December 4, 2020: Adam is Back – Bravely Diving Into Complex Issues like Health Care Fifteen joined the ASK Salt Spring Zoom gathering to welcome Adam back as our MLA. We had all missed him as he was forced into that candidate role again. Throughout the gathering, joy was repeatedly expressed that he can now get back to work to address those issues most important to us. 

He was pleased to introduce a new member of his team – Kate O’Conner – disappointed the she did not win in her riding but committed to providing her a wonderful experience serving our community. In the meantime, Adam and we all will benefit from having her on our team. Welcome, Kate! 

After a heartfelt territorial acknowledgment, we spent the first half hour learning more about the newly-released report, In Plain Sight, Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care (https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Full-Report.pdf) and discussing its implications. Among the shocking findings, we learned that 84% of the Indigenous British Columbians surveyed reported experiencing racism while seeking medical attention. 

While the allegations of an organized Price is Right game to guess the blood alcohol level of Indigenous patients seeking medical help that spurred the report were not proven, the results are deeply disturbing:

Through listening to thousands of voices – through survey results, direct submissions, health care 

data, and interviews – a picture is presented. . . of a B.C. health care system with widespread 

systemic racism against Indigenous people. . . . 

Adam was asked what he and his Green Party colleagues thought of this report and, more importantly, what are they going to do to address its disturbing findings. He began by telling us that the results were not surprising to him. From his work with the health care system, he was well aware of this pervasive racism. Almost more shocking to him was his conclusion that our health care leaders were also aware of this systemic problem – and were doing little, if anything, to address it.

Adam spoke of his sad conclusion that this racism exists not just in our health care system but throughout our government. Also disturbing to him is that studies like In Plain Sight only seem to be conducted when the government is embarrassed. According to Adam, change needs to be systemic not simply to address specific reported instances of racism. 

To begin to address this systemic problem, the Green Party will be recommending an all-party committee to explore racism throughout all levels of our government. They will also be recommending an Indigenous ombudsperson. Adam’s suggestion seemed to reflect a conclusion of In Plain Sight:

This Truth is what we build this report on, in structure, it is not to ‘name and shame.’ Our goal is 

to build the collective strength necessary to advance as a whole and healthy society.

In conclusion, it was suggested that we continue this conversation at each ASK Salt Spring gathering with Adam to insure that we remain aware of the racism that permeates our community and continually work to address it. On a positive note, Adam reminded us that this conversation would not have even happened when he was first elected to Central Saanich Council 12 years ago – a lot has changed since then. That we are having this conversation – as well as beginning our meeting with a territorial acknowledgement – is a clear sign that we are making progress. We have a long way to go, but good progress is being made. 

We switched gears when a participant asked: How do we take back our roads? Adam acknowledged that virtually all of our rural roads are in poor condition, and it will take enormous amounts of money to address them. Adam shared that the Ministry of Transportation and Infrastructure (MoTI) decision-makers are aware of this and are – quite honestly – fearful of even beginning the needed renovation. They are keenly-aware of the lack of good roadbeds challenging the majority of our roads and the huge costs required to rebuild them to the required urban standards. 

Adam suggested that he could continue lobbying MoTI as he has so strongly done in the past, with the expectation that results will be the same: disappointing. In his opinion, we need to change the conversation about our roads and find a different solution to address this very expensive problem. He is open to continuing conversations – both focusing on the Salish Sea Trail (bike lanes from Fulford to Vesuvius) as well as island-wide safety issues. 

Adam reminded us that our Transportation Commission places Salt Spring in a stronger position than other Gulf Islands to advocate for road improvements. When a participant mentioned that the Transportation Commission was not as effective partnering with MoTI as it could be, Adam suggested we look at other partnerships in which MoTI and municipalities work together to improve roads. He used the illustration of bike lanes that were recently built through a partnership between a North Saanich municipality and the ministry. To him, they were done with neither fanfare nor complexity – one day, the ditches were filled in and – voila – (from his perspective) bike lanes were built. 

Why couldn’t CRD act like a municipality and partner with MoTI to improve our roads on Salt Spring? Adam committed to convene a meeting to discuss such partnerships. He also promised to reach out to Rob Fleming, our new Transportation Minister, to begin that conversation at a political level. 

Adam was asked to recognize a mandate which is discriminatory: The ageism of requiring our 80-year olds to pay for an expensive physical exam and undergo testing to prove that they are still healthy and coherent enough to drive. Often costing over $100, this participant felt strongly that the entire process was unfair and unnecessary. 

Adam responded in a two-part answer: First, he agreed that seniors should not have to pay for this physical exam. But, second, – rather than forgoing the assessment of the driving ability of 80-year olds – he supports a proactive assessment of driving ability at multiple stages throughout our lives. He used a personal example when he admitted that he has not actually read the rules of the road since he passed his driving exam as a youth. These rules have changed significantly, and he believes that we should be periodically tested to prove that we understand them. 

Back to the issue concerning perceived ageism, Adam committed to try to rework the rules so that seniors approaching their 80th birthday are not targeted by a costly requirement to prove their driving competence. Adam welcomes letters to combat this ageism and promised to pass them along to those who can address this issue. 

The fact that independence is so tightly connected to driving is also a cause for concern. If there were easy ways for seniors to get where they wanted to go without feeling that driving themselves is their only option, some may be more willing to give up their licences. The challenge in our community is to create a transportation system responsive enough to the needs of our elderly to allow them to quit driving at the appropriate time. BC Transit is beginning an assessment of Salt Spring transit needs. One proposal has been an on-call system in which seniors could request transport rather than having make their way to an established bus route. While an expensive option, it my warrant further exploration. 

Concern was raised that Salt Spring is losing another doctor to retirement and, with his retirement, also losing a clinic. This began a discussion about the vast complexities of our health care system, made even more problematic by continuing the 1950s commitment to allow general practitioners to bill the system as independent contractors.

It has created an impossible system in which our general practitioners must retain tasks (like renewing long-term prescriptions) that could be done by other qualified professionals. Adam reminded us that, while specialists make a great deal of money, our primary doctors only receive $35 per appointment. If doctors give up their short appointments (like renewing prescriptions), focusing only on the more complex and time-consuming cases for which they are qualified, the renumeration of $35 per appointment would simply not be enough.

A promising solution, the team approach to health care, dubbed a Primary Care Network (PCN), got derailed, in Adam’s opinion, when it became linked with urgent care clinics. He believes that the PCN team approach to continuous care is markedly-different from what has evolved to date. Instead of providing continuous care, these new primary and urgent care clinics address only the urgent aspect of health care, leaving patients with no one to continually oversee their health. 

Adam is hopeful that, now that the pressures of an election are behind us, Adrian Dix will pause in his efforts to create ever more clinics focused on urgent care to look again at the promise of PCNs. It was suggested that Salt Spring may benefit from such a PCN, and this question will be posed to our health professionals. 

Adam agreed that too many do not have a doctor and that the situation is likely to get even worse as many of our aging doctors retire. He also reminded us that housing challenges on Salt Spring make it harder for us to attract doctors than other rural areas that are not restrained by such high housing costs. 

Adam asked us to collect letters from those in our community who do not have doctors, promising to make sure that those letters get to those who can address the problem: 

*Anyone here without a doctor? Please send a letter to ask@asksaltspring, and Adam will receive and forward it promptly. Adam also promised to initiate a conversation with our local Division of Family Services, the organisation responsible for recruiting doctors.