There are many changes occurring in the political landscape – Ontario has a new premier, federally, there is movement towards redefining the electoral map. Does this make a difference for rural residents? Yes, and it is significant enough that we need to be informed and involved. The new premier brings many positive attributes in her leadership abilities, she is also very Toronto centric. While she has expressed an intent to understand rural issues she may not fully understand the context of rural health. So how is this related to our health?? Because we are handing over decision making regarding policy that has an effect on our health to those who may not understand issues affecting rural communities.
A study conducted by physicians at St Michael’s hospital a number of years ago noted that a substantive number of traumatic injuries occur in rural Ontario. Of those injured, 62% are taken to their closest – most likely rural – facility for treatment. Further, 69% of those taken to a smaller community hospital are NEVER taken to an urban trauma centre. What does this mean?? This finding demonstrates that small, rural hospitals do an exceptional job of providing initial trauma care to those in need. This is important right now as we hear news of more local facilities changing processes that may result in negative outcomes for rural residents. One change that is common is the closure of maternity units – generally the decision is made that it doesn’t make economic sense for smaller centres to deliver babies. As a result expectant moms are must travel to access care. Which becomes a theme for rural residents — there is an expectation that individuals will travel to access care that is needed. This has been apparent in many of the outcomes attributed to the Local Health Integration Networks (or LHINs) that define how healthcare is provided in the Province. The LHINs were introduced as a means of decreasing duplication and ensuring accountability. While that may have occurred in some areas, there has been a more negative impact for rural communities. While we expect that we might have to travel to access some services – it wouldn’t make sense after all for a small rural hospital to have a Neuro-trauma unit for instance – we also have a right to access those services that maintain our health and prevent illness. We need to ensure that the decision makers we elect value this same access to exceptional care in rural settings. We need to demonstrate the value that rural healthcare providers bring to us as residents of the community as well. We need to be educated about changes in policy that will affect us. Finally we need to challenge to misnomer that we have made a choice to live where we do – while that may be true nowhere was it written that means we deserve less when it comes to healthcare access.
