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From http://www.timminspress.com/webapp/sitepages/content.asp?contentID=159899&catname=Local+News

Docs vacating the North, study reveals

James Wallace  /  Osprey News Network
Saturday, August 19, 2006

A third of all doctors living in Northwestern Ontario expect to leave their practices by 2009, shows an Ontario Medical Association study obtained by Osprey News.

The study not only confirms that doctor retention continues to be a chronic problem in the North but it also found current doctor-retention initiatives for underserviced areas are not working.

Almost nine out of 10 doctors believe there is a "serious physician retention problem in Northwestern Ontario" and 41 per cent believe that "regardless of physician-retention initiatives, more and more physicians will leave Northwestern Ontario to practise elsewhere."

Dr. David Bach, president of the Ontario Medical Association, said although the study focused on doctors in Northwestern Ontario, it likely reflects physician sentiments across the North and in rural, underserviced communities.

"I suspect it is broadly applicable because the issues that are identified here are common issues in semi-rural and northern places," Bach said.

The study found doctors decide to leave for a combination of professional and personal reasons but significantly concludes personal and family issues are the "most significant" factor influencing doctor intentions.

"Most physicians who expect to leave practice in Northwestern Ontario within five years state that they are leaving for personal/family reasons (54 per cent) as opposed to retirement (37 per cent), professional (25 per cent) or community (eight per cent) reasons," the study found.

Younger and female physicians are most likely to leave for personal and family reason and the more "rural" the community is, the higher the risk it will lose a physician.

While 18 per cent of Thunder Bay physicians intend to leave their practice within five years, 44 per cent of regional physicians outside of the city of Thunder Bay plan to move elsewhere.

Meanwhile, doctors who came to the North for "good income" were also more likely to leave within five years.

The study surveyed 200 doctors in Northwestern Ontario, almost two-thirds of all doctors in the region, and 100 spouses.

Specific personal concerns affecting doctor decisions to leave communities included a lack of time for family life, lack of access to relatives and friends and uninterrupted free time away from work, the study found. Other concerns included:

• Ease of travel in and out of community;
• Quality of education for children;
• Availability of cultural events;
• Spouses/partners' contentment in the community;
• Availability of recreation;
• Compatibility with the medical community.

Spousal satisfaction was found to be very influential in family decisions to stay or leave the North.

Professionally, physicians were most strongly dissatisfied with workloads, their relationship with hospitals and health care organizations and access to medical services including hospital and long-term care beds, home care services, social and psychological counseling for patients and technology.

Any of these personal or professional concerns could represent a "tipping point" for doctors who plan to leave their northern practice, and should be addressed in future retention strategies, the study found.

Strategies need to be developed that involve the provincial government, local health care systems and communities with more emphasis on a "personal," highly individualized approach to retaining physicians.

"Physicians are not commodities that can be supplied according to demand; communities must compete for physicians in an environment of physician shortages," the study concluded. "Because physician satisfaction and intention to stay is so individualized, planning and implementing retention strategies is a challenge."

Measures could be taken to address both personal and professional concerns.

The study suggests innovative measures are needed to improve personal and community satisfaction including lobbying airlines to facilitate easier access in and out of town and free family fares for doctors to visit relatives every six months.

Doctors who responded to the survey stated that "the community could be more welcoming and accepting toward physician families as newcomers, and that local medical colleagues and healthcare administrators could be more supportive."

Regarding their professional lives, physicians suggested a number of retention incentives including disability and dental benefits, pension plans, reduced workloads, premiums for doctors who stay in the North, paid sabbaticals, more medical education opportunities, higher income to reflect workloads and increased availability of visiting doctor locums.

"It was not the purpose of this study to recommend models for physician retention, however, the findings do suggest that new models are required," the researchers found.

"Retention strategies that target only professional factors and offer only monetary incentives are not supported by this research." The study was sponsored by the Thunder Bay Medical Society, funded by the Ontario Medical Association and conducted by a team of researchers at Lakehead University School of Social Work led by Professor Mary Lou Kelley.

Bach said the erosion of doctors from the North is also exacerbated by the number of doctors approaching retirement, approximately 20 per cent all the doctors in the province.

"This is a problem in the North but it is also a problem elsewhere," he said. "We could lose a fair number of doctors fairly quickly if things don't change."

"The physician shortage is an issue that's been with us for a while," Bach said. "It's an issue that's worrisome across the province and it's going to be with us for a while.

"So we all have to work on this together," he said.

From http://www.canada.com/topics/news/national/story.html?id=18988c28-3b64-422d-ac38-4f534dc96ec7&k=84650&p=1

First Nations say regulations, resources needed to protect drinking water

by Melanie Patten, Canadian Press
Published: Tuesday, August 15, 2006

HALIFAX (CP) - Native groups say the quality of water on First Nations reserves will continue to deteriorate unless more resources are given to band councils.

Representatives from First Nations communities in Atlantic Canada also told members of a federal panel Monday that regulatory standards should be set for drinking water on reserves.

There is concern, however, that communities will not be given the funding to match the extra responsibility.

"There's a ton of liability that could potentially fall to bands with no resources to legitimately do that work," Michael Cox of the Confederacy of Mainland Mi'kmaq said after a presentation to the panel.

"To go about creating protocols that are attached to funding agreements and holding bands hostage for that is not a good process."

The three-member independent panel of experts has been travelling across the country holding public hearings since June.

It will submit a report to Indian Affairs Minister Jim Prentice by September as part of a plan announced in March to improve water quality in First Nations communities.

There were 83 First Nations communities under boil-water orders as of Aug. 4. The Health Department also has a priority list of 21 communities with what it calls "high risk water systems."

There are three reserves with boil-water advisories in effect in Atlantic Canada.

Hundreds of people were evacuated in October from the Kashechewan First Nation in northern Ontario after E. coli was found in water samples.

Water quality on reserves is largely a shared responsibility between First Nations communities and the federal government.

Band councils are responsible for providing communities with clean drinking water, including sampling and testing it.

Indian and Northern Affairs Canada provides funding for construction and maintenance of water treatment facilities, as well as training and certifying operators. Health Canada ensures monitoring programs are in effect.

But Cox said he's concerned about who will be responsible for water quality if new regulations are enacted.

"In my experience, every time I see the Department of Indian Affairs or anybody else doing this it's to limit liability or to get themselves out of liability's path," said Cox, whose organization represents six First Nations communities in Nova Scotia.

The panel said First Nations communities they have heard from across Canada all agree they need more resources.

But panel chairman Harry Swain, director of the Canadian Institute for Climate Studies, said the communities disagree over what regulations should be in effect and how they would be enforced.

"Opinions are all over the block," he said during a break in the hearings. "Some say national, some say absolutely local, some say provincial, regional. Some say we don't need regulations at all."

Andy Nicholas of New Brunswick's Mawiw Council - which represents three First Nations in New Brunswick - said the same regulations should be set across Canada.

"We're talking quality of water here," he said.

"You're not going to have 600 different standards. I think water, air - this is common ground for all of us."

© The Canadian Press 2006

From http://www.kenoradailyminerandnews.com/story.php?id=248362

Treaty 3 Police turn sod on new headquarters

By Mike Aiken, Miner and News
Tuesday August 15, 2006

Treaty 3 Grand Chief Arnold Gardner called it a great day for nation building, as he helped break ground on a new police headquarters Monday.

Joined by the chief of police, Brian Rupert, Gardner said it would be good for the morale of the service.

“We’re going ahead with something that’s really needed,” he said Monday.

At present, about 40 officers are sharing the Kenora OPP detachment with their provincial colleagues, which measures only 54 square metres (600 sq. ft.) .

“They’ve been patient, and so have the OPP,” Rupert said, referring to his officers.

The 75-member force was created just over three years ago, and its membership is roughly three-quarters aboriginal. It was designed to fulfill the recommendations of numerous reports calling for an increased presence of First Nations officers in law enforcement.

Police board chairman Joe Red Thunderboy said financing for the project had already been approved by the banks. He estimated the total cost would be about $5.5 million for the 1,400 sq. ft. (126 square metre) building, and he hoped it would be completed within a year.

Located on Homestake Road, across Round Lake from the Treaty 3 administrative offices, the new headquarters will include holding cells and briefing rooms, which will make it easier for officers on patrol to do their work, Rupert said. It will also help senior officers stay in touch with their rank and file, he added.

According to the federal government, there are now 319 aboriginal communities in Canada with dedicated police services, and they employ close to 1,000 police officers, most of whom are of aboriginal descent.

Records kept by Public Safety and Emergency Preparedness Canada say there are single community services, such as at Six Nations where there is a population of 10,000, as well as multi-community agreements, such as in Nishnawbe-Aski, which serves 44 communities.