Winnipeg Free Press - PRINT EDITION

One-size-fits-all view of MDC absurd

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Recent editions of the Free Press have carried pieces by Will Braun and others regarding the Manitoba Developmental Centre at Portage la Prairie. Braun's piece is most provocative because it is superficial and smacks of zealotry.

He doesn't like the fact that some of the buildings are old; nor does anybody else probably. He then jumps into the one-size-fits-all thesis and argues that all patients/residents should be moved into the community, which is absurd.

In medieval times societies relied primarily on "cottage industries." Modern society, however, has moved away from that on a grand scale.

The supermarket replaces the corner store; 24-hour clinics replace doctor home visits; hospitals treat a vast array of different types of cases. Treatment in the home is expensive, though shifting costs from public to private budgets sometimes creates the illusion of economies. There are certainly cases where a small amount of home support enables people to remain in the community. Society is gradually beginning to accept this notion though we still have not worked out the decision borders between private and public responsibility.

The bottom line is that patients/residents are triaged. Those that cannot be cared for in the community are cared for in institutions like the MDC. They are not warehoused; they are cared for.

Are there some bad experiences in the community? Of course, just as there are some bad experiences in institutional care.

Some patients/residents who have no family support may have been institutionalized by court order but most, with their family's concurrence, have chosen to live in an institutional setting and enjoy the full range of support and care that it affords.

To move them would be "forcing" them out of the home that they know. Moreover, to provide commensurate care in the community would be exceedingly expensive for patients of this level of severity.

Braun goes on to assert that the families of patients/residents who value the services of MDC are only supported by the unions. Red herrings like this have no place in a serious discussion.

Unions, like medical, legal and other professional associations, have a right, indeed an obligation, to speak out on standards of behaviour in areas where they have expertise.

Braun attempts to persuade the reader with superficial references to "research" showing patient happiness in the community. But he makes no distinction between the levels of mental and physical morbidity in the cohorts of patients studied.

He thinks Manitoba is behind the rest of the country, but one might legitimately conclude that Manitoba is one of the few places that has the decency not to throw the severely disabled to the community-based wolves.

And yes, my brother lives at MDC and asks to be taken "home" to MDC when we take him in out for visits.


Glen Beck is professor emeritus of health economics at the University of Saskatchewan.

Republished from the Winnipeg Free Press print edition October 16, 2013 A9

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