Troubles at the BC Cancer Agency entered the political realm Wednesday, as B.C.'s Health Minister was put on the defensive over charges that deteriorating working conditions inside the organization are compromising patient care.
In the legislature, the provincial New Democrats cited a letter written by three of the leading oncologists in the province, and obtained by The Globe and Mail, that detailed numerous problems inside the agency, ones the physicians said have led to plummeting morale, surging staff burnout and increased waiting times.
NDP health critic Judy Darcy called on Health Minister Terry Lake to immediately investigate the complaints laid out in the document signed by oncologists Sharlene Gill and Tamara Shenkier, co-presidents of the Association of BCCA Medical Oncologists, and physician Paris-Ann Ingledew, president of BC Association of Radiation Oncologists.
"Something is not working when the number of people waiting over four weeks for treatment has more than doubled in the last seven years," Ms. Darcy told the legislature.
"The individuals who wrote this letter represent every doctor who treats cancer patients in the province … many of us have trusted them with our lives and with the lives of our loved ones. Surely the minister should trust them enough to stop claiming that everything [at the agency] is okay."
In response, Mr. Lake said a physician working group at the health authority was attempting to address many of the issues that the oncologists raised in their letter to Provincial Health Services Authority (PHSA) president Carl Roy. While acknowledging that an ever-aging population means the incidence of cancer will rise, the Health Minister made no promises that staff shortages at the agency will be addressed in the near future.
Waiting times have been growing at the agency for years. As have complaints that lousy working conditions that stem from an understaffed, overworked organization are leading to burgeoning levels of burnout and high doctor turnover. The Victoria cancer centre has lost nine oncologists in the past three years because of the quality of working conditions. These are issues that Mr. Lake appeared to be only hearing about for the first time this week.
Asked whether he felt confident he was being properly briefed by PHSA about mounting problems at BCCA, the minister said: "It's a concern that I haven't had this brought up to me sooner. I'll have that discussion with my deputy, the CEO of PHSA and the board chair."
He said a review of the health authority and its working relationship with the cancer agency will commence in January.
"We're putting a lot of pressure on the system with an aging population and the expectations people have," said the minister. "So the organization is feeling some of that stress for sure. We will work hard to turn this around. There is no question about that. We will make sure this situation is addressed."
The letter to Mr. Roy said patients are waiting longer than ever to see oncologists. Despite the cancer agency's goal of having 90 per cent of patients seen by an oncologist within four weeks of referral, the proportion of patients in B.C. waiting longer than four weeks has more than doubled in the past seven years.
In 2011, 65 per cent of responding BCCA medical and radiation oncologists reported severe levels of distress on at least one aspect of the Maslach Burnout Inventory, the most widely used instrument to measure mental fatigue among physicians. By comparison in the U.S., the prevalence of burnout among cancer doctors runs around 35 to 40 per cent.
Former NDP Leader Adrian Dix also criticized Mr. Lake in the legislature for failing to adequately respond to the many issues raised in the oncologists' letter.
"The suggestions of chaos at the agency are being made not be people from outside [the agency], but by oncologists," Mr. Dix told the legislature. "Will the minister respond to what they said? Will he meet with them in the next few days? Will he get to the bottom of an issue that is serious for everybody, not just cancer patients, but their families and everybody in British Columbia?"
Mr. Lake would not commit to meeting with the three physicians.