A longtime rural resident, I use my 60 plus years of life learning to opinionate here and elsewhere on the “interweb” on everything from politics to environmental issues. A believer in reasonable discourse rather than unhelpful attacks I try to give positive input to the blogesphere, so feel free to comment upon rural issues or anything else posted here. But don’t be surprised if you comments get zapped if you are not polite in your replys.

Saturday, October 28, 2017

Growth Beyond Cities

As I subscribe to the Rural Ontario Institute news feeds I get occational links to their recent reports on rural issues the moast recent being the Rural Ontario Foresight Papers which discusses a wide range of issues from rural growth to econimic issues to broadband infastructure.

I wont even atempt to sumerize the content of this 130 page “paper” which typicaly for acedemic reports goes on at great lenth to say what can be said in a much more readable lenth but non the less highlights a number of rural issues. That said here are a couple of extracts from the report which perhaps show the diffrent perspective rural and urban folks have on some important issues.

Renewable Energy and Rural Electricity
In recent years, Ontario has invested vast sums of money in renewable energy. At the same time, there has been a significant consolidation of power supply in the province, with most small municipal elect ricity systems being absorbed by Hydro One and electricity rates being harmonized across the province. In this process, electricity costs have sky -rocketed for many rural customers. This reflects much higher delivery charges, as well as higher cost generation. Ironically, renewable energy is far more likely to be generated in rural areas than was the case for coal or oil -fired power stations, which were sited close to cities. Now a rural household next to a large wind generation site may have an electricity bill much larger than an urban dweller for the same quantity of electricity because of large transmission and distribution charges, even though the urban household is hundreds of kilometers further away from the place the power was produced. Further, rural households have less scope for reducing their electricity bill. The existing rural housing stock is older, household incomes are lower, there is less op portunity for switching to gas and new, better -insulated homes are not being built. The result is a growing incidence of fuel poverty, especially in northern Ontario where more homes are heated with electricity and winters are long. Moreover, businesses in rural areas tend to be major electricity users, because the service sector is less important, and high electricity prices are affecting their ability to be competitive. The result is a provincial policy that has placed a disproportionate burden on rural citizens and regions.

I note that recent decisions by the current Ontario govenment have substantialy reduced rural home owner hydro costs however there may be a substantial price to pay later for these reductions acording to some observers.

Gasoline Taxes and Rural Households
Cars in rural areas are a more of a necessity than is the case in a city where public transit or taxi services are readily available. For a low - income rural household, operating a car is a major share of their household bud get. A major element of this cost is the price of gasoline. High provincial taxes on gasoline are justified, in part, as a way to fund public transit systems and encourage their use, and to reduce emissions associated with congested urban roads. Rural residents pay these taxes but do not have access to public transit and rarely experience congested highways. To be sure, rural residents tend to have relatively long distance commutes from their place of residence to work because in rural labour markets jobs are typically not available in close proximity to where they live. While they tend to drive more miles in a year than city residents, most of this travel is part of rural life where stores, schools, public services and jobs are dispersed. Gasoline taxes also fund roads and this use is clearly beneficial for rural residents, but perhaps some other form of tax might be a fairer way to address the problems of urban congestion

It must be pointed out that there is a substantial difference between 'in town' rural and 'out of town' rural on this issue, particularly for those for whom there are no alternatives to reliable vehicle ownership and such is a necessity not an option.

Access to Health Care by Rural Citizens
Dealing with rising healthcare costs and a growing number of older people are major challenges for the provincial government. In rural areas the problem is especially acute because aging is taking place at a faster rate and the population is widely dispersed making it more expensive to deliver health services. Moreover, the presence of a hospital in a commu nity, just like the presence of a high school, is a significant factor influencing economic attractiveness and quality of life. Places that lose these essential services become less desirable locations for firms and households. A big challenge is the trad e- off between ready access, which requires a large network of hospitals to allow proximity, and the lower cost of operating a smaller number of larger facilities that can capture economies of scale and that have higher utilization rates. Hospital consolidation, like school consolidation, imposes longer travel costs on users. Thus, part of the saving for the province from consolidation is offset by higher travel costs for citizens. In the case of health care , these costs can involve worse health outcomes, as well as additional monetary costs, if it takes too long to get to a treatment centre. For example, the large new regional hospital in St. Catharines offers more advanced care than was available previously at the old smaller hospitals in the Niagara Region . But, for the more remote part of the southern portion of the Region, the resulting loss of easy access to local hospitals has led to much greater travel distances, which makes it possible that access to health care is now worse than in the past. For people in the distant north, where roads are limited in number and distances are large, access to emergency health care is a particular challenge.

Health services are increasingly being 'consolidated' and 'centralized' and whilst basic services can in most cases be found 'locally' the specialization of many such services often necessitate a trip to distant urban 'heath centres'.

The ever increasing proportion of urban dwellers to rural residents will no doubt continue to increase the need for those rural residents to travel to or move to urban areas to receive services previously available localy. Are those who chose to avoid the big cities going to become second class citizens I wonder?

Sunday, October 1, 2017

Grey Bruce Area Heath Care

This year has been a bit traumatic for both myself and some other family members health wise, non of us had previously not had much to do with hospitals and associated heath services till this year so it was mostly a learning experience. Being aware of horror stories detailing waits of many hours to get attended to I wish to tell the other side of the story that we have experienced in recent months.

In my own case, as briefly mentioned in a previous post back in May I had a stroke and it was touch and go there for a bit (or so I am told, I was out of it) and whilst there is little doubt that the emergency staff and doctors who treated me in those first few hours saved my life it is the nursing staff and other 'health professionals' I am going to highlight in this article. Whilst the Doctors no doubt have a large amount of input into ones care it is the nurses and other 'health professionals' that provide the hands on care and interact with us when we need care, my experience with these folks have, with very few exceptions, been outstanding! Not only was the actual nursing care in the ICU provided in a competent, caring and (most important and under rated quality) friendly manner and the same was true of the various heath advisors who visited during my recovery, the recovery assessors, dietary and lifestyle information specialists and so on. In hospital is not a place where any of us (particularity those previously healthy, or so I thought) wish to be but apart from being challenged by the food choices (I am a vegetarian which it turned out was a good thing as I lost several pounds which I actually needed to loose during the stay) it was not a bad experience considering the circumstances. I am howeverglad that I had a quick, almost miraculous recovery and was able to come directly home after leaving the ICU.

After this scare and having not seen a family doctor for many years we then went looking for someone to fill this role. Having 'regestered' with the Markdale South East Grey Community Health Centre a couple of years ago but never having gone any further (not having needed their services till now) we made an apointmet to see one of their 'Nurse Practitioners' and were pleasently surprised to learn that they held a 'clinic' at the nearby Chatsworth Township office two days a week. After recieving care and advice from the NP and Nurse at said clinic for severak months now I am pleased to report that we could not have found a better couple of proffesionals to attend to our medical needs. The friendly and accomidating staff have made an otherwise stressfull situation almost pleasant which given my record of avoiding doctors and check ups is quite something!

A cousin has had a similar experience with the VON nursing organization, receiving care and advice several times a week in her own home in Wiarton regarding problems arising from a past minor injury turned septic and poor circulation. Needing additional treatment she was referred to the Tobermoury Hyperbaric facility where she received intense but similar friendly and outstanding care over a number of weeks. Perhaps I was put off by stories of long waits and seemingly uncaring assessments told by others who attending a hospital emergency department but our experience with these particular heath professionals has been has been nothing but good. I do note here that unless one identifies an urgent situation or is already receiving ongoing care it is often hard to see a doctor or NP in a timely manner, typical appointments can be weeks or even months ahead, even longer if referred to a 'specialist', my thought has always been 'if I can wait for weeks to come see you then perhaps I do not need to see you at all!'. A little cynical perhaps and given recent history I SHOULD have made that move several years ago, a near death experience can result in a change in perspective eh!

Whilst I will not identify the particular individuals I have spoken about in this post I would like to give the following heath care professionals a hearty thanks and a 'well done and keep up the good work'. You know who you are........

Thanks to
The nursing and support staff at the Owen Sound ICU unit.
The South East Grey Community Health Centre Nurses and Nurse Practitioners and staff.
The Victorian Order of Nurses Grey Bruce Nurses and support staff
The Tobermoury Hyperbaric Facility Doctor and staff.

PS. Yes I am fully recovered and my cousin is making good progress.