B.C. Election 2017: Parties agree home care, long-term care and mental health need more spending

Sophia Farquhar, a six year old Big Brooks volunteer, sits with Stella Zdrill, a Brookhaven Care resident in West Kelowna on June 2, 2014. Brookhaven Care is an Interior Health Authority long term care facility that has a program where kids interact with the residents. JEFF BASSETT / VANCOUVER SUN

The B.C. Green party wants to create three different health ministries, the B.C. NDP says it will boost hospital operating room times to reduce surgical wait times, while the B.C. Liberals plan to keep renovating and building new hospitals – with $2.7 billion earmarked in spending for such capital construction in the next three years alone.

The governing Liberals are also promising to increase the number of medical doctors graduating from the University of B.C., from the current 288 to 400 by 2025. UBC is already one of the largest medical schools in North America, but Liberal MLA Andrew Wilkinson, a medical doctor, said it should expand even more “because we need more doctors.”

The Liberals have committed to funding the training of 500 more nurses per year (about 1,300 registered nurses graduate each year) by 2022. The Liberals are emphasizing their record on doubling medical and nursing school spaces and building new hospitals to contrast with the NDP’s record of “failing to build a single new hospital” in the decade (1991 to 2001) it was last in power.

The three major parties in this B.C. election campaign are diverse in their approaches to many issues, but all are in agreement that home care, long-term (residential) care and mental health need to be bigger priorities. Amid the opioid crisis, there’s consensus among the parties that more services are needed, especially for addictions treatment.
The Liberals say that on top of the $1.5 billion being spent on mental health and addiction treatment, they will add another $165 million over five years for more recovery beds, counselling, research and housing for the most vulnerable. The NDP wants police to disrupt illicit drug supply chains and will advocate for tougher penalties on fentanyl drug dealers.

The Greens and the NDP believe a whole new ministry is needed to tackle mental health and addictions. The Greens also want to revive a healthy living ministry that the Liberals killed off after the 2010 Olympics. The focus would be on health promotion, disease prevention and active lifestyles. The Greens say their third health ministry would be focused on management of the overall acute care system.
“It’s not about creating more government bureaucracy,” said Green party spokeswoman Jillian Oliver, adding that having separate ministries means other priorities are getting just as much attention as, say, hospital budgets.

Hospitals gobble up at least one-third of the $20-billion provincial health-care budget but the steadily increasing allocated amount never seems to be enough to make a sizeable dent in waiting lists, now at an historical high.

With nearly 90,000 patients waiting for surgery, surgical wait times are a chronic challenge. Former health minister Terry Lake acknowledged in an exit interview that he regrets his government was not more successful in finding ways to tackle wait times for scheduled operations. Lake said although a surgical committee was set up three years ago to find ways to reduce wait times, he frankly admits the issue took a back seat to the fentanyl crisis, especially in the past year when overdose deaths kept escalating.
“My focus shifted somewhat and I probably didn’t spend enough time on surgical wait lists as I could have,” he said.
While someone else will be the next health minister, the now retired (from politics) Lake said population aging and patient expectations are two of the big factors causing wait lists to consistently grow. Although there’s been a 178-per-cent increase in the number of knee replacements in 15 years of Liberal rule and a 116 per cent increase in hip replacements, the latest report by the Canadian Institute of Health Information shows 40 per cent of patients are not getting hip replacements within the benchmark time of six months and just over half of patients are not getting knee replacements in the same time period.

The Liberal government drafted a 2015 policy paper about improving operating-room efficiencies and wait-times, but many of the recommendations have not been implemented apart from increasing the number of cases being contracted out — with public funding — to private surgery centres. Lake said just before the election writ dropped: “We have to find cost-effective ways to meet demands. We need to look at dedicated hospitals or outpatient clinics that can do those types of surgeries. Insofar as private clinics, I think we can contract for ‘X’ number of surgeries, while holding them to stiff quality controls, as long as it’s publicly paid and doesn’t violate laws.”
Soon after Lake made those comments, the Vancouver Island Health Authority (VIHA) disclosed it had signed a $30-million contract with a new private surgery clinic that will handle thousands of outsourced day surgeries over the next five years. Private clinics can only do minor operations since they can’t keep patients more than one night under current regulations.

Judy Darcy, a good bet to become health minister if the NDP wins the May 9 provincial election, said there wouldn’t be nearly 100,000 patients waiting for surgery if public hospital operating rooms weren’t sitting idle 18 per cent of the day. No operating rooms have extended hours, she said.
“There is unused capacity there and we think that one of the solutions is to extend hours, just like what the government finally did for MRI clinics, to reduce the incredible backlogs.”
Yet Darcy concedes a chronic shortage of operating room nurses is a factor in OR scheduling. And while the Liberal government has indicated willingness to depend on private clinics more through publicly funded contracts, the NDP is wary of that approach. 

Although there are many nurses who prefer working in private surgery settings, the NDP agrees with the B.C. Nurses’ Union that private clinics “drain” hospitals of nurses and doctors. Darcy said the trend toward contracting out is “worrisome” and the NDP would do rigorous audits to ensure patients aren’t queue jumping or that private clinics aren’t directly billing patients for services usually covered by the provincial health insurance scheme.

Darcy said she doesn’t buy Lake’s mea culpa that the opioid crisis has been so much of a distraction that the government has been unable to fix long wait times.
“The crisis in surgical wait times has been going on for many years. The government has been bragging about having a $2-billion surplus at the same time that people have been waiting too long for everything.”


Leave a Reply

Your email address will not be published. Required fields are marked *