Problem of “catch and release” offenders is a hot political issue

Kamloopsians are being terrorized, businesses vandalized and personal property stolen by a small number of people.

What can be done? It will certainly be an issue in the upcoming municipal election in October.

While it’s tempting to blame the homeless for crimes but the opposite is true: some vandals and petty thieves just happen to be homeless.

image: Kamloops RCMP

Some don’t even live in Kamloops but move from town to town.

Such was the case last month when Kamloops RCMP responded to complaints from merchants about thieves making off with shopping carts full of stolen merchandise. During the blitz, police made a number of arrests of men and women wanted in other B.C. cities.

Targeting prolific offenders is one solution but holding them is a problem.

In a letter to B.C.’s Attorney-General David Eby, mayors of the 13 largest B.C. cities told him that the province has failed to stop a tiny number of people from committing a large number of crimes.  And a similar small number of mentally ill make citizens feel unsafe in their communities.

The mayors of some cities said they had 10 to 50 offenders stuck in a “catch and release justice cycle.”

They suggested that more community courts should be created to divert some away from jail time and into treatment.

Many are obviously mentally ill. The parade of desperate humanity is hard to watch. It breaks my heart to my fellow human beings in such a traumatic state – walking down the street yelling at themselves or yelling at others, often lashing out at others.

Mayoral candidate Reid Hamer-jackson has seen the problem up close from his car lot on Victoria Street West. He told me that he knows a number of homeless Kamloopsians by name and fears for their health because they have been banned from shelters.

Hamer-jackson knows what vulnerable street people are going through, having spent some time on the streets of Edmonton.

He often gets up at four in the morning to talk to street people and especially in the dead of winter, to help them find shelter. Hamer-jackson told me that some of these frail addicted beings live on the edge of survival and some have died or are about to die if nothing is done.

Hamer-jackson would like to see treatment centres located in rural areas outside Kamloops like Vision Quest Located outside of Logan Lake, sprawled over 20 acres of land.

Or a treatment centre could be located on city property north of Rayleigh, Hamer-jackson said. Such a area outside the city would allow addicts to be away from bad influences. It might be a hard sell.  When he pitched the idea to one street person, they replied that they didn’t want to be held behind a fence. He replied: “the only ones behind fences will be cows.”

Not all of Kamloops’ homeless are criminal or addicted; they are just trying to get by. With winter gone, homeless camps have been springing up by the river, just a block from my home. When I walk by their camps on a warm spring day, their lives seem idyllic –until I realize they are not on vacation and that homelessness is not an option they choose.

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We are being tested by smoke, fire, heat and disease

As we emerge from the pandemic, Kamloopsians expect that summer, especially this summer, will be liberating.

image: Globe and Mail

After being cooped up all winter, carefully  cloistering ourselves and observing ceremonial cleansing, we look forward to being outside, basking in the glory of Kamloops’ legendary heat.

But this summer, the heat is oppressive. And like the pandemic, the smoke keeps us indoors. Now all we want to do is seek the refuge of an air conditioned shelter.

It all tests our resiliency and takes its toll on our psyche.

Instead of being rewarded for our good hygiene in fighting the pandemic, we are stuck inside as thick smoke from wildfires that blanket the city.

When you’re choking on smoke and your eyes are watering, it’s bad for your physical health to be outside. And it’s bad for your mental health to be inside.

We imagined that the “new normal” will be adjusting to a world in which most people are vaccinated and COVID-19 is just another bug in the cast of flu characters.

But our new normal will have to include hotter summers, wildfires and smoke. The areas burned will become even greater.

The area burned by wildfires in Canada has doubled since the early 1970s, says Dr. Mike Flannigan, research chair for fire science at Thompson Rivers University.

And it’s only going to get worse, says Flannigan, – it’s just a matter of how much worse. Modest predictive modelling suggests the area burned in Canada will double again by the end of the century; more aggressive modelling predicts an increase by 11 times.

We are getting familiar with the measurement of the smoke hazard –just how bad is it? The hazard is measured by the weight of smoke particles in a certain volume of air; specifically, the weight of PM2.5 particles in micrograms per cubic metre.

What makes the PM2.5 particles so potent is that they can affect every organ in the body, not just the lungs.

Sarah Henderson, scientific director in environmental health services at the B.C. Centre for Disease Control, says that the particles are dangerous long before you can smell and taste the smoke. At levels of only 30 micrograms per cubic metre, adverse reactions begin:

“When it looks really bad, people think it is really bad,” she said. “But it becomes unhealthy long before it looks terrible. The immunological response ends up causing inflammation, and that inflammation is systemic.”

Concerned about the smoke hazard, I recently installed an air sensor, made by Purple Air, in my house. While the weekly average reading has been nine micrograms per cubic metre, which is safe, sometimes it peaks at over 50.

George Bonanno, a clinical psychologist at Columbia University, has studied people’s resiliency in the aftermath of hurricanes, terrorist attacks, life-threatening injuries and epidemics such as the 2003 SARS outbreak.

Bonanno’s research shows three common psychological responses to hardship. Two thirds of people are resilient and maintain relatively stable psychological and physical health. About 25 percent struggle temporarily with psychopathology such as depression or post-traumatic stress disorder and then recover. And 10 percent suffer lasting psychological distress.

We are being tested on a number of fronts. Physical and mental illnesses are not a sign of weakness –they provide an occasion for everyone to rise to the challenge, to draw closer together and support those in need.

New doctors need to give up sense of entitlement

There are more doctors than ever before; yet two million Canadians can’t find one.

  image: davegranlund.com

An estimated 30,000 Kamloopsians don’t have a family doctor, although only about one-half of them are looking if national averages apply.

Something doesn’t add up. Why can’t Canadians find a doctor if there is a surplus? It’s complicated.

First, recent graduates of medical schools can’t find the residency they want. Without a residency, they will never become doctors.

This year, 2,980 will graduate from Canada’s 17 medical schools. They will compete for 3,308 residency spots. That would seem like every graduate should get a spot. However, 917 of those spots are in Quebec which means that there is a shortage for English-speaking graduates.

Then there is the arcane process of matching graduates to residencies which leaves some out. Health reporter André Picard says:

“But matching a graduate to a residency spot is a complex process, overseen by the Canadian Resident Matching Service (CaRMS). Medical students apply to CaRMS in one or more specialties; committees select who they wish to interview and rank them; graduates rank the programs and, finally, an algorithm spits out a match, and the student is legally bound to take that residency spot (Globe and Mail, May 1, 2018).”

Graduates have become pickier. They get assigned in residency specialties where they don’t want to work. As a result of preferences and the complexities of CaRMS, 115 graduates are unmatched this year. Jobs are waiting for them -there are 78 unfilled positions, 65 of them in family medicine.

The unmatched graduates have invested a lot. They have accumulated an average debt of $100,000 during four years of training. Taxpayers have invested a lot. We are on the hook for their subsidized education. The cost of training a medical student is $250,000.

Also, some graduates want a regular job where they work only 40 hours a week as in a hospital in a so-called “hospitalist” position. At $150 an hour, a hospitalist makes $300,000 a year with no overhead. Compare that with a doctor in his own private practice. After paying staff and rent, a doctor would have to earn $400,000 a year to take home that much -and they’d work longer hours with less medical equipment and fewer support staff such as nurses. But there are only so many hospitalist positions.

One-half of Canada’s physicians focus on sports medicine or palliative care says Dr. Danielle Martin on CBC’s the Current:

“. . .they’re not practicing what we would think of as full scope full service cradle-to-grave primary care family medicine, and that is what those people who are lining up at Dr. Pengilly’s clinic and asking [for a primary caregiver].”

Doctors need to abandon their sense of entitlement says Picard. We need more general practitioners, especially in small cities and rural Canada. Enrolling in medical school doesn’t entitle graduates to jobs wherever they want, in the speciality of their choice.

“Becoming a doctor is hard,” says Picard, “It’s also a privilege. We need a system that ensures the right doctors are working in the right places, not on where personal desires can trump societal needs.”

B.C.’s failed health-care experiment

Other provinces have opted for the team approach to solve the growing problem of patient access to doctors. Not in B.C. The team approach is not new. Roy Romanow recommended it in his 2002 report:

NorKam Medical Clinic (Google street view)

“in view of …changing trends, corresponding changes must be made in the way health care providers are educated and trained. If health care providers are expected to work together and share expertise in a team environment, it makes sense that their education and training should prepare them for this type of working arrangement.”

B.C. decided to keep doctors in their silos and try monetary reward.

B.C.’s experiment has failed, according to a report published in the Canadian Medical Association Journal. The report’s authors, Kimberlyn McGrail and Ruth Lavergne, professors at UBC and Simon Fraser University, respectively, wrote of their results in the Globe and Mail (August 17, 2016). Taxpayers have paid $397 million on the plan without much to show for it. Here’s how it was supposed to work.

The plan, called the Complex Care Initiative, was negotiated between the government of B.C. and doctors a decade ago. It gave doctors who treated patients with complex health problems an extra $315 each year per patient.

The rational was that if doctors cared for patients who were really sick, rather than those with minor complaints, the rest would go to a walk-in clinic. Dr, Shelley Ross, co-chair of the General Practice Services Committee, says that a doctor’s time is sometimes taken up with minor complaints, sometimes more serious. It could be a runny nose and sore throat or it could be case of diabetes, stroke, high blood pressure, and memory loss.

“So you can see the difference,” said Dr. Ross, “It is basically a time issue, it is not a knowledge issue. It’s not that we don’t know what to do, it’s just a matter of being able to spend the time to do the quality of care (Globe and Mail, August 15, 2016).”

While doctors understandably want to direct more attention to those in dire need, more walk-in clinics haven’t happened.

The failure of planning for clinics has left patients out on the street. I know, because last year I was one of them. Last year when my doctor was on vacation and I had an eye infection, I only got into the clinic on Tranquille with great persistence and intervention from the pharmacist next door.

Kamloopsians are expressing their concerns on social media. On Tuesday of this week, Megs (‏@PirateMeghan) tweeted “The walk in clinic doesn’t open til 8am and I’m waiting in a line up of 28 people outside. The need for doctors in #Kamloops is intense.”

I’m lucky to have a doctor. Tens of thousands of Kamloopsians don’t according to former city councillor Nancy Bepple: “Which is why it is no surprise that studies have reported between 15,000 and 30,000 people in Kamloops don’t have a family doctor. That is, between one in three and one in six people don’t have a doctor.”

The B.C. Liberal plan has left us with a shortage of doctors, overcrowded clinics, and no improvement in health care. Some plan.