The agency that oversees cancer care in British Columbia wants to assure the public it is doing its best to solve the plethora of problems doctors who treat the disease have made known in recent weeks.
That includes making a request to the provincial government to hire more oncologists – something those working inside the BC Cancer Agency say is necessary to address growing wait times, plummeting morale and surging staff burnout.
Those were among the pledges made by executives from the Provincial Health Services Authority at a meeting they called in response to columns and articles I have written in recent weeks about troubles inside the province's cancer agency.
Also attending were two of the oncologists who signed a letter sent to authority president Carl Roy, and obtained by The Globe and Mail, which outlined many of those concerns.
Both Arden Krystal, chief operating officer of the health authority, and Nick Foster, chief operating officer of the cancer agency, said that an appeal for funding to hire more cancer specialists was made this week.
Neither would say how much money was requested or how many doctors they are seeking to hire.
But they conceded that adding 24 oncologists would be enough to begin seriously attacking the wait-time problem that burdens the agency.
Each new oncologist costs the health-care system roughly $500,000, which includes salary and the support staff a doctor needs.
The health authority and the Health Ministry have both been on the defensive since The Globe began publicizing problems inside B.C.'s cancer agency a couple of weeks ago.
Recently, chief executive officer Max Coppes announced he was resigning after barely two years on the job. His predecessor didn't even last that long.
A former agency president wrote in a public letter that the agency's problems stemmed from its unhealthy relationship with the health authority. And then The Globe obtained the letter written by three leading oncologists inside the agency that portrayed a grim picture of the current state of affairs.
In that letter, oncologists Paris-Ann Ingledew, Sharlene Gill and Tamara Shenkier said conditions inside the agency were so bad it was "not possible to continue to provide quality care and research."
During this week's meeting, Dr. Ingledew and Dr. Gill (Dr. Shenkier did not attend) were more muted in their criticisms, but said they stood by everything they wrote in the Oct. 29 correspondence.
Both were guardedly optimistic that the health authority now understands the scope of the problems and that input from a physician workload committee might lead to positive change.
Here are some of the more pertinent matters Ms. Krystal and Dr. Foster raised at the meeting.
Beyond hiring physicians, the health authority is looking at other means to help alleviate the burden on oncologists, including finding roles for nurse practitioners and physician assistants.
Ms. Krystal said the authority has been making requests for extra oncologists over the past few years, but because of budget constraints, the Health Ministry has been unable to grant them.
She said the resignation of Dr. Coppes was a "tipping point … and a bit of a catalyst for several people who were feeling pressure to come forward." Dr. Foster added: "But things haven't suddenly gone to hell in a handbasket because Max left."
They said the provincial government is not conducting a review of the authority and its relationship with the cancer agency, contrary to what the Health Minister told me a week ago. In trying to explain the confusion, Ms. Krystal said it was a "nomenclature issue." She said what is taking place is an examination of the "journey of a cancer patient across the system," in the hopes it may reveal ways to find efficiencies that might cut waiting times.
The cancer agency is trying to develop a 10-year hiring plan, something that is more complicated in an age when doctors are not required to retire at 65. Because the agency isn't sure when any doctor will call it quits, it's difficult to chart a future employment path.
The title of president of the cancer agency was changed to vice-president to conform with other agencies. Ms. Krystal said she did not think the downgraded title will prevent the authority from finding a highly qualified person to fill the job.
In a tight fiscal environment, there are no assurances that the provincial government will accede to the health authority's labour demand, although there is little question the negative attention that has surrounded the cancer agency in recent weeks has caught many people's attention in Victoria.
The Globe stories recently prompted Dr. Foster to send a message to all staff at the cancer agency that recognized growing issues inside the organization.
"PHSA and the BC Cancer Agency acknowledge that we have been experiencing challenges in keeping up with demand as the population continues to grow and treatment gets more and more complex."
The memo assured staff the problems were being dealt with.
We'll soon see how committed both the health authority and the provincial Health Ministry are to turning an extremely problematic situation around.
Gary Mason