The provincial Ministers of Health met their federal counterpart in Vancouver on Nov. 7 and 8. The planned joint news conference was abandoned at the end of the meeting. The federal government was miffed that the Premiers released a letter saying there had been no progress and urging PM Trudeau to meet them (the Premiers). Wow, the feds must have very delicate dispositions!
BC’s Health Minister, Adrian Dix, said he was disappointed but not discouraged. Presumably, he was also not surprised. After all, the federal and provincial Health Ministers had not met for four years, and the federal government had declined all provincial requests to meet over the last 12 months, until now.
Not all the news on this file is negative, though. In the absence of further federal support, in British Columbia, the government has embarked on its own reforms to the healthcare system. Several positive changes have been made throughout 2022. As Dix has said, “There’s no one magic bullet to turn around the system to what we need.”
In February, the government announced a total of 600 nursing seats to be added to the existing 2000 in the province, at a number of colleges and universities in the province. In October, Dix announced 128 new seats for doctors at UBC over the next six years, forty beginning in the fall of 2023. The province has also expanded the responsibilities of pharmacists. They may now renew prescriptions for limited periods, and next year may prescribe medications for simple maladies. Expanded functions for ambulance paramedics and fire fighters have also been approved.
Perhaps, the biggest problem in primary care has been the “fee for service” system, which was working for neither patient nor doctor. It provided one fee per patient served ($30 - $40), regardless of the nature of the problem or the amount of time spent with patient. This often resulted in the doctor being unable to spend the appropriate time with the patient. Some doctors even restricted each appointment to one issue. So, patient care suffered.
As their costs rose, doctors were increasingly put in an unsustainable financial position. Family doctors retired or moved to other jurisdictions or to salaried positions. It became progressively more difficult for BC residents to find a family doctor. Now, over one million people do not have a doctor, and present at emergency for issues that formerly were addressed at local family practices. This contributed to the gridlock that was, and is, in every Emergency Department in every city in BC. And problems not dealt with on a timely basis, may result in patients with more serious issues later at other levels in the system.
At the end of October, Health Minister Dix announced a new funding model for family doctors, one that they had a role in creating. The model considers the time spent with the patient, the number of patients the Doctor sees in a day, the complexity of the patients’ issues, and more. It will result in improved remuneration for doctors, based upon genuine criteria. The model will take effect in February of 2023, and will improve healthcare over time. Dr Ramneek Dosanjh, President of the Doctors of BC, declares, “Everyone deserves a family doctor, and this new option [model] is a major step toward that reality.”
The federal government, in the 1960’s, contributed about 50% of the cost of public healthcare. That proportion has greatly decreased over time. They now contribute about 22%, or about 35%, depending upon who you believe, the provinces or the feds. The federal government transferred tax points to the provincial governments to be applied to healthcare a number of years ago. The value of those tax points is what creates the competing views on the level of the federal funding.
Some of the drama in Vancouver, no doubt, was the result of bargaining positions taken on both sides. However, to not engage, does not look good on the federal government. It is time for the Government of Canada, and the Prime Minister, to fully join the negotiating process, and to duly increase funding.
Bruce W Uzelman
I grew up in Paradise Hill, a village in Northwestern Saskatchewan. I come from a large family. My parents instilled good values, but yet afforded us, my seven siblings and I, much freedom to do the things we wished to do. I spent my early years exploring the hills and forests and fields surrounding the village, a great way to come of age. My parents owned a successful general store. My siblings and I were required to help out in the business, no choices allowed there!
I attended the University of Saskatchewan in Saskatoon. I considered studying journalism at one point, but did not ultimately pursue that. However, I obtained a Bachelor of Arts, Advanced with majors in Economics and Political Science in 1982.
My career has consisted exclusively of small business, primarily restaurant and retail. I was originally based in Alberta, and then BC, first in Summerland, then Victoria and finally Kelowna (for over 20 years). I was married in Alberta, and we have two daughters, who have returned to Alberta as adults for career reasons, as did my now ex-wife. My daughters are successful, and now have families of their own.
I have maintained a healthy interest in politics throughout my adult years, and wish to put that and my research skills to work as a political columnist.