Response from Vancouver Coastal Health Authority

I received this response today and thought I would post it. I hope some of us can interpret what it is saying and come up with some questions based on the info they have provided. I am not thinking all too clearly right now and would love to hear other's opinions. Thanks a bunch. Janice ******************************************************* Dear Ms. xxxxx, Thank you for your email of Tuesday, October 31, 2006 .I can appreciate your frustration with waiting to gain access to your surgical procedure. As you know, only one hospital in BC, the Royal Jubilee, in Victoria, currently provides this kind of surgery. It appears that you may have been led to believe that a decision had been made to perform surgeries at Vancouver General Hospital, (VGH) but that the surgeons were simply waiting to have time scheduled in the OR. This is not the case. Discussions around the possibility of performing gastric bypass, (bariatric) surgeries at another hospital in British Columbia are currently in the preliminary stages. St. Paul's Hospital, (where the program existed until the surgeon retired in 2002), and VGH, as part of Vancouver Coastal Health have participated in high level discussions with the Ministry of Health, other regional health authorities and the Provincial Health Services Authority of this issue. Given the nature of this surgery and the need to ensure it's success by developing a supporting program and infastructure,it is important that a thorough investigation and significant planning take place before any decisions are made. It is also important that these decisions represent the needs of all British Columbians. This is more complex than just booking time in an operating room - a challenge in itself, given the growing demand for surgical services. VCH will need to review and discuss program requirements and costs and the Regional Surgery Executive Council (RSEC)- the group responsible for providing overall leadership and guidance to the surgical programs across the region, will determine the most appropriate location for the program. On behalf of VCH, I want to thank you for your comments and reassure you that the planning team and RSEC will make decisions that are in the best interests of the residents of this province. The return address on the letter was Vancouver Acute HSDA Vancouver General Hospital Medical Affairs 855 W 12th Avenue, Vancouver BC V5Z 1M9

Hi Janice, Oh my god, I am speechless, I don't know what to say. I need some time to let this sink in. Well the good thing is that they responded to you very quick which is surprising to say the least. You obviously had an impact on them and I'm hoping that there are more people writing in. I have some major questions to ask them now. 1) Why are there surgeons in Vancouver like Dr. M. and a few more surgeons in training and why is he taking patients in and having these pre-op tests done-are these not a waste of tax payers $$ ?We can't have these tests done and then wait for years for the surgery? These tests will all have to be done again if too much time passes. 2) Dr. Amson has about 550 patients waiting. Do they actually think that one surgeon can do it all, there is an need for this surgery obviously, based on his numbers alone and they know that. We need to write a letter back and tell them that. I talked to Richard from Mission who had his surgery 5 years ago at St. Paul's and he said he is going to talk to Dr. Amson next Wednesday when he sees him for an appt about writing a support letter and helping us. 3) I would like to book another appt with Dr. M now and ask him to sign an out of country application for me as I am now under the impression that he is being treated the same way at Dr. Cleavor, Dr. Woodhead, and unless he advocates for this, it may be a long time for the surgery.... if at all. 4) Why did they kill the surgery (for lack of a better word) for the other surgeons when they tried to offer the WLS before. Are they going to do the same again for Dr. M. now? 5) How do they determine this so called location. I will go anywhere in BC for the surgery even if I have to crawl to get there so it does not matter where they have it as I'm sure most of us don't care where as long as we can get it. I am really getting upset now, and Mexico is starting to look pretty good for the WLS and now it is looking like this took take a while now for the surgery. 6) How long before they make a decision about this? Sim

Good morning Sim, I thought the letter was rather vague at the same time as it seemed kinda detailed. LOL My question to them was When will you be giving Dr. M the go ahead to start the surgeries? They did not really answer the question but one of the things I read into their response is that they have not even chosen where, what surgeon or when. Part of me thinks that Dr. M might have jumped the gun a little. So I gotta pick myself up and go to plan C. My sister thinks I should put my name on Amson's list...but when I think about doing that I get that horrible pit in the stomach kinda feeling and my thoughts immediately turn negative and I am powerless. I know I just gotta change my thoughts.... The other thing is OOCountry. I am going to phone and ask Anne to see if Dr. M will sign ooc forms and I am gonna check with my endocrinologist to see if he would sign them (read recently where someone's endo signed theirs-that was Ont I think). I am still going to write to my MLA and I am still looking for some kind of advocate who can help with the BC Health issues. And I am going to reply to the person who sent me this response from VCH. I wish I knew the answer. I will look for some signs. Have a great morning Janice

Hi Janice, I forwarded the response you received from them VCHA on Dr. Amson's support board so they can help write letters, etc. I did not put your name on the post but just said a colleague of mine received this response. Hope that's okay. Where do you get the OOcountry applications? I looked under MSP and there is an out of country form but it is more for when you are away and have to send receipts and send a claim ijn for reinbursement. This form does not have a place where a surgeon signs? My opinion is when you call Dr. M's office, it may not be a good idea to ask Ann about the purpose of your appt . I would bring a copy of the letter with you and request a 5 minute appt. and then let him know here is the response I got from them, it does not look like the surgeires are going to be happening any time soon, please help me and have him sign the form. I am worried that she may say he does not sign forms and think we have given up on them. What do you think? Sim

Hi Sim, Thanks for forwarding this VCH response to Dr. A's website group. And thanks for keeping my name out of it. My thinking around privacy when it comes to open forums and online discussions is that it is better to keep names out of re-posts or public posting of responses rec'd from others. Application for Insured Out of Country Medical Services https://www.healthservices.gov.bc.ca/exforms/mspprac/2810fil.pdf If I do ask Dr. M to approve OOC surgery, it will not be an in person discussion. I understand your concern about him not signing the ooc forms but it might be more useful for us to know beforehand whether he will or will not even consider signing ooc forms. I think that Dr. M is already very aware that there could be a long wait and it is to be expected that some of us will not wait for him. I am going to leave my name on his list but I am taking most of my eggs out of the Dr. M's basket and looking for a new home for them. And I guess my final remark is that this is not about Dr. M, this is about us. ttysoon Janice

Hi Janice, Talk about a letter of nothing. We are also residents of BC. I don't agree with all of the decisions made as far as surgeries done in BC. They have a model which could give them all the information they need as far as this surgery. Dr. Amson and the Royal Jubilee. They are foot dragging. Lets talk class action lawsuit. Sarah

Hey everyone, I jsut thought of something. According to what Ann said- there are only about 20 of us that have gone thru the pre-op tests and are now waiting as we were told time in and time again the surgeries would be happening even though we did not get an exact date. Even though they may have been done this with the best intentions- we were lead to believe this and I have witnesses as well as I have always brought a person with me for all my consults. I think we should get together and strategize as now we can say okay, we all went thru these tests and were lead to believe it would be happening. If we had known this would not be happening, we could have filled out the OCC country applications and applied for going out of country. Now more time has passed and it is going to be even harder as MSP has tightened their purse strings and is making it much harder now. I think we should put forward a proposal that we want approval to go out of country or operate on us. As I understand people who are now trying to get on a consult with Dr. M are being told he is not taking any more patients right now, so we would not be leaving anyone out here. Sim

Hi Sarah, I tend to agree with you about them already having a way to determine if it works or not...Dr. A must have lots of stats going back over the last 5 years or more. That is a question we should ask VCH. I will do some research about class action suits. Off the top of my head, I think we might actually have a case. In Chaoulli vs Quebec, the Supreme Court of Canada found that Quebec's public health insurance legislation violated the Quebec Charter of Rights when it prohibited the purchase of private insurance for publically insured health services and private payment for hospital services. If the provincial laws prohibit us from buying our own health insurance and we have no chance of obtaining the necessary health care in a reasonable time period it could be interpreted that the current laws are violating our guarantee to life, liberty and security under the Charter of Rights and Freedoms. My problem is I don't know enough about all these Charters and my own rights as a citizen of BC to even tell if we do have a case. Nor do I know of any lawyers who have experience with BC Health. But I think it is definately worth investigating.

Although you make very valid points, but Gastric Bypass surgery is not considered as a life or death surgery unfortunately. It is still very much considered an elective surgery unless it is on an emergency basis. So technically speaking, if you had private insuarance, that insurance company may approve somebody in another province such as Ontario where these are done regularily but the same company will deny somebody in BC since it's not deemed necesssary yet here.

Hello Bobby, I just want to clarify that Chaoulli vs Quebec was about a man who needed knee surgery. Not life and death surgery. I know that it is mandatory to pay for MSP health insurance but what I don't know yet is whether I can purchase other insurance..ie blue cross etc that might pay for the surgery too??? Anybody else know anything about alternate health insurance in BC? OHIP is the provincial health insurance for Ontario and they are the insurer who is paying for all the OOC surgeries in Ontario. There are no private insurance companies involved to the best of my knowledge. I believe that the reason Ontario is allowing oocountry is because their wait list is several years long. I should be able to find that out on the internet. Would be interesting to see. Janice