News

Peggy Verhoef's children were devastated earlier this month to learn their suicide support group had been put on hold. The social workers who lead the group near Montreal were reassigned to work as greeters at H1N1 vaccination centres.

Ms. Verhoef's children, 13 and 15, who attend because their father committed suicide last year, were “extremely upset,” she said Monday.

“The bureaucrats didn't stop to think about how it would affect the kids.”

Across the country, public health programs ranging from support groups to sexual health clinics to food-safety inspections are being postponed or suspended as officials redirect nurses and other staff to vaccinating Canadians against the H1N1 influenza.

Although the chaos that marked the first two weeks of the limited vaccine rollout has subsided, and the pandemic's second wave appears to have peaked, dozens of such programs remain in limbo because staff is still being diverted.

Many of these triage scenarios have been in the works for months. Public-health officials argue they're necessary in a pandemic situation to get care to as many people as possible, as quickly as possible. But the people depending on now-suspended services are questioning the decision to put their medical needs on hold.

Ms. Verhoef spoke out against the government's move and, last week, received notice that the suspension would be reversed.

Health authorities in several provinces – Quebec, New Brunswick and British Columbia among them – have postponed other school vaccinations, travel clinics and rollouts of the Human Papillomavirus vaccine.

“In six months' time when this has passed you have plenty of time to go back and give girls a third dose,” B.C.'s chief health officer Perry Kendall told a news conference in Victoria on Monday.

Meanwhile, health authorities in B.C., Saskatchewan, New Brunswick and Ontario have suspended prenatal classes to make room for vaccination clinics.

Gerry Predy, Alberta's senior medical officer of health, said the province's staffing challenge has been aggravated by absenteeism as some health-care workers fall ill themselves.

Health authorities such as Vancouver Coastal Health that have managed to avoid cutting services have done so by recruiting fresh blood in the form of nursing students, or putting calls out to retired nurses.

So many beds and staff resources are being devoted to people with H1N1 that Nova Scotia's largest health authority has sharply reduced the number of surgeries it can perform. Capital District Health Authority yesterday performed about half the normal number of scheduled surgeries and says it is assessing its capacity on a daily basis. Outpatient services in some B.C. hospitals have been closed to divert doctors to emergency room treatment.

“We run a system that is pretty much at capacity most of the time and so in order to cope with some of these pressures, we've had to do some movements of staff around,” Dr. Kendall said.

Hundreds of Toronto's public-health workers, ranging from registered nurses to clerks and health inspectors, have been retrained and redeployed – many of them to staff the 10 clinics that have so far doled out 80,000 doses of vaccine across the city.

That redeployment has closed sexual health clinics and strained or suspended family health programs. The city's food-safety inspectors are postponing routine inspections for low-risk sites and prioritizing medium-risk inspections.

“It is a significant concern. … People who need those services are not getting them, or are getting them at a reduced level,” said David McKeown, Toronto's medical officer of health. “We've tried to scale back services in a way that protects the most vulnerable, but there are impacts.”

The city has also hired contract nurses to beef up staffing at H1N1 vaccine clinics. That has helped to some extent, Dr. McKeown said, but it hasn't alleviated the need to take more than half of the public health department's staff out of their normal jobs.

Susan Makin, director of the city's healthy families services, said as the pandemic response ramps up, increasingly critical programs take a hit. She said it's possible more services will be suspended or curtailed in the coming weeks.

“It's still a gradual scale-back. We're not down to the very lowest we can go yet.”

Joanne Gilmore, a Healthy Families manager, has lost half her staff so far to pandemic work, and expects to lose another 10 per cent next week. She understands the need to triage staff, she said, but worries about the impact this has on new mothers who need the services and advice. Swamped staff are now trying to diagnose postpartum depression and other nutrition or health problems in rushed five-minute phone conversations.

“It's concerning that we're probably missing a lot of people.”

With files from Justine Hunter in Victoria, Katherine O'Neill in Edmonton and Oliver Moore in Halifax