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91ƵScotch Tape and wet paper91Ƶ: fragile B.C. health care key election issue

Communities across B.C. looking to provincial election candidates to heal cracking system
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Ambulances parked at the central reporting station in Victoria, B.C., on Thursday, Nov. 9, 2023. Temporary emergency room shutdowns have hit rural and urban hospitals alike, hundreds of cancer patients have been sent across the U.S. border for radiation therapy, and there91Ƶs a shortage of nurses and doctors. THE CANADIAN PRESS/Chad Hipolito

Mike Goetz has added bill collector to his list of responsibilities as mayor of Merritt in British Columbia91Ƶs Interior.

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 hospital services, as well as the cost when firefighters respond to medical calls because paramedics are busy transporting patients to Kamloops, 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.

91ƵThat91Ƶs unacceptable to ask our taxpayers to pay for this system twice. We91Ƶve paid for it once, we expect 365 days of coverage, because that91Ƶs what you charged us for,91Ƶ he said.

The mayor isn91Ƶt alone in his frustration with the state of B.C.91Ƶs health system. 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 there91Ƶs a shortage of nurses and doctors.

It91Ƶs a central issue ahead of the Oct. 19 provincial election, with the B.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.

Dr. Rita McCracken, a family doctor and assistant professor at the University of British Columbia, said fixing the province91Ƶs health-care system will require systemic changes, beyond hiring more employees.

91ƵWe don91Ƶt 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 we91Ƶre trying to graduate people and hire people into,91Ƶ she said.

B.C. Conservative Leader John Rustad made health care the focus of his first major platform commitment in July, long before Opposition Leader Kevin Falcon suspended his BC United Party91Ƶs campaign and threw his support behind the Conservatives.

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

91ƵOur health-care system in B.C. is in crisis. More than that, it is failing. More money into the system is not the solution,91Ƶ Rustad said in July.

Rustad faced criticism Monday over a video, circulated by the NDP, in which he tells a group of former public service employees who lost their jobs for refusing to be vaccinated against COVID-19 that he wishes he hadn91Ƶt received three shots of the 91Ƶso-called vaccine.91Ƶ

In the video from June, Rustad said he91Ƶd realized vaccination campaigns weren91Ƶt about trying to stop the spread of COVID-19 but rather were 91Ƶaround shaping opinion and control on the population.91Ƶ

The BC Greens have said they want to establish community health centres in all 93 ridings in B.C. to replace the current network of urgent and primary care centres, saying they had failed to retain staff and provide patients with primary care connections.

Leader Sonia Furstenau said the plan would put 91Ƶtimely, comprehensive care all in one place91Ƶ and streamline referrals by giving access to doctors, nurses, mental health professionals and specialists within a patient91Ƶs community.

As health minister, Adrian Dix has acknowledged the province91Ƶs struggles with health-care staffing that he said was a problem across the country.

In an interview with Global News over the Labour Day long weekend, when several emergency rooms were closed, Dix said the government was 91Ƶdoing absolutely everything we can91Ƶ and that 91Ƶwe don91Ƶt consider it ever acceptable91Ƶ for emergency rooms to close.

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.

In the Interior Health region 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 91Ƶin the last number of years91Ƶ 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 of services they 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.

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.

91ƵWe haven91Ƶt really been addressing 91Ƶ and it echoes over into nursing and emergency rooms and in all the different places 91Ƶ that we have not created a sophisticated-enough assessment of what we need to be providing care,91Ƶ she said.

Ahead of the election the The BC College of Family Physicians and BC Family Doctors published a series of requests for its members from the next government, including access to extended health and 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 don91Ƶt 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 91Ƶsome very significant shifts in the right direction,91Ƶ pointing to a new payment model for doctors launched in 2023, but added such moves represented 91Ƶthe first two or three steps of probably 100 that we need to take in order to stabilize the system.91Ƶ

Adriane Gear, president of the BC Nurses91Ƶ Union said working in an emergency room was a particularly challenging role.

91ƵNurses have tried their very best to hold up the system. But you can only work short staffed so often. You can only know that you91Ƶre actually not providing the care that people need so many times. And then you look around and you go, 91Ƶyou know what? This is killing me,91Ƶ91Ƶ 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 described health care as 91Ƶwhack-a-mole these days91Ƶ with multiple serious issues popping up that affect voters.

91ƵWhen you91Ƶre having a health crisis 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 it91Ƶs going to get transmitted to active discussions during the campaign,91Ƶ she said.

In Merritt, Goetz said in an interview near the end of August that he had not received a response to the bill from Dix. But if he doesn91Ƶt get one, he said he was 91Ƶsending it to collections.91Ƶ

91ƵI91Ƶve called it a house on fire, and that91Ƶs exactly what it is,91Ƶ he said.





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