, Health P.E.I. appears to have taken a contrary approach,” the report states.

“It is instead pushing the patient to the most expensive level of care (specialist services) and one which has been shown to have less bearing on both the medical and quality of life outcomes than other variables and factors in the hemodialysis treatment regimen.”

The report also argues longer travel time for patients on dialysis significantly increases their probability of death.

A large-scale international outcomes study found dialysis patients who had to travel an hour or more had a 20 per cent increase in mortality and a 10 per cent increase in withdrawal, skipping of treatments or shortened sessions due to travel difficulties.

“We can conclude that the proposed consolidation of dialysis does not meet Health P.E.I.’s own test of fair and timely access to care,” Buchanan’s report states.

“While an hour of travel for the occasional treatment of a chronic condition would normally be regarded as reasonable, a burden of travel that so dramatically shortens one’s lifespan cannot be similarly accepted.”

The report was sent to Currie, Premier Robert Ghiz and to acting Health P.E.I. CEO Dr. Richard Wedge.

Dialysis patient Nathan Bushey said he hopes the report will be considered as government continues to mull over the future of dialysis in Souris and Alberton.

“Good ministers make good decisions with good information, and we’re providing good information so I expect they will keep the units open.”

The P.E.I. Islandwide Dialysis Patient Support Group will be holding a roundtable discussion on March 26 to discuss the report. Ghiz, Currie and Wedge have been invited to take part in this discussion.

No one from government was made available for comment on this story.

Organizations: Health P.E.I., P.E.I. Islandwide Dialysis Patient Support Group, Western Hospital Province House

Geographic location: Souris Hospital.The, Charlottetown, Summerside

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Recent comments

  • New brunswicker
    March 15, 2013 - 13:56

    I live 90 km from a hospital. Sour is is only 80km from Charlottetown is it not? What exactly is the problem with driving to the qeh?

  • numbers please
    March 14, 2013 - 19:21

    There are fewer than 5,000 people from Morell to East Point. How many people are on kidney dialysis in this area? Furthermore, if the percentage is higher than the national average, is the PEI government looking into the causes so that we can lower the number of people with kidney disease in the future, saving future taxpayers some money? Oh, forgot, that would be forward thinking, wouldn't it?

    • Thomas Eldershaw
      March 14, 2013 - 22:26

      There may be only one and if I happen to be that one then keeping the Souris unit open is a good idea ! Nuff said ?

    • taxpayer
      March 15, 2013 - 01:25

      Not if the rest of us are paying for it. I have a neighbour who has been on dialysis for years. She does it in her home HERSELF. Why can't people be more independent and self-sufficient? Always wanting other taxpayers to fund medical help for every little tummy ache. Leeches....

  • hugh
    March 14, 2013 - 12:10

    I guess the good people from Souris and Alberton are more important then the people from Montague, Murray Harbour, Morell, Rustico etc as these people will have to travel the same distance for their medical needs.... We are spreading our precious medical resources too thin. The only way we will have good medical care when all islanders will no longer have to travel off island for our medical needs, is to have fewer but better hospitals to serve all islanders.

    • uh huh
      March 14, 2013 - 19:32

      When the people of Murray Harbour donate equipment for KCMH and the government says thanks for giving more money to the QEH and bleep off, then you will have a point.

  • Bill Kays
    Bill Kays
    March 14, 2013 - 10:30

    Golf courses are NOT ESSENTIAL. DIALYSIS UNITS ARE.Where are this government's priorities, oh yea, traffic circles, road construction, and let's not forget their cherry on top "TOURISM". Study this, study that, pay for advice, yet still make the wrong decisions for the common Islander but they make the right decisions for their corporate and development buddies. I want to throw up but I cannot afford to eat. Perhaps Mr Ghiz would allow me to glean a few heads of grain from his overflowing fields or a few of his majestty's table scraps. Trickle down economics is just that. Those at the bottom MAY GET A TRICKLE yet those are the most in need. You help a society most and more quickly by helping the least fortunate ones first, not the other way around. We need to startat the bottom and let those at the top who do not need our help fend for themselves.

  • A Souris dialysis patient
    March 14, 2013 - 10:20

    Mr. Ghiz, , you and your counterparts have been invited to Souris. Come and make a common sense argument for closing these remote units. We , the people dependant on these satellite units will listen. If you can't make that argument come to the meeting to defend your stupid decision at least !

  • Garbage in, Garbage out . . .
    March 14, 2013 - 09:38

    Alan Buchanan, is a "7.5er" Liberal provincial health minister. That may hold him in good standing with some, but for many it appeared then that he had absolutely no backbone and there's no evidence he has a background in public health research. If he does, his expertise isn't mentioned in the article. Would anyone turn to the present Liberal provincial health minister, or for that matter, any elected official, to write a report? An average grade 10 student can cut and paste documents. And with all due respect to Souris Mayor David MacDonald, there's no way the report (as described) serves as "scientific evidence" any more than a Google search constitutes scientific research. That said, maybe I'm wrong. But it's hard to know because the "large-scale international outcomes study" isn't even identified in this article and there's no link to Mr. Buchanan's report. With an issue as serious as this, you'd think the people professing to be authorities would take it more seriously.

    • Veronica LAidlaw
      March 15, 2013 - 07:41

      I am a member of the PEIIDSG committee and we invite you and anyone else interested to review the report in its entirety. A readable/printable PDF copy can be found for download to anyone wishing to read/print it at http://www.facebook.com/groups/305815576160022/ or email me (sirlaidlaw@gmail.com) and I will forward a copy to you. The large scale international study is DOPPS (Dialysis Outcomes and Practice Patterns Study).

    • Kyle
      March 15, 2013 - 08:12

      Garbage, That is what your comment is. If you bothered to do a little research you would realize that all the information complied in this report is from numerous published scientific articles and papers stating these as facts! Maybe next time you should do a little research of your own

  • Freddie
    March 14, 2013 - 09:01

    Way to go Alan Buchanan. The man who should have been made Liberal leader a decade ago. What a tale of woe instead. All of the old Alan supporters know very well they should be going NDP now. It is morally wrong for literate people to be manipulating the rest of the population with the Ghiz is good lie. Ghiz has proven every fear from those who know the truth of hereditary problems with power. The arrogance. The waste. That his mistakes are somebody ésleś problem down the road. Hurting the weak as with this sick move on dialysis cuts. And that is all fine. Because he is great so say the Liberals . The fears of the royal curse have all come to pass. And thousands of people know that is true. Instead of outing Ghiz you back Justin. Same mistake. Times ten. As for Doug Currie that is even sadder. Good work Alan. It is what we do in the end that matters. Keep up the great work. As for the last line in the article----------- deep, deep shame!!!!!

  • Frustrated
    March 14, 2013 - 08:58

    I think the worst part about this situation is that the Community of Alberton put a lot of time, effort and money into fundraising to purchase the current dialysis equipment. The community thought they were doing something good by donating the equipment to the Alberton hospital. Now, the equipment that was hard earned by community members is going to be taken away at a higher cost to tax payers? I can understand not purchasing new equipment and asking people to travel to where the new equipment is located, as we are really lucky to have services so close to home. BUT when the equipment has been donated by a community LEAVE IT THERE.

  • Tom Paine
    March 14, 2013 - 07:15

    that's ok. They know best.

  • bravo for bushey
    March 14, 2013 - 07:06

    Hats off to Mr. Bushey who has worked hard for this program to continue where it is necessary and ESSENTIAL. Get it? ESSENTIAL.

  • Supporter of Dialysis Units
    March 14, 2013 - 06:39

    Government should do the right thing and leave these dialysis units where they work best, in each community. Patients have an opportunity to be close to their loved ones while having this treatment three times a week. Government has wasted millions of dollars on foolish agendas so don't lay the fiscial BS on us.

  • voter
    March 14, 2013 - 06:16

    alan buchanan -another liberal 7.5'er who still lurks on the peoples financial tailcoat

    • mej
      March 14, 2013 - 08:50

      Not that it has anything to do with the story at hand, but perhaps you didn't quite understand the story. Mr. Buchanan owns his own consulting business now. What part of that is on the people's financial tailcoat??