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Letters Oct. 1: Are MDs justified in opting out of MSP?; Canada's need for submarines

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A group protests in front of the the premiers' meeting in July at the Empress Hotel for improved access to family physicians. Letter-writers are divided on the merits of family doctors de-enrolling from the Medical Services Plan to earn a better living. ADRIAN LAM, TIMES COLONIST

We need to value primary health care

Re: “Authorities must act to preserve health care,” editorial, Sept. 29.

We live in a democracy. We don’t force anyone in our country to do a job to the detriment of their personal and financial well-being.

That’s what we are asking family physicians in this province to do. It is within their right to opt out of MSP payments and charge patients directly for care received, then have the patient receive reimbursement for our governments.

It is also within their right to bill patients extra for services not covered by MSP (soft opt out). These ideas expressed in this editorial will only alienate the few remaining and any recruitment efforts to attract new family physicians.

In my opinion, those who have opted out of the MSP payment schedule are only doing so in protest — and with good reason, as the current payment schedule falls so far behind the realities of running a practice.

This is evident by the one million B.C. residents who can’t find a ­family ­physician. We rank second-last in the high-income ranking health-system ­published in 2021.

Why? Mainly because we don’t value primary health care and family physicians as citizens and in our political system.

The editorial says that “physicians who de-enrol from the public plan are abasing their profession” — but who exactly are they belittling or degrading?

It’s you and I who elect our government, so we as citizens in a democracy need to take responsibility for this ­failure. It’s not the family physicians who are left standing in a system that doesn’t value them.

Instead of pointing fingers and threatening those who are trying their best to provide us with care, take responsibility for your actions.

We all have a voice to fix this problem by electing a government that values health care. For now, I stand with all my family physician colleagues.

As an emergency-department physician, it is disheartening to see so many people under my care with no family physician and nowhere to follow up, especially those in their 70s, 80s, and 90s.

Dr. Alex Brothers CCFP (EM) — ­Emergency Medicine
Emergency Department Medical Site Lead
Chief of Staff
Saanich Peninsula Hospital

Community centres will help health care

Re: “Authorities must act to preserve health care,” editorial, Sept. 29.

Congratulations to the editorial board for words of sense on the primary care situation — rare among the misinformation and hysteria of the past year or more.

It can only be helpful and should be applauded when you state that more ­funding is not a panacea, that the ­“crisis” can be laid as much (if not more) at the feet of the medical profession as the ­government, and that telehealth is ­contributing to, not solving, the problem while exploiting it for profit.

The only thing missing was a call for the increased role of nurse practitioners in alleviating the crisis in the short term.

In the longer term we have to move to community health centres staffed by teams of carers accountable to their enrolled citizens. This needs to be funded by per enrollee payments and/or salaries, not fees for each service, along with ­government funding of the necessary infrastructure.

This solution was first proposed in the Hastings Report of the early 1960s, ­frequently reiterated in subsequent ­commissions and reports over the past 50 years, and recently floated for B.C. by Green Leader Sonia Furstenau.

Unfortunately, this entails the ­political courage to confront entrenched ­(physicians) and emerging (telecoms) interests. This has been absent historically and currently seems unlikely.

Jonathan Lomas, O.C., FRSC, FCAHS
Former CEO, Canadian Health Services Research Foundation
Victoria

We must do better with Canada’s navy

Several writers in recent days have promoted Canada’s need to have a balanced fleet of navy ships. One has decried the need for submarines.

All of this is, of course, very much part of a Canadian trait, and that is debating an issue forever without actually doing much that is practical.

If Canada wants to take an established place in the world as a responsible ­middle-ranking power, of course we need to invest in defence, and that includes having a combat-capable balanced fleet that is not rusting out or so lacking in sailors that the ships can’t sail.

But the real problem is successive ­governments that do not invest the ­necessary funds in a timely fashion and accelerate a procurement process that seemingly has as its main goal anything but a concrete result.

We can and should do better.

David Collins
Victoria

Navy is our first response to international crises

Re: “Is there a place for subs in our navy?” letter, Sept. 29.

Canada needs a balanced and affordable combat-capable naval fleet because our country has the longest coastline of any country in the world and an ocean area of interest that is larger than the land mass of the nation.

Freedom of movement on the world’s oceans is vital to Canada as our economy floats on salt water. The water space is three-dimensional, and submarines are a vital part of a balanced and affordable navy fleet capable of operating under, on and above the oceans of the world.

A single submarine can keep watch over 125 square miles of ocean for an extended period with the strategic benefit of no one knowing exactly where it is.

Because Canada operates under water, we participate with other nations in the submerged traffic system. Right now, today, Canadian Navy ships are working with allied navies in the Pacific to uphold international “law of the sea protocols” while simultaneously maintaining a presence in the eastern Atlantic.

Since its establishment in 1910, the Navy has always been Canada’s first response to international crises.

Gerald W. Pash
Victoria

NATO member nations must meet commitment

In 2014, the 30 members of NATO agreed to increase their defence spending to a minimum of two per cent of their national gross domestic product.

However, a report recently released by NATO Secretary-General Jens Stoltenberg estimates Canadian defence spending will instead decline as a share of GDP to 1.27 per cent this year, down from 1.32 per cent last year and 1.42 per cent in 2020.

Canada has announced plans to inject an additional $8 billion into defence appropriations over the next five years (an average of $1.6 billion per year).

That barely moves the needle toward NATO’s two per cent target; it would bring Canada’s defence spending up to 1.59 per cent of GDP. The current budget is $36.3 billion.

When questioned on our commitment to NATO, the government of the day tends to prevaricate with statements like “We are punching above our weight,” “We do other things that make up the ­difference” or “We are committed to (insert project of the day).”

The only way that NATO can maintain its credibility is for all nations to live up to their commitments, otherwise the ­Russians will continue to act the way they do now.

Unlike the Second World War, if NATO does become embroiled in a fight, it will be a “come as you are party.”

There will be little time to make up for deficiencies, particularly in equipment and well-trained combatants.

John Gabel
Saanich

Appalled at the loss of trees along Shelbourne

I was appalled to find the magnificent old trees that used to line Shelbourne Street have been butchered. I am told it is to make way for bicycle lanes. Really?

Shelbourne is to become a one-lane only for vehicles travelling in each direction, instantly creating major gridlock. Someone has the wrong priorities.

Shelbourne is a major bus route. Shelbourne is a major commuting route. Shelbourne is a major shopping route. Shelbourne is a major route to the Royal Jubilee Hospital. Shelbourne is a major pedestrian route.

Trees that are healthy need to stay, be cherished for the sake of humanity, for beauty, for health, for sanity.

Clearly, in this case, the ­forestry ­industry is not involved (as in ­clearcutting) but equally clearly there is a total lack of understanding of the worth of trees in cities.

Such lack of understanding has huge consequences for the future growth of Greater Victoria, and I sincerely hope there are consequences for those who elected to permit the cutting of such old, healthy, cherished trees as we watch the current consequences of global warming right now all around the planet.

Sylvia Bews-Wright
Victoria

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• Email letters to: letters@timescolonist.com

• Mail: Letters to the editor, Times Colonist, 201-655 Tyee Rd., Victoria, B.C. V9A 6X5

• Submissions should be no more than 250 words; subject to editing for length and clarity. Provide your contact information; it will not be published. Avoid sending your letter as an email attachment.

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