Fixing B.C. health system is key election issue

Mike Goetz has added bill collector to his list of responsibilities as mayor of Merritt inBritishColumbia'sInterior.

In June, Goetz sent the province an invoice for $103,831.87, the cost, he said, for closures of the Nicola Valley Hospital emergency room.

He said the bill for the 19 closures last year and the first five closures this year includes a partial refund of what the city paid for hospitalservices, as well as the cost when firefighters respond tomedicalcalls because paramedics are busy transporting patients toKamloops, about 85 kilometres to the northeast.

And GST, of course.

Goetz said the costs would be equivalent to a one-per-cent increase in taxes for the community, unless the province picked up the tab, and came on top of the more than $600,000 the municipality already pays the province annually for its hospital.

"That's unacceptable to ask our taxpayers to pay for this system twice. We've paid for it once, we expect 365 days of coverage, because that's what you charged us for," he said.

The mayor isn't alone in his frustration with the state ofB.C.'shealthsystem. Temporary emergency room shutdowns have hit rural and urban hospitals, hundreds of cancer patients have been sent across the U.S. border for radiation therapy, and there's a shortage of nurses and doctors.

It's a central issue ahead of the Oct. 19 provincial election, with theB.C. Conservatives offering sweeping changes and at least one major change promised by the governing New Democrats not set to be fully implemented until after the election.

'Scotch Tape and wet paper'

Dr. Rita McCracken, a family doctor and assistant professor at the University ofBritishColumbia, said fixing the province'shealth-caresystem will require systemic changes, beyond hiring more employees.

"We don't have enough people doing the jobs, but at the same time, we have a system that is made out of Scotch Tape and wet paper that we're trying to graduate people and hire people into," she said.

B.C. Conservative Leader John Rustad madehealthcarethe focus of his first major platform commitment in July, long before Opposition Leader Kevin Falcon suspended hisB.C. United Party's campaign and threw his support behind the Conservatives.

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The Conservatives say that if elected they will pay to send more people outside the province forhealthcareand expand the use of private clinics. Rustad has also promised to compensatehealthworkers who lost their jobs for refusing to get the COVID-19 vaccine.

"Ourhealth-caresystem inB.C. is in crisis. More than that, it is failing. More money into the system is not the solution," Rustad said in July.

Rustad faced criticism Monday over a video, circulated by the NDP, in which he sayshe regrets getting the "so-called vaccine" against COVID-19.The videois an edited version oflonger footage posted onlineby theB.C. Public Service Employees for Freedom, agroup of former workers, both vaccinated and unvaccinated, who believe vaccination mandates in workplaces violated medical privacy and human rights.

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TheB.C. Greens have said they want to establish communityhealthcentres in all 93 ridings inB.C. to replace the current network of urgent and primarycarecentres, saying they had failed to retain staff and provide patients with primarycareconnections.

Leader Sonia Furstenau said the plan would put "timely, comprehensivecareall in one place" and streamline referrals by giving access to doctors, nurses, mentalhealthprofessionals and specialists within a patient's community.

Ashealthminister, Adrian Dix has acknowledged the province's struggles withhealth-carestaffing that he said was a problem across the country.

The province does not compile a public tally of emergency room closures but there have been dozens over the summer, in the Interior, north and elsewhere. But in the InteriorHealthregion alone, there were 66 emergency room closures in the first half of 2024 because of a lack of either nurses or doctors.

Dix has said the province added 250,000 nursing hours "in the last number of years" and had 831 net new family doctors.

The NDP is promising that if re-elected it will expand when pharmacists can prescribe medications, reduce paperwork for doctors, add more physician assistants and expand the range ofservicesthey provide.

Leader David Eby said a re-elected government would provide immediate provisional licences for doctors, nurses, and midwives trained in Canada who stepped out of the system, and offer the same licences in six weeks for professionals trained in some regions outside of the country.

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But McCracken said whoever wins in October will have more to worry about than hiring. She said the next government has to do a better job of quantifying exactly what is required, and understanding the system so that doctors want to stay where they are most needed.

Benefits, sick days, pension plan

Ahead of the election theB.C.College of Family Physicians andB.C.Family Doctors published a series of requests for its members from the next government, including access to extendedhealthand dental benefits, sick days and a pension plan.

They say the government needs to reduce paperwork and fund additional supports like nurses in family medicine clinics.

The organizations estimate more than 700,000 British Columbians don't have access to a family doctor and nearly 40 per cent of family doctors are set to retire or reduce clinical hours within five years.

McCracken said under the NDP government there had been "some very significant shifts in the right direction," pointing to a new payment model for doctors launched in 2023, but added such moves represented "the first two or three steps of probably 100 that we need to take in order to stabilize the system."

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Dr. Rita McCracken, a family physician and UBC assistant professor, says that if this situation were easy to fix, it would have been done by now.

Adriane Gear, president of theB.C.Nurses' Union said working in an emergency room was a particularly challenging role.

"Nurses have tried their very best to hold up the system. But you can only work short staffed so often. You can only know that you're actually not providing thecarethat people need so many times. And then you look around and you go, 'you know what? This is killing me,'" she said.

She said the union wanted a promise from political leaders to continue working on meeting nurse-patient ratios.

In March,B.C. announced it would be the first province to implement such a policy, something Gear said had helped retain and recruit nurses in other countries.

In the days leading up to the election campaign in September, the NDP government announced a series of agreed-to ratios including one nurse to three patients for general emergency room visits, 1:1 for trauma, and 1:4 for short surgical stays.

It said implementation would begin this fall.

Gear said she wanted a similar promise from the other party leaders if they are elected.

McCracken describedhealthcareas "whack-a-mole these days" with multiple serious issues popping up that affect voters.

"When you're having ahealthcrisis and you realize you need to drive for 3 1/2 hours in the middle of the night, that just brings up a lot of feelings, and I think it's going to get transmitted to active discussions during the campaign," she said.