Kamloops lawyer John O’Fee has succeeded Kelowna resident Erwin Malzer as the new chair of the Interior Health board of directors. O’Fee will chair his first meeting of the board for 2017 on Feb. 6 at the IH headquarters in downtown Kelowna, 505 Doyle. Ave.
Black Press asked O’Fee to respond to a series of questions about some of the issues the board will be facing in the year ahead, and his answers are outlined below.
John O’Fee at a glance
Home community: Kamloops
Marital/number of kids status: Married (28 years) two boys, ages 18 and 23
Profession: Lawyer/University Instructor: Teaches Commercial Law and Employment Law for the School of Business and Economics and also an instructor of Real Estate Transactions for the Thompson Rivers University School of Law
Hobbies: Golf, hockey (twice a week in the winter), gardening—and this year a lot of snow shovelling.
Education: Bachelor of Commerce (B.Comm.); Sauder School of Business, UBC; Juris Doctor (J.D.), Allard School of Law, UBC (1987)
Past political resume: four-term councilor City of Kamloops, 1999-2011; chair, Thompson Regional Hospital Board; board director, Thompson-Nicola Regional District; school trustee, Kamloops-Thompson school board, 1988-1996
Biggest personal achievements: Convincing his wife Daniela (against her better judgement) that she should marry me; Thompson Rivers University Distinguished Alumnus Award, 1995; B.C. Community Service Award (2011); appointed Queen’s Counsel, 2015
Q: Do you foresee the need for drug safe injection sites becoming necessary in other communities across the IH region? Why or why not?
O’Fee: First, there is no such thing as a safe injection site in that no street drug can be described as “safe.” Supervised consumption sites are part of a harm reduction strategy that should be employed where viable. We need to have an adult conversation around addictions. Most of us considering our circle of friends and families can quickly find a person with an addiction problem. My view is that addiction is a significant medical problem needing a sensible and humane approach. Supervised consumption sites are in no way a solution, only a way of mitigating the harm.
2) Speak to the success of the nurse practitioner program in the rural or less populated areas of the region and do you see that program expanding? Do you think it can be a viable solution for lack of doctors in rural areas of the region?
Nurse practitioners (NP) are valuable members of the interdisciplinary health care team and key primary care providers. Their experience uniquely positions them to function both independently and collaboratively in a variety of settings across the continuum of care.
The primary focus of the NP role is clinical. This may include providing comprehensive care to clients of all ages, including health promotion and disease prevention, supportive, curative, rehabilitative and palliative care.
That being said, they are a partial response to the need of small communities to access medical services. While they are a welcome addition, they cannot generally be viewed as a solution in and of themselves. Other developments, including tele-health, can assist in providing rural centres with better access. However, we also recognize that conditional access to physicians is not generally meeting community needs, and strategies are being employed to attract and retain physicians as well.
3) Nurse practitioners may be one example, but talk about some of the other initiatives IH is looking at to help people live longer in their own homes rather than relying on institutional care?
In my private legal practice I was involved in the establishment of some innovative seniors’ housing initiatives. These included seniors’ housing cooperatives geared towards providing at least some rental units for low income seniors. We all recognize that allowing a senior to stay in their own residence near friends and family is the best alternative when medically viable.
One of the areas we are working on is expanding team-based care to enhance primary care for this population. We are also developing services to better support those with frailty and age-related medical conditions through a multi-disciplinary approach and access to specialist services including geriatricians. Our adult day programs play an important role in helping seniors remain at home.
4) Growing waiting lists times is an ongoing concern for people in need of surgery. What is IH able to do right now given current funding limitations to try and alleviate those concerns?
Matching skills and resources to needs is always a challenge. We can clearly do a better job in non-urgent care and surgeries. Part of this is ensuring we have the individuals with the necessary skill sets to perform these needed services, but this has to be combined with the physical resources, staff and hospital beds necessary. As our population ages, this will become a growing challenge.
In June 2015, IH opened a regional operating room at Kelowna General Hospital’s Interior Heart and Surgical Centre. Surgeons from Vernon, Penticton and, for a time, Kamloops have travelled to Kelowna to take advantage of the OR time, enabling access to surgery for both local patients and for patients outside of the Central Okanagan and allowing surgeons to perform extra surgeries and reduce wait times for the longest-waiting patients. In 2016-17, a total of 1,647 surgical procedures have been planned across Interior Health sites, benefiting patients in the Okanagan through IH’s regional operating room at KGH, as well as at Vernon Jubilee Hospital, Kootenay Boundary Regional Hospital in Trail, Pleasant Valley Health Centre in Armstrong, and Royal Inland Hospital (RIH) in Kamloops.
5) What is on the immediate horizon for planned major capital investment project priorities for the region?
We have seen significant capital investments in Cranbrook, Kelowna and Vernon over the past number of years. Most recently, Royal Inland Hospital in Kamloops opened the first of a multi-phase hospital master plan, the Clinical Services Building. Ground was also broken this spring on a new Patient Care Tower in Penticton. Going forward, IH is hoping to proceed with the next phase of the hospital master plan in Kamloops.
6) The Community Paramedicine program is expected to roll out in early 2017 in 30 communities across the health region. Can you describe what that program is and how it can enhance health care services.
Matching needs with skill sets will become increasingly important. While doctors have unique and highly specialized skill sets, other dedicated health professionals can also provide medical assistance at a level commensurate with their skill levels. Paramedics are a vital part of the health-care team and are capable of providing some level of health care beyond emergency transportation to and from a hospital.
In a rural and remote setting particularly, paramedics are the frontline health-care providers and we need to use their skills sensibly and with a patient focus. For example, a rural patient may require some post hospital discharge follow up care such as administering medication by needle or establishing an IV drip. A properly trained paramedic could provide these services to the patient in their home, saving that person from a long journey to a hospital or medical centre and assisting in their recovery.
B.C.’s community paramedicine initiative is a first for the province. The traditional focus of paramedics in 73 rural communities – including 31 within Interior Health – is being broadened from pre-hospital emergency care to include basic health-care services in non-urgent settings, in patients’ homes or the community. This will provide better access to primary health care and a more stabilized paramedic presence for emergency response.
Community paramedics were hired last year within Interior Health’s prototype communities of Creston and Princeton. The second round of hiring and training for the remaining communities is expected to wrap up this spring.
7) MyHealthPortal is a new tool that can provide 24-hour access to their health information via their smartphone, tablet or computer through a secure portal from the IH website. Why has this been important to establish this service for IH region residents?
We all bear some responsibility for our own health care outcomes and no person is more likely to pay closer attention to a medical record than a patient or their loved ones. Having access to one’s medical record ensures it remains accurate, up to date and informative. Our board shares the view that this information should be available and transparent to patients.
8) What do you see as the IH board’s key objectives or challenges ahead for 2017?
Financial pressure is always a consideration for any organization such as ours. We recognize that IH is the biggest public financial entity in this region by a wide margin. We could take every municipal budget within IH and still fall far short of what we spend on health care. We are in a constant quest for savings and efficiencies to better meet our mandate.
We also need to employ new strategies in recruiting and retaining top medical talent, look into effective ways to shift our services and care away from our hospitals and into the community and continue to focus on improving productivity and efficiency with our current services.
9) For your predecessor Erwin Malzer, he made significant personal efforts to begin to improve IH’s relationship with First Nations people, particularly those living in isolated communities. Do you have goals as IH board chair that resonate personally with you, issues you would like to see addressed?
I spent over two years as the Chief Executive Officer of the Tk’emlups te Secwepemc (Kamloops Indian Band) where I helped manage a wide range of business, governance and social entities. This afforded me some insight into the challenges faced by both urban and rural Aboriginal communities concerning health care. I am looking forward to participating in a meaningful way with our Partnership Accord.
At the same time, our motto as an organization is that “Every Person Matters.” In my view, IH needs to continue its strategy of bringing access to health care to everyone. Technology is advancing at a rapid rate to the point where a specialist working on a video conference with a nurse practitioner can provide a high level of service that might have previously been unattainable.
Access to reasonable levels of affordable health care is a shared Canadian value transcending party politics and personal differences. Being able to efficiently match health care skill sets with patient needs will be how we are able to deliver on our shared value.
10) As a former school board chair and trustee in Kamloops guiding education policies, how has that differed from serving on a board that oversees management of health care services?
My community service includes being school board chair, a Kamloops city councillor, Thompson Rivers University Foundation chair, Municipal Finance Authority director, and Hospital District Board chair. Prior to my appointment to IH’s board, I served as a director and audit/finance committee member of the Provincial Health Services Authority. I am well acquainted with the principles of effective governance and the importance of public oversight into what is the single largest expenditure of public dollars in this province.
The biggest difference is not so much the sorts of responsibilities and duties one brings to the role, but the sheer scale of the organization. Like IH, large school districts like Kamloops-Thompson have a mix of urban and rural needs and a trustee quickly realizes that what might work well in an urban centre may work less well in a small town or rural setting. But in the final analysis, school boards trustees and IH board members share a core value of public oversight for key services.
11) Do you foresee a day where IH board members will be elected rather than appointed? Is that really necessary?
Putting on my lawyer hat… a fundamental principal of democracy is that the public should elect those able to levy taxes upon them. As the adage goes, taxation without representation is tyranny. The taxation in this context is levied by the provincial government and the Regional Hospital Districts which are comprised of MLAs and elected regional district directors respectively.
IH directors levy no direct taxes and as such, the argument for their election is less strong. In addition, the provision of health care should never be a partisan political thing. I believe that all the board members are in place because of a true commitment to the provision of effective health care throughout IH. We have a remarkable skill set on our board and they bring this expertise to bear as a matter of public service versus political agendas.