Government announces plan for provincial dialysis services

Health and Community Services Minister Gerald Smith today released the report of the Provincial Renal Advisory Committee and announced that government will move forward to implement the committee�s recommendations. Minister Smith made the announcement at a news conference today, where he was joined by Dr. Brendan Barrett, a nephrologist and chair of the Advisory Committee.

The Provincial Renal Advisory Committee was established in December 2000 with a mandate to advise on issues related to the planning, development, implementation, and evaluation of renal services for Newfoundland and Labrador. In its work, the committee examined the experience in existing dialysis sites in St. John�s, Corner Brook, Grand Falls-Windsor, Stephenville and Clarenville.

"The committee�s primary recommendation is that government should establish a coordinated provincial kidney program which will focus on continual planning, implementation and evaluation of services for people with kidney disease, and government accepts this recommendation," said Minister Smith. "We will begin work immediately to establish a provincial kidney program, including appointing a full-time coordinator and a part-time medical director."

Dr. Barrett explained that provincial coordination is critical to ensuring the necessary kidney services meet the needs of patients in the province. "No one region can stand alone when it comes to providing care for kidney disease," he said. "Satellite services need a link to the province�s tertiary care site. In addition, provincial coordination will ensure that there is a consistent quality of care in the services provided across the province."

The committee also examined the factors to be considered when establishing new dialysis sites in the province, and recommends a minimum of 10-12 dialysis patients that require facility-based therapy in order to establish new sites. The committee noted that many people benefit from home-based therapy (peritoneal dialysis) and, as such, do not form part of the target population for new, board-operated dialysis sites. In addition, people with advanced stages of kidney disease and those who require closer supervision and monitoring are not candidates for satellite dialysis sites.

"The committee analyzed current patient volumes and demographic information, and evaluated pilot satellite dialysis sites in Clarenville and Stephenville. Based on that work, the committee identified the criteria for establishing new dialysis sites in the province. Some regions currently have the threshold caseload to start operations, and other regions are expected to reach the threshold in the short-to-medium-term," said Minister Smith. "New sites in Carbonear and Gander will be implemented first. Government will now work with provincial program and the boards to look at an appropriate time for implementation for dialysis sites for the Burin Peninsula, St. Anthony, and Labrador."

Minister Smith explained that based on the recommendation of the committee, the new sites in Carbonear and Gander will be established once the provincial kidney program is operational. "The provincial program will be starting in the coming weeks and months," he said. "The committee has also strongly urged government to ensure that any new dialysis service delivery, along with existing services, be coordinated, implemented, and evaluated in the context of a provincial framework, and government will do just that."

Dr. Barrett explained that there are a number of factors to consider when determining the location of satellite dialysis sites. "It is important to realize not all patients with advanced kidney disease have the same treatment needs. Some patients benefit from organ transplantation, some patients benefit from home-based therapy and others need hospital-based treatment," he said. "Therefore, we must ensure that the treatment methods offered meet patients� needs."

"I want to thank Dr. Barrett and all committee members for their work. They have completed a comprehensive examination of kidney disease and the treatment needs for our province. Their work will be the foundation for the work of the provincial kidney program," concluded Minister Smith.

A copy of the Provincial Renal Advisory Committee Report is available at www.gov.nl.ca/health/publications/default.htm

Media contact: Diane Keough, Communications, (709) 729-1377.

2003 07 30                                    11:15 a.m.