PEI Blues

A crisis of medical care, locally and nationally, while resources are devoted to new "anti-racism" initiatives, doesn't bode well for the future.

(Getty Images, Credit: Peter Unger)

My wife and I (and our dogs and cat) moved to PEI from the Pacific Northwest of the United States three years ago.   Many factors prompted our move, including the inherent beauty of the island here, the affordability of housing, and the genial and laid-back culture so reminiscent of life 40 years ago, isolated from so much of the current polarization and animosity that played role in making the US less pleasant for us as a place to live.  And equally important, the availability of free medical care here was very attractive. 

On so many counts we have not been disappointed.  The Island is beautiful.  In summer it is a tourist paradise, and in the fall the pace of life settles down, as tourists leave, many seasonal enterprises shut down, and we hunker down to join our neighbors to await the winter, which, in spite of its length, has its own charm. 

The people are just as warm and down to earth as I remembered from my visits many years ago.  Delivery men always stop for a chat, about the weather, or the neighborhood, or boats and machines.  Earlier this month, a package arrived at the local post office while we were away, and a notice came to the house saying it would be held for 14 calendar days only.  We arrived back 5 days after the final notice had been mailed. I called the post office, and the post office woman said she held on to it against normal procedure because she knew I got a lot of packages and I eventually came and picked them up.  A place where people treat each other as people and not just as customers or service providers is wonderful, if rare.

In spite of this, in the long run we may be driven away from our hoped-for sanctuary due to several of the factors that prompted our original move here: availability of medical care, the politics surrounding it, and potentially divisive public policies. 

No national papers are home delivered here, so I get most of my news online from national and international sources, and I thus tend to miss out on much of the local news. We do get a small local rag that covers news in our surrounding county area.  It includes such vital happenings as local parades, hockey tournaments, and updates on a nearby horse sanctuary. Last week, however, there were two more serious news items that caught my attention, and exacerbated a growing concern about the situation here in PEI, and Canada more generally.

The first was an open letter from 42 local doctors stating that an emergency exists regarding critical and acute care at the local Prince County Hospital (PCH), the only hospital providing ICU-level servicers for the western half of the province.  The claims are devastating, suggesting an ongoing lack of internal medicine and critical care, and the impending loss of 24/7 in-house respiratory therapy coverage.   The situation has apparently been worsening over the last 17 months without significant action from the province.

According to various estimators, including a Government of Canada Job Bank survey, wages for doctors in PEI are somewhat lower than in Ontario and Alberta, but given the lower cost of living here that doesn’t seem like it should be a key factor in explaining the shortage of key medical staff.  Rather we are faced with a self-perpetuating dilemma.  The shortage of doctors makes working conditions difficult, and those working conditions discourage new doctors from entering the workforce here. The station has become particularly acute in the local hospital ICU unit.

After two doctors retired a few years ago, the shortage of staff at the ICU meant a 1 in three night all night on-call requirement for those who remained went on for nine months—a level of staffing more usual for hospital residents than senior staff. During this time, the province did little to ameliorate the situation, bringing in physicians from time to time from another hospital and paying them extra, much to the chagrin of the already overworked ICU doctors at PCH. But there appeared to be no long-term commitment for improvement. Eventually two more physicians left to protect themselves and their family’s lives.

Unless some permanent and sustainable solution is found, it is likely to result in the loss of critical and acute care for the western half of the province. Without substantial infusions of money to recruit groups of new doctors, to ameliorate the critical care workload, perhaps requiring a partnership with the federal government, this ongoing crisis is not likely to be resolved in the foreseeable future. And if it is not resolved, older folks who live in PEI will be severely disadvantaged.

The government needs to become more proactive than reactive. As a medical friend of mine put it, every physician knows that prevention is better than treating a problem after it occurs. For the past few years, Health PEI appeared to be ignoring the symptoms, hoping they would go away. One hopes that will change.

The shortage of doctors is a general problem in Canada.  Here in PEI the wait to be assigned a family doctor is in excess of 3 years.   This is bad enough, of course.  But if urgent care facilities, in particular ones with an ICU become unavailable as a backup, then effective medical care becomes inaccessible.

It is with regard to the issue of government spending that the second article in the local rag, caught my attention. I learned that PEI is now devoting $100,000 to new “Anti-Racism Grants” for non-profits.  This is part of a larger, almost $500,000 provincial Anti-Racism Action plan that has been announced, which in turn is aligns with Canada’s national “Anti-Racism strategy”.    

Canada’s new fixation on anti-racism, in particular with regard to its indigenous population, has resulted in a variety of ludicrous national policies about which I have written—including restricting new academic positions to individuals of only certain races or genders, and misplaced efforts to ‘decolonize’ and ‘indigenize’ higher educational institutions, such as the recent effort I reported on at Concordia University.

When it comes to PEI, goal of improving diversity and inclusion in the province is laudable, but relying on the dubious postmodernist notions of critical race theory, which have produced a more divisive, rather than inclusive environment, is of some concern. 

Fundamentally anit-racism programs are based on the challengeable assumption that political and social interactions must always be viewed through the lenses of power and oppression, and that systemic racism is, without the need for empirical verification, endemic through government and education.  Even more objectionable is that fact that in spite of the explosion of faddish interest that surrounded it after the George Floyd killing in 2020, anti-racism as it is now embodied is effectively an intellectual heir of racism. Both focus on the notion that people can and should be labelled and judged by the color of their skin, rather than the quality of their character, as Martin Luther King opined.

Proposals that a system of quotas that attempt to ensure that workforce representation in government and academia will identically mimic the demographic makeup of the background population are logically questionable because they are based on the unproven and often false assertion that any demographic discrepancies are based on racism or sexism rather than on other cultural factors (why are most teachers female, and bricklayers male, for example).  And imposing quotas is also a logistical nightmare.  Singling out individuals for differential treatment based on race, gender, or sexual identity and preferences most often has the opposite effect of the goal of inclusion.

$500,000 is not a large fraction of the $3 Billion provincial budget, and the goal of enhancing real diversity and inclusiveness is well intentioned.  But as disappointing as it might be to see money that could be used for other purposes potentially wasted, in this case it may be worse. If other programs throughout Canada and the US are any guides, the PEI program could equally have a negative impact on the community.

While initiatives like the Anti-Racism Action plan provide the government an opportunity for virtue signaling, spending money to recruit and retain ICU doctors addresses an acute health care problem, and will save lives now and in the future. Special programs to recruit doctors from places like India and China, for example, would be a great alternative way to increase both diversity in the province and address pressing health care needs.   

Free medical care, a factor in our decision to come back to Canada, only makes a difference if there is available medical care.  Addressing that very real problem, rather than social justice concerns that are not likely to improve life in the province, is perhaps the most important way to help keep PEI, and in a more general sense, Canada, the kind of place where anyone would not only be happy to move, but also happy to stay.