It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Monday, September 22, 2025
UK Planning to Open an Additional Submarine Dockyard
Full speed ahead for the front end of HMS Dreadnought through Barrow in Furness en route to the BAE Submarine Assembly Hall (Dreadnought Alliance)
In response to a parliamentary written question, the British Ministry of Defence has confirmed that as part of a $460m upgrade to Rosyth Dockyard on the East coast of Scotland, a docking facility is to be created able to receive Dreadnought Class nuclear ballistic missile submarines.
The requirement has arisen because once launched from Barrow, scheduled not before 2028, first-in-class HMS Dreadnought will be too large to get back into Barrow after its fit-out and during sea trials. The lack of sufficient space is likely to get worse, as submarine production at Barrow is accelerated to deliver a submarine every 18 months as part of the AUKUS program. Nor will there be capacity for the boat in the Faslane Naval Base on the Clyde.
Rosyth Dockyard, with HMS Queen Elizabeth (R08) under maintenance in 2024 (Google Earth/Airbus/CJRC)
Although it still retains a Royal Navy presence in the form of the shore station HMS Caledonia, the Rosyth Dockyard was privatized in 1993 and bought by Babcock International. The dockyard currently has a role is breaking up decommissioned nuclear submarines, the Royal Navy’s two aircraft carriers were completed at Rosyth, and Type 31 frigates are built in the yard. A submarine maintenance facility was built at the yard in the late 1980s, but was never brought into use before the work was transferred to Devonport. Hence it is likely that the new facility can take advantage of some existing infrastructure.
With a period approaching when the UK’s nuclear attack submarine fleet is to nearly double in size, with the nuclear ballistic Vanguard Class coming out of service and the Dreadnoughts coming into service, the Ministry of Defence may have concluded that having only two active submarine dockyards, at Faslane and Devonport, presents too much concentration of risk and insufficient contingency capacity. The scope and role of the new facility, and who is going to pay for it, is likely to be the subject of ongoing discussions between Babcock and the UK government.
Police in the Canary Islands have charged 19 people with murder in connection with the deaths of dozens of migrants who went "missing" from a wooden boat on the crossing from Senegal, a route that is always perilous but may have had an additional hazard on this particular voyage.
About 300 people set out from Senegal in August aboard a 20-meter wooden boat, bound for the Canary Islands and the opportunity for EU asylum. On August 24, the rescue boat Guardamar Urania made a long voyage south from Gran Canaria to reach the migrant vessel off Dajla, a town in southern Morocco (or Western Sahara). At the time of intercept and rescue, there were 248 people still alive on the vessel.
Upon return to the dock, the surviving passengers identified 19 individuals as the organizers of the voyage. The survivors alleged that this group of human smugglers "assaulted dozens of people" and even "threw migrant alive into the sea." Anyone who went overboard accidentally was left behind.
The motives behind these killings were twofold, according to police. The organizers allegedly wished to get rid of migrants who they believed to be practitioners of "witchcraft," and thereby responsible for breakdowns, bad weather or other failures on board. Survivors told the police that the smugglers would throw "witches" into the sea whenever misfortune occurred. Others were selected for elimination because they disagreed with the smugglers or protested their circumstances on board.
Based on the number of people who set out and the number who survived to be rescued, prosecutors estimate that the organizers killed at least 30 and likely more than 50 people. According to El Dia, the 19 smugglers face charges of bodily harm, homicide, torture, and assisting illegal immigration.
Even with a well-intentioned crew, the crossing to the Canary Islands is long and dangerous. Those leaving Senegal or Mauritania have a northerly voyage of 1,000 nautical miles to cross in order to reach their destination, though (as in this particular case) SAR forces may reach them much sooner. The hazards in the open Atlantic ocean are severe, and an estimated 10,000 people died on the crossing in 2024, according to aid group Caminando Fronteras.
Spain's naval chief of staff, Admiral General Antonio Pineiro, recently emphasized the government's priority on search and rescue, rather than the pushback campaigns seen in parts of the Mediterranean. "We're not here to fight the cayucos, but to help them," he told El Dia in an interview Friday.
Morocco Celebrates Expansion Milestones in Casablanca Port Complex
King Mohammed VI of Morocco visits Port of Casablanca (Moroccan Embassy in the UK)
As Morocco pushes ahead with expansion of its maritime infrastructure, last week the country launched several development initiatives in Casablanca port complex. The launch event was presided by King Mohammed VI, who is keen to position Morocco as a global maritime hub.
The Casablanca port complex expansion project is valued at around $577 million. This involves renovation of a fish port, construction of a new shipyard and expansion of the cruise terminal. A new office complex is also underway, with Casablanca aiming to house port stakeholders under one roof.
The fish port project is valued at $120 million, an investment targeted at expanding Morocco’s fish processing capacity and export volumes. The fish port is expected to accommodate 260 artisanal fishing boats and about 100 coastal fishing vessels. The port will also have ice generators, modern fish market and offices for shipowners.
An important highlight of the launch event is King Mohammed VI’s tour of the new Casablanca port shipyard. In a speech in 2023, the King directed for development “of a strong, competitive, national commercial marine fleet.” As a follow-up measure, a Moroccan public think-tank - the Economic, Social and Environmental Council (CESE) - last year opened a public consultation for Morocco’s national shipbuilding roadmap.
These efforts in domestic shipbuilding are reflected in the government’s investment of $250 million towards the Casablanca shipyard. The Moroccan National Port Agency is about to issue a private firm with rights to operate and further develop the yard.
The new Casablanca port cruise terminal was also inaugurated, a project expected to boost the city’s status as a tourism destination in the Mediterranean region. The terminal has capacity to host up to 450,000 cruise passengers annually. The $72 million terminal features a 650-meter disembarkation quay, three gangways and a parking area for 44 coaches.
The upgrades in Casablanca port complex are coming at a time Moroccan ports are recording growth in cargo throughput. In the first quarter of 2025, Moroccan ports reached a cargo volume of 60.80 million tons representing an increase of 10.2% year on year, according to data released recently by the Directorate of Studies and Financial Forecasts. The directorate attributed the surge in commercial activity to strengthening transshipment traffic, which accounted for 49.9% of total traffic.
During the same period, cruise activity also recorded growth of 46.9%, with 55,668 cruise passengers handled in Moroccan ports.
ALL THAT IS OLD IS NEW AGAIN
Royal Navy Returns to Sail Training for Young Officers
Sail training ship Pelican of London on the Dart (Royal Navy)
The Royal Navy is looking to train officers under sail for the first time in decades by chartering a tall ship.
Experts believe the unique experience of crewing a traditional sailing vessel around the British Isles will teach vital navigational skills and nurture a strong bond of teamwork and community spirit integral to life in the Royal Navy.
Several trials have taken place this year on the British-flagged square rigged Sail Training Ship Pelican of London, with sailors experiencing sailing in the Irish Sea and Bristol Channel and visiting Liverpool, Dublin, Belfast.
The feedback has been overwhelmingly positive, said Lieutenant Commander David Carter, the Royal Navy’s liaison officer with the Merchant Navy, who is now hoping to charter a similar vessel for nine months in 2026, giving hundreds of trainee officers and sailors the unique experience.
The initiative would mostly benefit would-be warfare officers waiting to begin their demanding courses. With space limited on Royal Navy warships, some of the key elements of practical, real-world instruction could be delivered on a sailing vessel.
Lt Cdr Carter said Pelican of London was a “fabulous ship for instilling Royal Navy ethos and concentrating on training value”, hosting up to 32 trainees and four instructors at a time. “It’s also a morale lifter, a truly fabulous experience for many starting at sea.”
While the tall ship may lack the technology and sensors of a modern warship, the fundamentals of seafaring are identical, and the experience of crewing such a ship has fostered a strong sense of teamwork and boosted morale.
The latest batch of junior officers – both Royal Navy and Royal Fleet Auxiliary – helped bring Pelican of London into Dartmouth this week after battering through a Force 8 gale in the Channel.
The tall ship’s Master Captain Roy Love said life aboard his vessel – a former trawler built just after World War 2, converted into a sail training vessel for young people – was rudimentary, but the experience was hugely beneficial.
“The modern Navy is very technical – we are not,” he explained. “There are few electronics. We are here to teach the basics of seamanship, what’s it like to live and work at sea, how to work together. It’s a steep learning curve for most, but the skills benefit anyone who sails with us.”
Sub Lieutenant Isaac Robinson struggled with seasickness on the voyage from Dublin, but when on duty found it an exhilarating experience.
“This is an experience of real life at sea – a great starting block, learning the basics of life at sea, getting into the rhythm. It’s harking back to what our ancestors did and the origins of the Navy,” said the junior officer from Ramsgate in Kent.
Aboard on the same rough crossing was Royal Fleet Auxiliary Cadet Adam Dennis. Although he’s undergone six months of intensive training in college, he had not spent any time at sea until joining the Pelican.
“It’s been an experience – certainly rougher than we expected, but once we’ve dried off I think we will look back and say we enjoyed it. I certainly jumped in at the deep end, picked things up on board quickly. I would absolutely recommend it,” he said.
Sub Lieutenant Joel Crownshaw said crewing a vessel like the Pelican had provided an excellent introduction to important training – as well as broader experience of life at sea in the Navy.
“The ship offers a good introduction - she makes approximately six knots, allowing a calm environment in which to consider situations and make measured decisions, building up confidence before you move on to larger and faster vessels,” Joel explained.
“In addition, the mix of officers and ratings provided a career first introduction to personnel support and considerations – the two are generally kept quite separate up to this point. All of us found that experience incredibly beneficial in setting us up for future responsibilities.”
There was also praise for the merchant crew who passed on their skills and experience to the young Royal Navy officers, like Sub Lieutenant Hilton Forsyth who sailed to Portsmouth, Dartmouth, Dublin and the wildlife haven of Lundy in the Bristol Channel and find his several weeks at sea and found them packed with “worthwhile experiences”.
“The most notable benefit for warfare young officers was a navigation teaching/testing/discussion session with an experienced crew member,” Hilton added. “His teaching style is memorable and was of great benefit.”
This article appears courtesy of Royal Navy News and may be found in its original form here.
The opinions expressed herein are the author's and not necessarily those of The Maritime Executive.
Charity Plans to Move Aging Frigate From Pakistan to UK as Museum Ship
PNS Babur, a sister ship of HMS Ambuscade (USN file image)
A charity organization in the United Kingdom is undertaking an ambitious project that will see a decommissioned Royal Navy warship make a 6000-mile journey from Pakistan to the Clyde, where she will start a new life as a floating museum and education center.
In a mission aimed at preserving the rich shipbuilding history of the River Clyde for future generations, Clyde Naval Heritage (CNH) said plans are ongoing to bring the former HMS Ambuscade back to the UK.
Commissioned in 1975, the Amazon class Type 21 frigate served during the Falklands conflict as an electronic warfare picket ship, and took part in several bombardments of Argentine positions. In 1993, the warship was decommissioned and sold to the Pakistan Navy and recommissioned as PNS Tariq. She remained in active service for three decades.
CNH is announcing that the Pakistan government has since donated Ambuscade to the charity to become part of the Clyde Naval & Shipbuilding Heritage site. Plans are underway to bring the vessel back to the Clyde with the ship expected to make the 6,000-mile journey from Karachi later this year. On arrival, the intention is to preserve her as a floating museum and ensure she helps preserve the rich shipbuilding history of the River Clyde.
The Clyde’s shipbuilding history spans centuries, evolving from the construction of medieval fishing vessels to becoming one of the world’s most important industrial shipbuilding centers. Many commercial and naval warships have been built in the Clyde’s shipyards for both the Royal Navy and many countries around the world. They include world’s most iconic transatlantic liners such as the Queen Mary, Queen Elizabeth and QE2. Unfortunately, most of the shipyards are long gone and only a few pockets remain of the region's shipbuilding heritage.
As part of the project to bring Ambuscade back to the Clyde, CNH has appointed consultancy firm Tricolor Collective as its lead development partner with the task of leading the next phase of project development, business planning, and strategic fundraising to bring the Clyde’s naval legacy back to life.
“The Clyde’s shipbuilding heritage is a powerful symbol of Scottish innovation, craftsmanship, and industrial strength. We intend to harness that legacy to drive the regeneration of a region that has seen significant decline. Our immediate goal is to bring the former HMS Ambuscade (PNS Tariq) back from Pakistan to the Clyde, where she was built,” said O’Neill.
Apart from bringing back Ambuscade, CNH also plans to create the Clyde Historic Dockyard, a new maritime heritage destination combining cultural programming, community co-creation spaces, naval innovation showcases, and heritage skills hubs.
“Our vision is to create a dynamic, inclusive, and future-facing heritage destination anchored by the Ambuscade/Tariq and innovative multi-dimensional immersive access to the global maritime story,” said Sarah Dowd, Tricolor Founding Director.
Urgent awareness gap: 1 in 3 Europeans unfamiliar with cystitis (UTI) , half unaware women are most at risk
Urinary tract infections (UTI) are the second most common infections, affecting millions of people each year.
New study highlights need for public education on UTIs amid rising antibiotic resistance
Urinary tract infections (UTIs) are the second most common infections, affecting millions of people each year.
This major public health concern can often be prevented or cured if treated correctly. Experiencing a burning sensation down there? Talk to your doctor about it.
Arnhem, 22 September 2025 – A new international study has uncovered a concerning lack of public understanding about cystitis and urinary tract infections (UTIs) – common health issues that disproportionately affect women. The findings, which also highlight widespread misconceptions about prevention and treatment, underscore the urgent need for education to combat rising antibiotic resistance.
In a survey of over 3,000 adults across France, Germany, Italy, Spain, and the UK, 35% of respondents could not correctly define cystitis as a bladder infection, with some confusing it for a skin condition or even food allergies. Among younger adults aged 18–24, fewer than half (45%) were able to identify cystitis correctly.
A hidden gender gap in awareness Despite medical consensus that women are significantly more affected by UTIs, only half (51%) of respondents recognised this, while nearly 1 in 5 men incorrectly believed that men are more commonly affected. Encouragingly, awareness was higher among women themselves, with 63% correctly identifying their increased risk compared to just 38% of men.
Missed opportunities for prevention UTIs are often preventable, but knowledge of basic prevention strategies is worryingly low:
71% knew that drinking plenty of water can help.
Only 43% recognised the importance of proper hygiene (wiping front to back).
Just 35% understood the need to urinate after sexual activity.
Alarmingly, 17% mistakenly believed taking antibiotics without medical advice could prevent UTIs.
Only 21% of all respondents could identify all three key prevention strategies, and 1 in 6 couldn’t name a single correct preventive measure. Women are three times more likely to identify the three correct ways of prevention.
"Many teenagers today are sexually active without understanding the risks of bladder infections. Young women in particular are more vulnerable because of their anatomy, yet too often they think the contraceptive pill protects them from all risks and that condoms are unnecessary. We urgently need to address this through school education and social media, otherwise we risk a new generation of young women suffering repeated urinary tract infections and even long-term bladder damage," says Jane Meijlink, chair of the International Painful Bladder Foundation.
Antibiotic misuse adds to the challenge While not all UTIs require antibiotics, 16% of respondents incorrectly believe they are always needed—a misconception that fuels antibiotic overuse and resistance. Even among those affected, awareness of the risks associated with antibiotic resistance is not widespread. Almost half of respondents either underestimated or were unaware of the growing difficulty in treating UTIs due to antibiotic resistance.
"Urinary tract infections affect over 400 million people worldwide and cause approximately 240,000 deaths each year, with rising antibiotic resistance making them harder to treat," said Prof. Gernot Bonkat (CH), chair of the EAU Infections Guidelines Panel. "This study shows that raising public awareness, as well as education about symptoms, causes, and treatment, is still essential to prevent infections, reduce suffering, and slow the spread of resistance. Importantly, not every infection needs to be treated with antibiotics—judicious use is key to combating resistance. "
About UTIs and Urology Week 2025 The survey is part of Urology Week 2025 (22-26 September), an initiative by the European Association of Urology to create awareness of urological conditions among the general public. This year the focus lies on urinary tract infections (UTIs) and in particular cystitis.
Urinary tract infections (UTIs) are among the most common infections, affecting millions globally. They are the second most common infection after respiratory infections and are significantly more prevalent in women than men. Approximately 50-60% of women will experience a UTI at least once in their lives.
UTIs are a major public health concern due to their high incidence and morbidity. Their financial burden is substantial, estimated at billions of euros annually worldwide. Understanding the prevalence, risk factors, and consequences of UTIs is crucial for effective prevention and treatment strategies. That is why this year Urology Week is focusing on raising awareness for urinary tract infections. For more information about Urology Week, visit http://urologyweek.org. For more information about urinary tract infections, please see https://patients.uroweb.org/condition/urinary-infections.
ENDS
Urinary tract infections (UTIs) are the second most common infections, affecting millions of people each year.
This major public health concern can often be prevented or cured if treated correctly. Experiencing a burning sensation down there? Talk to your doctor about it.
Credit
European Association of Urology
About the survey
The new survey was commissioned by the European Association of Urology (EAU) for its annual Urology Week (22-26 September 2025). Over 3,000 members of the public from Spain, France, Germany, the UK and Italy were asked about their knowledge of and experience with urinary tract infections. The survey was supported by GSK. The information was sourced in July 2025.
About the European Association of Urology (EAU) The European Association of Urology is a non-profit organisation which supports medical professionals working in the field of urology through many of its scientific, professional, educational and awareness-building initiatives. The overarching mission is to raise the level of urological care in Europe, and for many years this has been done through educational and scientific programmes aimed at urologists. Today the EAU represents more than 19,000 medical professionals working in Europe and beyond its borders. For more information see www.uroweb.org
About GSK GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together. GSK has pioneered innovation in infectious diseases for over 70 years, and the Company’s pipeline of medicines and vaccines is one of the largest and most diverse in the industry, with a goal of developing preventive and therapeutic treatments for multiple disease areas or diseases with high unmet needs globally. Find out more at gsk.com.
Science journalists as brokers of trust
According to a new JCOM study involving media professionals, journalism also involves an active mediating role with the public
“Trust in science is collapsing”—that’s the alarm we often hear. It’s not surprising, then, that recent years have seen major efforts to study the phenomenon and its dynamics in the general population. Far less attention, however, has been paid to the information professionals—journalists—who play a crucial bridging role between the world of scientific research and the public. A new paper in the Journal of Science Communication (JCOM) by a research group at the Institute for Technology Assessment and Systems Analysis (ITAS) of the Karlsruhe Institute of Technology (KIT), Germany, gives voice to journalists in three countries—Germany, Italy, and Lithuania—each representing a different media ecosystem.
The picture that emerges is far more fragmented and nuanced—and, above all, strongly context-dependent—than the common narrative would suggest. The journalists described themselves as being in constant negotiation with their audiences, calling themselves “knowledge brokers.” They also stressed that, in today’s science journalism, fact-checking and accuracy must be coupled with political, social, and emotional dimensions and with audience expectations, and they highlighted the need for new co-creative media formats.
“According to the journalists involved in our study, trust in science is not collapsing,” explains Nora Weinberger, a researcher at ITAS and one of the authors of the study, who contributed to the analysis of the focus-group data (that were all pre-analyzed locally). “That was kind of a surprise for me, because in the media and in discussions among researchers there’s this idea of a collapse, while participants in our study see trust as being constantly negotiated.”
“Public trust in science is not uniformly declining,” confirms Dana Mahr, also a researcher at ITAS and the study’s first author. “It’s fragmented, dynamic, and highly dependent on social, political, and media contexts, as well as individual expectations.”
The focus-group study involved 87 participants—mostly journalists (also including a number of science and institutional communicators and a few scientists)—across three very different countries. Germany shows a relatively solid landscape for science journalism, with dedicated desks in public broadcasters and major outlets, a strong professional network, and good fact-checking practices. Italy is more fragmented, with fewer pure science desks, many freelancers, and often poorly paid. As described by one Italian participant: “Science journalism in Italy is treated as a luxury. When there’s a crisis, it suddenly matters. Otherwise, it’s ignored.” Lithuania, shaped by its post-communist past, has a very small market with few full-time specialists; science is often covered by generalists or in collaboration with universities and research centers.
Context effects and fragmentation
Journalists highlighted the public’s growing ideological polarization: some continue to trust scientific institutions, while others assess information through an emotional and political lens. As one German participant put it: “People don’t evaluate scientific facts independently anymore. They trust or reject science based on whether it aligns with their political identity.”
They also criticized a reactive form of journalism that works on a very short time horizon and often depends on contingencies and public mood. In practice, topics are covered mainly in emergencies (think of the pandemic), while in-depth, long-term reporting is rare. This dynamic, by reducing the public’s familiarity with scientific issues, ends up triggering a vicious circle that further undermines trust in scientific research.
Online sets the agenda
Another key point is that dynamics of the online sphere spill over offline, shaping what appears in print. “The same article gets published in print and online, and if it gets no clicks online, then the topic doesn’t come up next time in the editorial discussions with regard to the print,” explains Mahr.
This further restricts in-depth coverage of important topics — from vaccines to climate change: if a subject doesn’t draw online interest, it stops being covered. Mahr cites global warming: although it’s scientifically crucial, it no longer attracts audiences unless framed with sensational headlines (often misleading, sometimes not evidence-based), and is gradually sidelined by outlets. “The journalists in our focus groups expressed the idea that basically you cannot do journalism on climate change because the public is overladen with information. Basically they are tired of the topic of climate change.” This, in turn, creates space for “alternative information” (not evidence-based and driven by a specific political agenda), which spreads pseudoscientific misinformation.
The role of support structures
Because journalism is so dependent on context and “market” factors, participants stressed the need for broader infrastructures to support their work: “Whether journalists can foster trust depends less on individual reporting and more on systemic conditions,” explains Weinberger. “Now there is really a need for media infrastructures and institutional support. Trust, and political culture, are questions of structures in society, not only of journalistic skills or good stories. For me, that was really surprising, in a way.”
The envisaged structures include elements that help mitigate market pressure: more stable funding (e.g., public service media), dedicated science desks, investigative funds, fact-checking units, collaboration networks, and ongoing training. In Germany, for example, these supports are more established than elsewhere, reducing click pressure and enabling longer-term, well-contextualized coverage.
Trust brokers and co-creation
“What I found really interesting was that they see their role as trust brokers—not only translating complex research, but also building trust,” says Weinberger. “That is not their formal job description, and from my point of view this represents a shift in their role.” This emerges in all three countries studied, despite clear differences in the media landscape. Journalists do not see their work as only conveying scientific information clearly, fairly, and accurately. They also take on an active role of mediation and dialogue with the public, in some cases pushing the profession toward the edge of activism. They feel literally tasked with building public trust in science.
For this reason, they believe news formats should incorporate more co-creation. “The journalists are aware of the social contract that we connect to the role of journalists—so they want to make it even stronger, with more transparency, more humility, and more dialogue with audiences. Basically, their idea is to allow more co-production.”
The strategies mentioned include producing interactive formats such as podcasts and Q&A sessions, and building relationships within digital communities instead of relying on one-way messaging, adapting content to the platforms without compromising scientific accuracy. These approaches are not panaceas, but necessary experiments that mark a shift from simple dissemination to dialogue and from authority to co-creation, recognizing that trust must be built by meeting audiences where they already are.
The article “Science journalists and public trust: comparative insights from Germany, Italy, and Lithuania” by Dana Mahr, Arianna Bussoletti, Christopher Coenen, Francesca Comunello, Julija Baniukevic and Nora Weinberger is published in the Journal of science Communication JCOM. The study was conducted as part of the EU Horizon Europe project IANUS (Inspiring and Anchoring Trust in Science, Research and Innovation, Link: https://trustinscience.eu/) aimed at strengthening warranted trust in science, research, and innovation through inclusive, value-sensitive, and participatory approaches.
Journal
Journal of Science Communication
Method of Research
Observational study
Article Title
Science journalists and public trust: comparative insights from Germany, Italy, and Lithuania
Article Publication Date
22-Sep-2025
Virtual care expansion did not expand specialist access in rural areas
Despite the expansion of virtual care in Ontario prompted by the COVID-19 pandemic, specialist physicians did not expand reach to patients living at great distances from where they provided care, found new research published in CMAJ (Canadian Medical Association Journal). https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250166
“We found that widespread availability of virtual care, accompanied by remuneration changes, was not associated with substantial expansion of specialists’ practices to serve patients who lived farther away,” writes Dr. Natasha Saunders, a pediatrician at The Hospital for Sick Children (SickKids); adjunct scientist, ICES; and associate professor, University of Toronto, Toronto, Ontario, with coauthors.
About 18% of Canada’s population lives in rural areas, but only 2.2% of specialists practise in these regions. It has been widely suggested that virtual care could increase access to health care for people in rural areas.
To understand if changes in virtual care in Ontario — which included billing codes and technological infrastructure to enable physician use — extended reach of specialist care, researchers compared driving distance and driving time between patients and physicians in a pre–virtual care period (January 1, 2019, to November 30, 2019) and a virtual care period (January 1, 2022, to November 30, 2022). The study included more than 11 000 specialists and more than 5.3 million patients who had over 25 million visits during the virtual care period.
The researchers did not find meaningful changes in distance between patients and specialists, except in psychiatry, where there were modest changes across all measures.
“If virtual care is to increase access to specialty care for rural patients, efforts are required to identify and target other barriers for virtual care, one of which could be that providers refer to specialists within their own self-contained networks,” the authors write. “In other words, rural patients may not be referred to specialists who are far away because their provider is not aware of them. Centralized referral systems could pool patient referrals and match patients to specialists.”
The authors also suggest considering patient preferences could increase use of virtual care among patients who may have health conditions or transportation or time challenges that would make virtual care a better option.
“To make virtual care more accessible, especially for patients living in rural areas, attention should be paid to other factors such as referral patterns and the role of patients in determining the type of visit they prefer,” the authors conclude.
