On this edition of Journal, we take a closer look at one piece of our health care system that doesn’t usually get much attention, even though we see them working on our streets all the time: paramedics.

We hear about doctor shortages and nurse shortages, but did you know we have a paramedic shortage? In rural and remote areas of the province alone, there are close to 400 vacancies.

The problem is exacerbated when an emergency call comes in but the ER is closed or on diversion. According to Mayor Goetz (of Merritt, British Columbia), a paramedic – if available – must transport and accompany the patient around 100 kilometres to the nearest hospital for emergency care. That takes time, leaving the community vulnerable.

Also, the province does not allow the service to pre-schedule overtime coverage in advance when there are known holes in the schedule – for vacations, as an example. This results in a patchwork system, sometimes covered by firefighters but often resulting in wait times that are too long.

So, a few questions:

What is a day in the life of a paramedic like?

What training is required?

Why aren’t more people applying for these vacant positions?

I can’t help but worry about the constant stress that our overdose crisis has added to the job of being a paramedic. Imagine reviving the same person over and over again with the same result. That must take a toll.

To talk about some of these issues is Ian Tait, spokesperson for the Ambulance Paramedics of BC, who are currently in negotiation with the government. What are the biggest issues and possible solutions?

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Carole Taylor's Journal is a public affairs dialogue that digs deep into the most pressing issues of our times. For more, see our website at http://www.caroletaylorsjournal.ca.

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On this edition of Journal; an opportunity to look back at British Columbia’s failed experiment of decriminalization – and look forward to what might come next.

Dr. Julian Somers, a clinical psychologist and distinguished professor at Simon Fraser University, was one of the first voices to speak up about the perils of decriminalization and safe supply of drugs when these initiatives were first announced, and the powers-that-be didn’t like that – or him. At one point, he was told to destroy his report and not rock the boat.

Initially, we were all told that the goal of these policies was to destigmatize drug addicts and prevent overdose deaths. But as the Minister of Health, Minister Osborne, has now admitted, it didn’t work. What it did do, however, was lead to increased public use of drugs on our streets and in our neighbourhoods, raising disorder and public safety concerns – an unintended consequence that should have been anticipated.

So, now we are moving on. To what, you might ask? And how?

Is there a consensus on first steps? I would suggest one of the most important changes that must happen is a sea change in attitude away from just supplying drugs to addicts, to the consideration of other strategies for care or recovery.

For sure, it will involve more treatment beds, more available social services for support, and – in some severe cases – involuntary care models. But are we ready to even have this conversation?

Dr. Somers believes that underpinning any future success must be data. “We need to state how our interventions are expected to result in improvements and how we’re going to measure progress.”

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Carole Taylor's Journal is a public affairs dialogue that digs deep into the most pressing issues of our times. For more, see our website at http://www.caroletaylorsjournal.ca.

ctj064 #decriminalization #britishcolumbia #bcpoli

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On this edition of Journal, we look at the sad Vancouver tale of the rise and fall of Woodward’s on Hastings Street.

Built in 1903, the Woodward’s building was the place to be in Vancouver – a one-stop department store famous for its renowned food floor. Glory days.

But few things stay the same forever. The Woodward's decline began in the 1960s as both shopping patterns and Vancouver’s Downtown Eastside began to change. Many shoppers chose the shiny new suburban malls rather than the deteriorating downtown location. The losses at Woodward’s began to mount company-wide until they declared bankruptcy in 1993, 90 years after its much-celebrated opening on Hastings Street.

But that wasn’t the end of the Woodward’s story. The heritage building remained empty until the city bought it in 2001, with grand visions of a revitalized anchor for the Downtown Eastside of Vancouver, providing homes and services for the community. This project was controversial from the outset, with some fighting against this so-called gentrification, while others worried that too much social housing in one project would not work.

But reopen it did, in 2009 with much fanfare about the anchor tenants supporting the redevelopment: Nesters Market, TD Bank, London Drugs, J.J. Bean, among others. But that was then and this is now: TD bank has closed its doors, J.J. Bean is gone and now London Drugs has announced its imminent closure.

The reasons are all similar – increased crime and disorder on the streets, worry about safety for staff and customers, and financial losses.

Clint Mahlman, CEO of London Drugs, joins me to talk about this difficult decision.

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