Dr. Scott Mckee brought his concerns to Salmon Arm council and CSRD
While B.C. Minister of Health Adrian Dix assures that “Shuswap Lake General Hospital (SLGH) is an integral part of the community and the province is committed to pursuing long-term site development plans for SLGH,” hospital medical staff have grave concerns about the facility and its ability to provide acute and operating room (OR) care if the hospital does not receive substantial capital funding.
SLGH’ head of internal medicine department, Dr. Scott Mckee recently presented concerns to Salmon Arm council and the Columbia Shuswap Regional District (CSRD) board on behalf of the hospital’s medical team.
McKee provided an outline of capital projects that have been on the books, and removed, since 2006.
The hospital, which opened its doors on the current site in 1958, saw the completion of emergency room and radiology expansions in 2006. In the same year, a master site utilization plan for future hospital expansions for ICU, medical wards and surgery were submitted. The plan, which McKee said sits on a shelf somewhere, was never funded.
“Between 2006 and 2023, no major infrastructure modernization nor service expansion has taken place,” he said. “We are becoming the equivalent of a rural level one hospital, stabilizing patients then moving them to another centre.”
In 2017, medical staff received Interior Health (IH) funding to submit a modernization plan that included operating rooms, HAU, (also known as ICU), Ambulatory Care and equipment sterilization. The following year, an OR redesign was submitted to IH capital funding for prioritization and in 2019 was listed as number three on the priority list.
Those plans were disrupted by the COVID-19 pandemic, which also resulted in the loss of many nurses at SLGH and the inability to keep the ICU open, said McKee. In June 2022, Interior Health approved $1 million for the planning phase of an OR redesign but funding was withdrawn in October.
“The project was downgraded to ill-defined OR renovations,” said McKee, noting that a pharmacy upgrade that was supposed to take four months is now into its third year.
CSRD board chair Kevin Flynn sits on the board of the North Okanagan Columbia Shuswap Regional Hospital District and said the funding withdrawal was made without the hospital board’s knowledge.
“It is disappointing that SLGH is an extremely low priority for IH,” said Flynn who is also a Salmon Arm councillor. “They can defend all they want, but when a previously approved project is pulled without communication, it shows us where we stand.”
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The Ministry of Health disputes medical staff claims that no capital investment has been made in SLGH.
According to an Aug. 4 Ministry email, since 2017, the government has made $6.7 million in capital investments at SLGH. These include: $2.8 million for pharmacy renovation now under way; $500,000 for hot water loop repairs, which are also in progress; a $1 million operating room expansion completed in 2021 and the installation of a $300,000 hot water boiler replacement completed in 2020.
Also on the ministry list is the $2.1 million CT Scanner replacement of 2022. But the entire cost of the project, including installation, came from the Shuswap Hospital Foundation and the North Okanagan Columbia Shuswap Regional Hospital District. Thanks to donations from community members, the foundation contributed $1,768,500, while the hospital district paid $627,250, which represents 25 per cent of the project cost.
The ministry contradicts medical staff concerns about the growing inability to provide ICU or OR services.
“To clarify, it would be inaccurate to say that SLGH patients have been sent to other centres due to insufficient OR or HAU capacity,” reads the email.
While noting that the medical staff appreciates the supportive theme contained in the Aug. 4 ministry response, McKee disagrees with the province’s stance on patient transfers.
“When the ministry states that patients are not sent out to other centres for surgical or HAU (high acute unit) care, what they mean is that there have been no administrative decisions to transfer patients,” he said. However, McKee points out that attending physicians are very frequently making decisions to do exactly this, based on lack of space, staffing and the calculated risks of post-operative complications.
“The definition of who needs a higher level of care is usually based more on day-to-day hospital factors than the severity of patent illness,” he said. “Many days, our three HAU beds now sit empty or are partially filled with ward patients.”
In a second Aug. 4 email response, Heather Wood, Interior Health’s interim executive director, clinical operations, North Okanagan, reiterates provincial and IH commitment to pursuing long-term site development plans for SLGH, including obtaining capital funding for future construction.
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A utilization study currently underway includes exploring options for construction at the site and will be based on demographics, population health data and engagement with health-care providers. Once completed later this fall, “the report will inform the next steps and timelines for future development.”
“SLGH’s current top priority for investment is surgery and we are actively pursuing a renovation project focused on the redevelopment of the surgical space with the support of the regional hospital district,” writes Wood.
McKee, however, said surgical care involves a number of factors besides operating room space and equipment.
“The medical staff has emphasized the need for a comprehensive approach to surgery that also includes modernization of ambulatory care for minor procedures and endoscopy, modernization of the sterilization room where equipment is cleaned, and updates to the HAU so that surgical patients can have optimal post-operative care when needed.
