Eye specialist says bureaucrats may force end to clinic he's run since 1988

An eye specialist who speaks French and has been providing care to Chéticamp residents for decades says health bureaucrats have withdrawn the supports he needs to run the clinic in the Cape Breton Acadian community.

Dr. John Hamilton has offered the monthly service since 1988 and travels in from Antigonish. But the service will end, the ophthalmologist said, unless the Nova Scotia Health Authority reverses its decision to take away a licensed practical nurse and restrict the work of a registered nurse at the clinic.

"With no support, basically it is not cost-effective for me to absorb the costs of the clinic and travel two and a half hours to Chéticamp and back and stay overnight," Hamilton said in an interview.

"It would reduce the ability to see patients from approximately 50 per day to maybe 20 or 15."

Told of cuts before Christmas

Hamilton runs the clinic out of Chéticamp's Sacred Heart Community Health Centre. He said staff nurses normally administer eye drops and conduct other basic eye tests before he sees patients.

But he said he was told by a health authority administrator the week before Christmas that an LPN would no longer be available to him and the RN would no longer be allowed to enter patient information electronically.

He sees it as a purely cost-cutting measure with no regard for patient care.

"I don't like it because I've been doing this clinic for 30 years and trying to facilitate the access [to] populations that have been disadvantaged by distance."

Closing the clinic, he said, will mean his patients would have to travel for the specialty services.

"It is two and a half hours to Antigonish. It's about two hours and 15 minutes to Sydney," he said. "Many people wouldn't be able to go."

Francophone patients

Hamilton said his patients are predominantly seniors, and if they have visual problems they are not able to drive themselves. They would have to depend on family members or friends to get to appointments, and Hamilton worries "people would just not come."

Hamilton also sees it as a blow to the francophones who live in Chéticamp.

In a blistering Dec. 18 email to the administrator who informed him of the cuts, Hamilton wrote: "You have therefore bureaucratically ended these clinics and again marginalized a francophone population from specialty care sourced locally in an official language which I have tried to provide in partnership with the community for thirty years."

But Dr. Warren Wilkes, the Nova Scotia Health Authority's medical director for the area that includes Chéticamp, was optimistic the "appropriate resources" could be found to keep the clinic open.

He said the decision to reassign the nurses at the clinic was based on the fact that they are primary care staff doing specialty medicine.

"I think with discussions with the health authority, we'll be able to find some appropriate nurses and LPNs to work and we're very focused and willing to keep this going," he told CBC News in a telephone interview from Sydney.

Hamilton has a clinic in Chéticamp planned for next Wednesday. He also plans to meet with administrators to see if there's a way to restore the support he needs to keep the clinic going.