Tuesday, July 14, 2009

Isotope crisis impacting the health care system

Two reports in the last day indicate that the Canadian health care system is now seriously grappling with the impact of the medical isotope shortage. We are now living that vulnerable situation nuclear medicine specialists have warned the government about, where Canadian patients are left at the mercy of foreign reactors for isotope materials that have a shelf life of hours. This is because Chalk River supplied 80% of the Canadian market's needs for isotope production in Canada. Without any backup planning in place for that domestic production, Canadians are left in the lurch. Well done, Harper Conservatives.

So, the Ontario government is now warning its hospitals:
Ontario's Ministry of Health is warning the province's hospitals to brace for further shortages of medical isotopes, following the month-long maintenance shutdown of a Dutch nuclear reactor scheduled for this weekend. Nuclear medicine specialists fear that Canada's most populous province will feel the brunt of the shortage, leaving them without enough isotopes to treat emergency-room patients.
Dr. Christopher O'Brien, head of the Ontario Association of Nuclear Medicine, speaks of having no information at all about what to expect as that Dutch reactor shuts down, the scheduling difficulties that are occurring, and compromised emergency tests.

In the backdrop to what's going on in the hospitals, a bit of illuminating political back and forth has occurred in letters exchanged between Dalton McGuinty and Stephen Harper (linked to in the Globe).

On June 10th, McGuinty wrote to Harper asking what the plan was to deal with the coming crisis. McGuinty set out the costs that Ontario is incurring as a result of this shutdown, monetary and human, including: higher prices that suppliers are now charging for an increasingly scarce resource; staff overtime costs increasing due to longer wait times and technicians working late hours round the clock to scramble when they do get the isotopes ("Whenever a hospital receives a technetium-99m generator, workers go into overdrive trying to schedule patients for the next day." There are clearly incredible stresses being added to the health care system that haven't been foreseen by the Harper "strategy" of having no backup to Chalk River in place and to rely on foreign suppliers.

Also of note in McGuinty's letter, his request to Harper to ask the Dutch to delay their reactor's imminent maintenance shutdown due to the emergency situation. Mr. Harper says nothing in his response about that particular request beyond a reference to a need for international cooperation, so we don't know what efforts were made.

One other point from the McGuinty letter, he raises an aspect of this crisis not widely discussed to date, the prospect of the lost jobs that might result. Here, McGuinty focuses on the 1175 jobs at MDS Nordion ("a $1.2 billion life sciences company"), based in Ontario, that are at risk from the present shutdown and likely beyond given Mr. Harper's expressed intent to get out of the isotope business in the long run. No doubt there will be many more than that.

Mr. Harper's response to McGuinty comes 20 days later. You can see that Mr. Harper clearly prefers to characterize the isotope problem as an international one, deflecting attention away from his own government's responsibility for failed oversight of the Chalk River facility, and for shutting down the new yet unfinished Maples replacement reactors. Mr. Harper writes:
"Secure medical isotope supply is not only an issue for Canada; it is an international issue that must be addressed cooperatively by all isotope producing countries."
Well, now that Chalk River is no longer producing 80% of the Canadian market's needs, yes of course we need help from the international community. And of course isotope supply has become an international issue given that Canada has stopped producing a third of the world's isotope needs. We're a principal cause of it. So to suggest that our isotope shortage is a result of international failings is totally disingenuous. To attempt to dilute his government's responsibility for failing to contingency plan by suggesting other nations are having the same issues, expected. This "international" spin from the Harper government should be knocked back and is something to watch for as the crisis worsens.

To sum up...political spin, hospitals scrambling, untold costs adding up, patients left at the mercy of foreign suppliers...welcome to our health care future under the Harper Conservatives.

For more on this topic, see: Blog Post Index: Medical Isotope crisis & Chalk River shutdown.