The facts of the case #nlpoli

From the start of the pandemic, the provincial government  took decisions for political reasons, not medical ones.  It continues to do so.  It is clear that the provincial government has maintained very tight restrictions on the public far longer than necessary and that far more extensive efforts to control the public since 30 April are not based on evidence and medical necessity.

This is fundamental mismanagement that is harming the province and its people. 

The root of the problem is the political divisions in cabinet. The prospect of a new Premier to replace Dwight Ball brings with it the chance to sort out the problems and get the province ready to deal with COVID-19 for as long as necessary.  

The current situation is unconscionable.

Whatever it takes

The government's own advisors give evidence
that contradicts government's decision.

The Chief Medical Officer disclosed the first case of COVID-19 detected in Newfoundland and Labrador on 14 March.  The woman had recently returned from a cruise in the Caribbean.  Public health officials had tested 114 people half of whom had tested negative for the disease.  They and another eight besides were quarantined at home as a precaution.

The government’s first action attributed to COVID-19 came two days later.  At a news conference, Premier Dwight Ball, health minister John Haggie, education minister Brian Warr, and chief medical officer Dr. Janice Fitzgerald sat literally shoulder to shoulder behind a long desk.

We are “in uncharted waters” Ball told reporters.

Effective immediately, Ball and Warr announced, they had closed the province’s schools and daycares as well as College of the North Atlantic.  The move sent 74,000 children home along with thousands of adults across the province from the post-secondary college.

Haggie told reporters that effective immediately, the province’s health system had stopped all elective, diagnostic and surgical procedures. 

Ball said that public servants were also going to work from home, effective immediately.

“We will do whatever it takes, when necessary, to ensure your safety,” Ball said.

Asked about the impact of public cries to close schools as other provinces had done, Ball said "You always listen to people. We want to do what's best."

Ball and his ministers made the decisions to close schools, hospitals, and the provincial government that Monday morning.  There was a single case of COVID-19 in the province.

Fighting the Boogeyman with Dwight, John, and Janice #nlpoli

Ontario Premier Doug Ford pleaded with Ontarians to get tested for COVID-19 on Sunday, even if they were not showing any symptoms. He repeated the call on Monday after a weekend gathering saw thousands pack a Toronto Park and the number of new COVID infections climbed for the eighth straight day.

In St. John’s on Monday, chief medical officer Dr. Janice Fitzgerald warned Newfoundlanders and Labradorians that “as we move around more” we will see more cases of the disease in the province. Asked by a reporter if there could be asymptomatic people in the province, Fitzgerald said there as no way to be sure. They could be out there, infecting people.

That sounds reasonable enough until you realize that there is only one active case of COVID-19 in the province and that person is in hospital, where he or she has been for weeks. The last reported cases were on 07 May.  Even then, there was some question that one or both might have been false positives.  But in any event, we are now more than the incubation period of the virus.  Fitzgerald described it as almost three weeks, which would be one and a half times the incubation period for the disease.

The province’s borders are sealed to all but a handful of people and those are subject to monitored isolation for two weeks before they can move around. Health minister John Haggie has described that two-week wait – the worst-case incubation period for the disease – as the best test there is for it.

Haggie has also used the prospect of cases suddenly springing up and swamping the health system as a reason for the very slow relaxation of the province-wide lockdown.  He hasn’t gone to the spectre once in a while.  It is a frequent explanation for the government’s approach to COVID-19.

You can understand why Doug Ford and his officials talk of asymptomatic cases or new outbreaks.  They are staring at a dramatic surge in cases after cresting the first wave and reducing the number of active cases. But in Newfoundland and Labrador, Haggie and Fitzgerald have gone beyond prudence or a reasonable dose of caution. They are basically dismissing evidence and justifying their decisions to restrict just about every aspect of life in the province because they think there’s a boogeyman out there.

In front of your nose #nlpoli

Orwell, c. 1940
Colourised by Cassowary Colurization

A truly free and democratic society must be based on fundamental rights and freedoms that individuals may enjoy and that are restricted rarely and only to the extent necessary to protect other rights.

In Canada, 38 years after the proclamation of the Charter of Rights and Freedoms, this should be well understood.

But in Newfoundland and Labrador, these rights are foreign ideas not well understood or generally accepted.

The latest example of how easily fundamental rights can be denied with popular support is the decision, supposedly taken by Brian Jones alone, to stop writing a column for his employer The Telegram.

He did so in the midst of a controversy over a column that appeared on May 20.  There was nothing remarkable about this column compared to the thousands of others he has written in his long career as a journalist and editor, except that this time, Jones aimed his characteristically malodorous vowel movements at public sector workers. 

The Authoritarian Impulse #nlpoli

Special Measures Enforcement

Jim Dinn used to be a teacher.

As head of the provincial teachers’ union, he spearheaded a drive against the public’s right to know how politicians spent public money.

And now he is a member of the provincial legislature.

“Let’s talk about rights,” said Jim Dinn on May 5, explaining why he felt it was a good idea to give the minister of justice the power to send police out to take people away to a detention centre. 

Not a judge. 

A politician.

“Funerals, people can’t be present for the passing of their loved ones. It is my right to attend a funeral, peaceful gatherings, …  for me, it’s the fact that I can’t be around my grandchildren. Now we have the double bubble and I’ll do anything to defend it. Weddings – all of them are rights. I took my mother to the hospital the other day. I couldn’t even go into the hospital with her. That’s my right, to go with her. I could not go.”

Not rights at all, really.  Things people like to do.  Things they expect to do.

But not the same as voting, speaking one’s mind freely, or – and this is the important one for this discussion – not having the police kick in your front door and spirit you away to some detention centre somewhere in the province because a minister said it was okay.

This is the kind of stuff they used to do in Argentina when the junta’s agents would disappear people.

They do it all the time in North Korea.

But in a democratic country like Canada, even in an emergency, we do not allow arbitrary arrest and detention, let alone do so quite so cavalierly as Dinn and the other members of the House allowed.

But in Jim Dinn’s world, this sort of thing is no biggie.  He felt it more important not to be like the United States.   

Not satisfied with his frighteningly shallow argument, Jim then praised himself and his colleagues for their “collaboration, co-operation and self-sacrifice” in attending the House of Assembly for a few minutes one afternoon to pass a few pieces of legislation.

Terra Nova field production halted for up to two years #nlpoli

No one should be surprised that the partners in the Terra Nova field are planning to lay up the production platform and will likely stop production from the field until 2022.

There are five perspectives we can bring to bear on this one event.

FPSO:  The pandemic knocked the planned refit of the Floating Production Storage and Offloading platform off schedule for 2020 anyway.  The operators needed to lay the ship alongside until a yard opened that could do the work.

Field:  There’s no sense in selling off a highly valuable asset very cheaply if you don’t need to do so.

The glut of oil and the downturn in policies make it sensible to shut down production from the field.

Terra Nova oil is light and sweet.  It is cheap to produce and easy to refine. With the FPSO paid off long ago, the Terra Nova operators can leave the very profitable field in storage until prices rebound and deliver the kind of higher profits that the field can generate.   

GNL:  The provincial government will take a serious financial hit with Terra Nova out of production for a couple of years.  But, as with the company perspective, it’s actually in the public’s long-term interest to leave the highly profitable oil in the ground rather than sell it off cheaply.

Provincial society and politics: Unfortunately, 15 years of using public money to buy political favour has produced a situation in Newfoundland and Labrador that is much like the one in Venezuela. So many groups across the whole of society are so addicted to public spending that they will treat this smart and understandable move as a catastrophe.

Expect calls for federal welfare for oil companies to become louder along with renewed demands for a federal bailout of the provincial government.

Federal Government:   The federal government will provide some financial assistance to governments, companies, and individuals across Canada to deal with the pandemic, but it has neither the political will nor the financial muscle to bailout oil companies and provincial governments.  There is no support for such moves at the bureaucratic level nor is there any support for bailouts at the political level either.

-srbp-

Ferkakte #nlpoli

In the past 36 days,  the Government of Newfoundland and Labrador has reported no new cases of CVD-19 on 21 of them.

Three weeks worth of zero.

More than a month in which the reproduction rate for the virus is well below the level in which the disease would be considered under control.

The number of active cases n the province outside hospital all date from the middle of April and later, for the most part.  The four cases in hospital have been there a long time and likely are four people with very serious illnesses besides CVD.

And yet the provincial government lowered its restrictions very slightly on Monday, warned that it would take at least 28 days to see if it might be possible to safely loosen up restrictions a bit more.

The ferkakte alert system announced by the provincial government on 30 April 2020 is full of contradictions and confusion. There are too many to list.  The "plan" is full of other things, too.

The Bow Wow Parliament creates a Kangaroo Court #nlpoli

The Bow Wow Parliament

The first casualty of the current pandemic in Newfoundland and Labrador was democracy and on Tuesday, the pandemic added to its draconian toll.

A handful of members of the House met with the permission of a government official and passed without much discussion a measure that created a kangaroo court in which the official could apply in secret to two cabinet ministers, obtain a de facto conviction of someone without what lawyers call due process, and then send off the police to scoop up the hapless person who may or may not have violated a health order under the health protection law. 

Health minister John Haggie introduced the amendment. He shed no light on why the government had banned all non-residents from entering the province except people in two special categories.  Haggie did not explain why the restrictions that had been in place were not working. He gave no indication why he and his colleague the justice minister needed the powers of a judge already set out in another section of the health protection law to enforce any orders.

When his turn to speak came, opposition leader Ches Crosbie spoke briefly about what he referred to as new police powers that would be used to enforce all the chief medical officer’s special orders.  He noted the concerned expressed to him by lawyers that the recent travel ban was illegal and/or unconstitutional. 

Then Crosbie said that he and his caucus had decided to vote for amendment in exchange for a promise the government would:   

1. read a submission from the Canadian Bar Association about the travel ban, and 
2. ask the chief medical officer to amend her improper travel ban to allow a few categories of exemptions they wanted.

That is all.

Such are the intellectual, ethical, and legal standards of the Bow Wow Parliament.

Troubling travel ban may be illegal, unconstitutional #nlpoli

Government of Newfoundland and Labrador
 guards at COVID-19 Border Check Point
(not exactly as illustrated)

No other province in Canada has banned travel into the province by non-residents in the way Newfoundland and Labrador has done during the current public health emergency.

Under Special Order No. 11, issued on 29 April 2020, “[a]ll individuals are prohibited from entering Newfoundland and Labrador, except for the following:

a.  residents of Newfoundland and Labrador, 

b.  asymptomatic workers and individuals who are subject to the Updated Exemption Order effective April 22, 2020, and 

c.  individuals who have been permitted entry to the province in extenuating circumstances, as approved in advance by the Chief Medical Officer of Health.”

There is a definition of resident provided in the order.

There is provision for an exemption granted by the Chief Medical Officer but no indication of the reasons why such an exemption might be granted, or the time delays involved.

The power to do this comes from section 28 (1) of the Public Health Promotion and Protection Act.

In making the announcement, the chief medical officer offered no explanation or justification for the except that she felt it necessary to amend the existing restriction on individuals entering the province in order to deal with COVID-19.

There have been no confirmed reports of travelers violating the ban.  Rumours about tourists, covered by news media the day before the new order, lacked any evidence either that tourists had entered the province.  There is no information in public that any travelers had violated restrictions on people entering the province and caused a new outbreak.

To the contrary, the number of active cases in the province continues to decline, with very few new cases having been reported in the past two weeks.

In response to a reporter’s question about the constitutionality of the ban, health minister John Haggie replied on Monday that section 13 of the public health protection law says any measures imposed during an emergency should be limited to what is necessary. 

The trouble with bubbles #nlpoli

Another type of Bubbles

Stay in your bubble.

A cute, clever little phrase that Newfoundlanders and Labradorians have been hearing for weeks.

We all assume it means something like protect yourself as you go about your daily life. 

Or stay at home unless you have to go out.

And if that’s what it meant, if that’s all the phrase was, then the notion of a bubble is innocent enough.

Last week, though, Newfoundlanders and Labradorians found out “bubble” was something else.

As the province’s chief medical officer unveiled what she called the strategy for living with COVID-19, she outlined a series of what she called Alert Levels.  In Alert Level 4, people would be able to mix their one bubble with another bubble.

Except that the bubble mixing was allowed to start while we are still in the current state of alert with all its greater restrictions.

People wondered if they could safely mix with more than one bubble.  Like say, in families with two sets of grandparents close by.  Would they be able to go over and check on both of them without having to look at them from outside the house?  What if they had to go over and help out with a problem with the house. The kids would love to see nan and pop and maybe that would boost morale.

No, came the reply.  One bubble and one bubble only.  You pick.

Bollocks said your humble e-scribbler.  Inherently and in the circumstances in the province mixing more than two bubbles at the moment has about the same risk as mixing one bubble.

Whoa there, said someone else. There was a mathematically knowable risk of mixing more than one extra bubble right now.  Better be safe than sorry.

Not a mathematical problem at all, said your humble e-scribbler in reply.

Oohhh yes, it is, said the knowledgeable one, missing the point.

The difficulty is not in the math but in the concept.

Bursting bureaucratic bullshit bubbles #nlpoli

The daily average for new CVD cases
has been declining since late March.

In one of the provinces hardest hit by COVID-19,  Ontarians got a roadmap on Monday on how the provincial government will loosen restrictions on their daily lives.

One of the indicators used to make the judgment will be two to four weeks of lowering daily numbers of infections.  Not zero cases, mind you, but a clear downward trend that was about half of the current rate, according to Ontario's chief medical officer of health last week.

Two other key indicators will a decrease in cases not traced to a source and a decrease in new hospitalizations.

In one of the provinces least affected by COVID-19, people in Newfoundland and Labrador found out on Monday that they could be locked down for weeks and potentially months more before provincial government bureaucrats and politicians will consider easing any of the restrictions imposed on them in mid-March.

That chilly outlook came from politicians Monday afternoon after a presentation by one of the government’s key advisors that confirmed:

• we are now in the fourth week of declining and lately low numbers of new cases per day,
• only two percent of cases across the province cannot be traced to a source, 
• that there have been no new hospital admissions for COVID-19 for more than a week (it's actually two weeks), and 
• no deaths for more than two weeks.

In Ontario, a decision to loosen restrictions will also depend on available capacity in the health care system to handle a surge of new cases.  In Newfoundland and Labrador, health managers emptied half the beds across the province by halting elective and non-urgent surgeries and postponing treatment for a wide variety of other conditions.

The three CVD19 pressures the NL government will face #nlpoli

Last week, SRBP raised the likelihood that declining numbers of active cases of CVD19 in Newfoundland and Labrador will put pressure on the provincial government to ease the current restrictions on daily life and the economy.

Officially, government officials like the Premier and health minister blew off the idea of restrictions with concern that supposed bad behaviour on the Easter weekend might trigger a renewed climb in numbers.

More testing.  Fewer cases.

Well, we are a week past Easter and the average number of daily cases is at two, down from three the week before.  At the same time, health officials completed two of the largest days of testing at the end of the week.

The number of active case son Sunday was 62, down from a peak on 06 Apr of 192.  Basically, the active cases on Monday date from infections dated after 01 April.  That is, they date from just before the peak.

Governments across Canada faced choices when responding to CVD-19.  They had two extreme choice, neither of which was politically nor practically feasible.

Trends #nlpoli

How do you keep in place the very necessary and successful restrictions on public life needed to combat the spread of CVD19 when the success of those measures reduces the local daily number of active cases either to zero or to a handful and hence the threat appears to have passed?

In the 15 years I’ve been writing SRBP, the one enduring feature of public discussion about my writing happened again this week, in spades.

People come at me on social media about what is going on in their own heads and attribute that to me.

They don’t deal with the point I was actually making.  They deal with whatever they imagine I said.  And no amount of explanation will dissuade them from their crusade to shut me up or take me down or do whatever it is they are hell-bent on doing besides understanding my point and then having a productive conversation.

On Monday and Tuesday, I wrote about the very real political dilemma facing the current government.  It’s the one spelled out in the first sentence of this post.  I thought it would come in a couple weeks.  It appears to have arrived Tuesday.

So much for forecasts.

John Haggie is already frustrated that people are not listening.  On Tuesday, I told him the government need to ditch the current daily briefing format and messaging for something else that was less patronizing.  In the Tuesday briefing, Haggie delivered his stock message but did it for merely 53-odd seconds before taking questions.

Not really the point, but if the current trends continue, as they seem likely to do, then we will likely also see the mounting public pressure to ease restrictions on life in Newfoundland and Labrador.

The federal government is already talking to the provinces about the return to something approaching normal with the mention of re-opening the economy.  The economy never shut so what they are using is a code word for easing up the limitations on the public.  Saskatchewan, Prince Edward Island and some others will undoubtedly do so by the end of this month or early next month.

In Newfoundland and Labrador, though we will have to think twice about that.  Our two bordering provinces – Nova Scotia and Quebec – are still fighting a hot war against the spread of the disease.  The risk of infection across the border is real.  New Brunswick will face the same challenge.

The challenge for the - quite literally – two or three people effectively running the government in Newfoundland and Labrador will be holding off that political pressure and sustaining restrictions because the threat of disease will remain.  The situation of needing to do something unpopular will not be unprecedented.  We have lots of experience recently with it. Every time, the politicians have failed.

Will the trend continue?

Time will tell.

-srbp-

Doctor Aggie's H'Answer #nlpoli

“What do I have to do to get you to listen?” health minister John Haggie asked rhetorically and with considerable exasperation at Monday’s daily COVID-19 briefing.

Haggie was ranting once again about people across the province who he claims are flouting the restrictions on public comingling during the current health emergency.

On Monday, though, Haggie’s daily rants started to sound a bit more shrill and more than a bit condescending.

Anyone can appreciate his deep concern to prevent an outbreak of COVID-19 of the sort people have seen in Italy, New York City, or even Quebec.

But Dr, Haggie has the problem that the measures put in place so far have worked so well at containing the disease across the province that no one can see the danger in front of them.

And to be honest it is hard for the ordinary person to see the immediate danger, at least in the extreme way Haggie apparently sees it.

Number of active COVID cases in NL declines dramatically #nlpoli

Newfoundland and Labrador is already emerging from the first wave of the COVID-19 infection.

The data from the provincial government’s daily COVID-19 media briefings is clear.

Starting on April 6,  the number of new cases detected was less than the number of recovered cases.  As the week progressed,  the number of recovered cases increased as rapidly as the infections had increased two weeks before. 

The result, shown in the chart at right, is that the number of active COVID-19 cases (cumulative total less cumulative recovered and deceased) has been declining steadily.  

By the end of this week,  the number of active cases should be about the same as they were before the massive increases started on 23 March 2020.

The most likely thing that could change that forecast drop in active cases is an increase in the number of tests conducted by provincial health officials.  But to produce a dramatic increase in the number of new cases – on the order of what we saw in the middle of March – the province would have to test thousands of people a day.

That’s because a consistent testing effort yielded a steadily declining number of new cases. An average of 177 daily tests the week of March 23 produced an average number of 18 new cases daily. 

The following week 208 daily tests yielded an average of 12 new cases per day.  In the first full week of April, though, an average of 178 tests a day produced only an average four new cases.

Financial Fustications #nlpoli

If we had Equalization, we'd have a budget surplus.

On Friday, 20 Mar 20, Premier Dwight Ball wrote to the Prime minister to say that the financial arse was out of Newfoundland and Labrador.

Ball included in the letter not a shred of financial evidence nor did he include any hint as to what exactly he expected the federal government to do to fix this situation.

Last weekend, once the public heard about this alarming letter, the Premier was anywhere and everywhere confirming that the provincial government was mostly, completely destitute.

*This* weekend his finance minister is – not surprisingly – telling a completely different story. 

Bollocks #nlpoli

Kill the wabbit?

Moody’s has changed its outlook on the provincial government’s debt from stable to negative while sustaining the A1 rating it gave the province in July 2019. That, by the way, was a downgrade.

In a statement issued Wednesday, Moody’s said the change in outlook reflects the company’s view that the provincial government’s “credit profile will weaken due to the sharp decline in oil prices and its reduced budgetary flexibility to adjust to this shock. Under Moody's base case, oil prices are expected to average $40-$45/bbl in 2020 before returning to $50-$55/bbl in 2021…”.

Moody’s expects the provincial deficit for 2020 could reach 25% of revenue in 2020 and about 11% in 2021. Previously, Moody’s had forecast deficits of 11%  and 4% respectively for those years.

Moody’s expects the provincial debt will reach 270% of revenue by 2023 with pressure that this will increase after 2023.  In other words, Moody’s doesn’t believe that the government will balance the budget in 2023.

All around in circles #nlpoli

Going around in circles must be frustrating.

Plummeting crude prices have dropped refining margins to negative numbers and so it isn’t surprising that Come by Chance refinery announced Sunday it is shutting down operations for upwards of five months.

The official excuse is the pandemic but the real reason is economics. There’s no point in running a business that isn’t making money.  And you cannot make money in a global market where demand for petroleum products has dropped like a stone.

The same economic reality that is hitting the oil industry is hitting governments in provinces that depend heavily on oil royalties.  In Alberta, Western Canada Select was trading at less than five Canadian dollars a barrel on Friday. 

According to the National Post, the provincial government estimates that every dollar in crude prices costs the Alberta government $355 million in lost royalties. Economist Trevor Tombe estimates the drop in crude prices thus far has cost the Alberta government about $5 billion in royalties.

Newfoundland and Labrador is in worse shape.  Going into what is now the crisis year of 2020, Dwight Ball’s Liberal administration forecast as deficit of almost $800 million.  Last Thursday, the provincial legislature approved government requests to borrow almost $3 billion dollars directly or through the provincial hydro corporation.  Finance minister Tom Osborne told reporters outside the House of Assembly he had no idea how big the 2020 deficit would be.

Facing the financial wall, again #nlpoli

Newfoundland and Labrador Hydro makes money by making and selling electricity. In 2018, the last year for which we have statistics,  Hydro made about 40 gigawatt hours of electricity and sold it for slightly less than a billion dollars. Most of the electricity went to Quebec and most of the money came from Newfoundland and Labrador.

On Thursday,  the House of Assembly gave Hydro permission to borrow $500 million in 2020 to cover losses from sales.  “Anticipated reduction in revenue during the pandemic” is the way NTV’s Michael Connors described it on Twitter.

That’s half Nalcor’s income.

No one explained on Thursday during the pantomime session of the legislature why anyone expected that half of Hydro’s business would disappear during April, May, and June.  No one nows if they will lose money,  natural resources minister Siobhan Coady said in the House.  This just allows them money if they need it.

Bank of Canada to help GNL make payroll #nlpoli

Bank of Canada
234 Wellington St, Ottawa

The Bank of Canada announced today that it will purchase up to 40% of money market securities with terms to maturity of 12 months or less that are  issued directly by Canadian provinces.

The Bank of Canada will make the first purchases on Wednesday, 25 March 2020.  The purchases will include treasury bills and short-term promissory notes. The Bank may adjust the percentage based on markets.

The program – called Provincial Money Market Purchase (PMMP) – will give help to all provinces.  It will be especially welcome news for the Government of Newfoundland and Labrador, which relies on short-term debt to fill in gaps in its cash flow. 

There is a relatively limited pool of capital for the provincial government anyway.  Its relatively low credit rating can make it harder for the government to borrow money at rates it can afford.  For about six months in late 2015 and early 2016, the provincial government came close to being unable to meet payroll due to a shortage of capital in the markets and uncertainty in the markets about the intentions of the provincial government after the 2015 general election.

The doctor is out... of the province #nlpoli

Health minister John Haggie announced on Friday that doctors in the province could now start seeing patients remotely either by telephone or using video conferencing.

Kinda bizarre, though, given that some doctors in the province have already been doing this.

In any event, using technology to see patients remotely is a good idea not only now but in the future.

It allows doctors to treat patients in remote areas where there is a constant turn-over of resident doctors.  Last year, SRBP wrote about the potential for technology to help with the supply of family doctors

Meanwhile, last week Shoppers Drug Mart also quietly rolled out a service in conjunction with a cash-for-service doctor company called MAPLE. 

This is “virtual care”  - a truly hideous term - as well but it comes with a big twist people need to watch out for besides the cat MAPLE isn;t covered by MCP. The same twist will affect any local patients who are in Newfoundland and Labrador but wind up being treated by doctors living and working outside the province using remote communication technology.

Under a new policy established in March 2017,  the College of Physicians and Surgeons of Newfoundland and Labrador has decided that care takes place where the doctor is, not where the patient is.  Under the old policy, CPSNL held that care took place where the patient was.

Under the new policy,  a patient in Comfort Cove who sees a doctor via Skype while the doctor is in British Columbia will have to complain to the BC College and deal directly with the BC College about it.  CPSNL will pass the complaint along but after that the patient is must find their own comfort.

The policy doesn’t just cover Canadian doctors, whose licences incidentally, the local College doesn’t recognize as valid anyway.  Same thing applies for a doctor living anywhere in the world.  You see, the CPSNL policy states that the “College considers the practice of medicine to take place in the jurisdiction in which the physician resides and holds a licence.”

So if the local patient winds up dealing with a doctor in the United States,  Mexico, Sri Lanka, or India, the complaint will have to go to whatever country the doctor is in.

These days, technology allows doctors from anywhere in the world to treat patients anywhere else.  It’s a common practice in commercial shipping where doctors work for international contractors.  Got a problem on a rig offshore or a ship at sea and you could find the captain calling a doctor in Europe whose company has the contract to supply health care to the ship owner’s crews. 

But people living in Arnold’s Cove are not used to that.

Patients need to look closely at the contracts they sign for medical service under virtual care by doctors not living in Newfoundland and Labrador.

And, of course, no one from the provincial government or the College of Physicians and Surgeons has told the public about this let alone warned them of the implications should something go wrong.  

After all,  there really isn't anyone in the province responsible for protecting the public in these sorts of things, is there?

-srbp-