NB cuts: New Brunswick's Conservative government is feeling the sting of public outrage as it cuts hospitals and beds in an attempt to save health care dollars. Premier Bernard Lord is pleading with New Brunswickers, considered one of the unhealthiest populations in Canada, to take more personal responsibility for their health. “We need to change the way we live,” he says, promising more money for health promotion. The largely rural province is closing 7 small hospitals, changing most into community clinics. About 300 hospital beds will disappear. There will be more nurse practitioners and enhanced ambulance services. Lord says 70 new physicians will be recruited. Despite the promises, there have been angry demonstrations at the provincial legislature. “They're cutting the hearts out of our communities,” says Clem Tremblay, the mayor of Dalhousie where a hospital is being closed. — Christine Morris, Fredericton
Figure. Photo by: Comstock
Electronic health records: Clinician involvement is critical to moving the e-health agenda forward, says the new head of Canada Health Infoway, an organization dedicated to advancing the electronic health record in Canada. Earlier this year, Richard Alvarez became president and CEO of Canada Health Infoway, which distributes $1.2 billion in federal funds to projects advancing the electronic health records (EHR). Some physicians have criticized Infoway for the time and bureaucracy involved in approving and funding e-health projects. Alvarez says he is committed to reviewing the process. The EHR will change the way doctors practise, so without physician involvement, building an EHR in Canada will mean “absolutely nothing,” he adds. To date, Infoway has allocated $125 million to 55 health information projects, with another $80 million in funding approved but not yet assigned. An additional $278 million will be invested over the next year. But Infoway's current budget of $1 billion to develop the EHR, and an estimated $4.6 billion in additional required government funding are probably not enough to complete the task, Alvarez says. — Pat Rich, CMA
Coroner overhaul: The UK government has announced a major overhaul of the coroner system in England and Wales, the biggest in 200 years. This includes more rigorous procedures for death certification, which should close the loopholes that allowed Harold Shipman to conceal the killing of around 200 patients (CMAJ 2001;164[4]:535). Deaths will be verified by a doctor, paramedic or senior nurse, who will complete a verification form. The death certificate will be issued by the doctor who previously treated the deceased. Coroners will be given new powers to seize documents from surgeries and hospitals to investigate the circumstances of a death. — Cathel Kerr, Fife, Scotland
Figure. Photo by: B. Sibbald
BC tobacco lawsuit: After years of setbacks, BC has won the right to recover billions of dollars in tobacco-related healthcare costs from the tobacco industry. In May, the BC Court of Appeal overturned an earlier decision and upheld legislation that will allow BC to launch a massive lawsuit against large tobacco firms, similar to those that were successful in the US. The province could recover up to $10 billion. The Canadian Tobacco Manufacturers' Council intends to appeal the ruling to the Supreme Court of Canada. “We are not prepared to settle this case [out of court] because we don't believe we've done anything wrong,” spokesman David Laundry told The Globe and Mail.
IMGs get matched: A record-breaking 87 international medical graduates (IMGs) received a residency position after the second round of the 2004 match was completed, reports the Canadian Resident Matching Service. This seems impressive, however, the number of IMGs applying for residency positions has nearly tripled since 1995, from 240 to 657. This year 13.2% of IMGs were matched, compared with 16.7% in 2002 — the largest percentage. At the end of the second round, only 30 residency positions remained unfilled; all but 1 were in family medicine. — Compiled by Barbara Sibbald, CMAJ