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As mayor of Merritt in the British Columbia area, Mike Goetz has added the role of debt collector to his to-do list.
In June, Goetz sent the province a bill for $103,831.87, which he said was for the cost of closing the emergency room at Nicola Valley Hospital.
He said the bill for last year’s 19 closures and the first five closures this year includes a partial reimbursement of what the city paid for hospital services, as well as the costs 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 cost would be equivalent to a 1 percent tax increase for the community unless the county foots the bill. The cost is on top of the more than $600,000 the community already pays the county annually for its hospital.
“It is unacceptable to ask our taxpayers to pay for this system twice. We paid for it once, we expect 365 days of coverage, because that is what you charge us for,” he said.
The mayor is not alone in his frustration with the state of British Columbia’s health care system. Emergency department closures have hit rural and urban hospitals, hundreds of cancer patients have been sent across the U.S. border for radiation therapy, and there are shortages of nurses and doctors.
It’s a hot topic ahead of the Oct. 19 provincial election, with the BC Conservatives proposing sweeping changes and the governing New Democrats promising at least one major change that won’t be fully implemented until after the election.
‘Scotch Tape and Wet Paper’
According to Dr. Rita McCracken, a family physician and assistant professor at the University of British Columbia, rebuilding the province’s health care system will require not just more workers, but systemic changes.
“We don’t have enough people doing the work, but we do have a system of tape and wet paper, where we try to turn people out and hire people,” she said.
British Columbia Conservative Party Leader John Rustad made health care the centerpiece of his first major election platform in July, long before Opposition Leader Kevin Falcon suspended his BC United Party campaign and threw his support behind the Conservatives.
Political analysts say health care is becoming an increasingly prominent issue in Surrey, B.C., as the provincial election approaches. Jon Hernandez explains how the municipality is poised to become a major battleground.
The Conservatives say that if elected, they will pay to send more people out of province for health care and expand the use of private clinics. Rustad has also promised to compensate health care workers who lost their jobs because they refused the COVID-19 vaccine.
“Our health care system in British Columbia is in crisis. In fact, it is failing. Throwing more money into the system is not the answer,” Rustad said in July.
Rustad was criticized Monday for a video distributed by the NDP in which he says he regrets getting the “so-called vaccine” against COVID-19. The video is an edited version of longer images posted online by the BC Public Service Employees for Freedom, a group of former employeesboth vaccinated and unvaccinated, who believe that workplace vaccination mandates violate medical privacy and human rights.
British Columbia Conservative Party Leader John Rustad was questioned during the campaign after the BC NDP released a video in which he said he regretted the “so-called vaccine” for COVID-19.
The British Columbia Greens have said they want to establish community health centres in all 93 constituencies in British Columbia to replace the current network of urgent care and primary care centres, saying they have failed to retain staff and provide patients with access to primary care.
Leader Sonia Furstenau said the plan would bring together “timely, comprehensive care in one place” and streamline referrals by giving patients access to doctors, nurses, mental health professionals and specialists in their communities.
As Minister of Health, Adrian Dix has acknowledged the province’s struggle to find health care workers, a problem he says is nationwide.
The province doesn’t keep a public count of emergency department closures, but there have been dozens over the summer, in the Interior, the North and elsewhere. But in the Interior Health region alone, there were 66 emergency department closures in the first half of 2024 due to a shortage of nurses or doctors.
Dix said the province has added 250,000 nursing hours “in recent years” and added 831 net new primary care physicians.
The NDP promises that if re-elected, it will expand the ability of pharmacists to prescribe medications, reduce paperwork for doctors, hire more physician assistants and expand the range of services they provide.
Leader David Eby said a re-elected government would immediately grant provisional licenses to doctors, nurses and midwives who trained in Canada and left the system. Within six weeks, the same licenses would be granted to professionals trained in certain regions outside the country.
BC Today host Michelle Eliot provides an update on the provincial election campaign, which saw BC NDP Leader David Eby and BC Conservative Leader John Rustad make promises on health care and housing, respectively.
But McCracken said whoever wins in October will have more to worry about than just hiring. She said the next administration needs to do a better job of quantifying what exactly is needed and understanding the system so doctors will want to stay where they are needed most.
Benefits, sick days, pension scheme
Before the election, the BC College of Family Physicians and BC Family Doctors published a series of demands for their members from the next government, including access to comprehensive health and dental benefits, sick days and a pension plan.
They say the government should cut paperwork and fund additional support, such as nurses in GP practices.
The organizations estimate that more than 700,000 British Columbia residents do not have access to a family doctor and that nearly 40 percent of family doctors will retire or reduce their clinical hours within five years.
McCracken said there had been “some very significant shifts in the right direction” under the NDP government, pointing to a new payment model for physicians set to launch in 2023. He added that such steps “are the first two or three steps of probably 100 that we need to take to stabilize the system.”
Dr. Rita McCracken, a family physician and assistant professor at UBC, says if this situation were easy to fix, it would have happened already.
Adriane Gear, president of the BC Nurses’ Union, said working in the emergency department was a particularly challenging role.
“Nurses have done their very best to keep the system afloat. But you can’t always be understaffed. You can’t always know that you’re not giving people the care they need. And then you look around and you think, ‘You know what? This is killing me,'” she said.
She said the union expects a commitment from political leaders to continue working toward achieving the nurse-patient ratio.
In March, British Columbia announced it would be the first province to implement such a policy, which Gear says has helped retain and recruit nurses in other countries.
In the run-up to the September election campaign, the NDP government announced a number of agreed-upon ratios, including one nurse to three patients for general emergency department visits, 1:1 for trauma and 1:4 for short surgical stays.
It was said that implementation would begin this fall.
Gear said she expects a similar pledge from other party leaders if they are elected.
McCracken described health care as a “whack-a-mole” these days, with multiple serious issues affecting voters.
“When you have a health crisis and you realize you have to drive 3.5 hours in the middle of the night, it stirs up a lot of emotions. I think that will lead to active discussions during the campaign,” she said.
