Not a week went by this summer when there wasn’t at least one Emergency Room closure in Northern Health, despite assurances the health authority was working to solve the issue. A closed ER in northeastern B.C. means residents not only don’t have reasonable access to emergency care, they often have to travel unreasonably long distances to find one that’s open.
“If our emergency room goes down, we have to come here,” Fort Nelson Mayor Rob Fraser told participants at a recent healthcare rally in Fort St. John.
“You spend three and a half, four hours, just getting to Fort Nelson to find out that the emergency room is closed, and you have to make another four-hour trip to [Fort St. John]. If that emergency room is closed it’s another hour [to Dawson Creek].
“I sure hope we don’t see closures here, Fort Nelson and Dawson Creek, because it’s a long trip after that,” Fraser said, speaking at the Rally for Better Healthcare, organized by local BC United MLA Dan Davies to draw government’s attention to healthcare issues in the northeast.
Health authority model lacks community focus
The region has had a shortage of doctors since the 1990s, but Fraser believes today’s problems with ER closures and chronic staff shortages reach back to 2001 when then-premier Gordon Campbell and his minister of Health reduced the 52 health boards down to five health authorities.
The move was designed to “minimize the duplication of administrative services that are adding to confusion and cost,” Fraser said. At the time, the 52 health boards had a total of about 600 administrators – which was probably too many of both – but they were all trying doing the best for their communities and the system, he said.
“One of our fears, back in 2001, was that the geographic regions were going to be too large, because they went from 52 to five,” said Fraser who was on the North Peace Health Board in the late 1990s.
The change eliminated local influence and the system lost an understanding of community culture.
“They don’t represent you or the region. They represent Northern Health.”
Rob Fraser
“[Previously] we were acting as healthcare governance. We could interact with the people in our communities who would tell us what the culture was within our facilities. If it was going bad, we could have a discussion at the board table with the leaders and let them know that things were going sideways. They were responsive to us. That’s not happening anymore.”
Nothing has changed for the better since then, he said, citing unpredictable and unacceptably long waits for treatment, and inconsistent quality of care in the province. All it’s done is remove locally elected community members from the equation.
“They don’t represent you or the region. They represent Northern Health,” he told the rally audience.
A primary objective of Canadian health care policy is to “facilitate reasonable access to health services without financial or other barriers,” according to the Canada Health Act. After two decades of healthcare management through the five health authorities, many British Columbians don’t have reasonable access to services, particularly in rural and remote areas of the province.
‘Communication was silenced’
The new health authority structure was supposed to eliminate duplication and costs, he said, but when the BC NDP came to power in 2017, they took 15 years of bad healthcare policy and made it worse.
“Basically, they took governance and policy underground, communication was silenced. Regional health authorities were not responsible or accountable [to communities],” Fraser said.
“Regional Health Authorities were not responsible or accountable [to communities].”
Rob Fraser
“You couldn’t talk to them about what was happening in your area, and there were no representatives from our area.”
Any community representatives who did work with Northern Health were told they were representing the health authority, not the local people.
On top of that, BC Health transferred worker recruitment to gate-keeper organizations which made more difficult to attract foreign-trained professionals, increasing shortages of doctors, nurses and other healthcare workers.
The impact on healthcare, particularly in the North, has been profound.
Quality healthcare key to community sustainability
Fort Nelson no longer has a full-service hospital. Now, expectant mothers have to travel to Fort St. John to deliver, or even further to Dawson Creek if the birthing unit at Fort St. John Hospital is closed as it was recently.
Fort St. John has an overdose prevention site and some day services for people with addictions and mental health issues, but the nearest detox or treatment facility is in Prince George, a five-hour drive, and weeks on a waitlist away.
Then there’s senior’s housing. Fort St. John’s only long-term care facility has been full since it opened in 2013. The business plan for an expansion that was approved two years ago with no indication if or when it will be built. Meanwhile, dozens of seniors must wait for their peers to die to advance up the waiting list.
“We’re hearing from our residents the frustration, the anger, the fear – this can be a life and death situation,” Fort St. John Mayor Lilia Hansen told the crowd. “Having access to quality healthcare is imperative to a community for its vibrancy, and its sustainability.”
“We have some of the best doctors, nurses, healthcare professionals anywhere. We’ve got a lot to be proud of. I have deep gratitude for their service and their dedication. Not only to their patients, but to this community,” said Hansen.
“I am asking for the provincial government to listen to our voices.”
Lilia Hansen
Yet those same doctors, nurses and other staff are hard to recruit and retain in the northeast. Hansen acknowledged the community has helped where it can, such as advocating for the Northern Baccalaureate Nursing Program through Northern Lights College and University of Northern BC.
“We appreciate the successes that have happened, but we’re not seeing the changes that we need,” Hansen said.
“I am asking for the provincial government to listen to our voices, listen to our actual examples and what happens to us if we don’t have the healthcare that we need. We need to have those tools and resources to support our healthcare workers for when we need that help.”
Hudson’s Hope ambulance poached
Hudson’s Hope is another community with inadequate health services, according to Mayor Travous Quibell.
The community has a health clinic that closes on weekends and is the only regional B.C. Emergency Health Service station, which provides part-time, pre-hospital services and ambulance service.
During several regional ER closures, the community’s ambulance was used to support other communities, leaving Hudson’s Hope with no emergency transport.
“Imagine not having an ambulance available and have to drive yourself, broken and bleeding,” said Quibell.
“Imagine not having an ambulance available and having to drive yourself, broken and bleeding.”
Travous Quibell
A couple of weeks ago during Hudson’s Hope rodeo, two people were injured with severe broken bones. Chetwynd’s ER was closed. The next closest emergency care was in Fort St. John, an hour’s drive away, and Hudson’s Hope ambulance was serving another community.
“The decision was made without warning or notice, to pull our ambulance from Hudson’s Hope to cross-cover in another community.”
When a Code 3 emergency call came in, the ambulance returned, but instead of a five-minute response time, it took more than an hour to arrive.
“Luckily for the two individuals, broken bones are serious, but not life-threatening,” Quibell said.
Health authorities: big, slow and unresponsive
A large part of the problem, is the size of health authorities, said Fort Nelson’s Fraser.
“Health authorities are too large and slow to react… and they don’t report to the public,” he said suggesting Northern Health be broken up into three operational areas; northwest, central and northeast
“Bring those budgets back here, appoint local representatives for a local health board. [So] there’s an opportunity for all of us, the public, to get back into the system,” he said.
Northeastern B.C. sends a lot of money to Victoria through the resource sector, but we hardly get anything in return when it comes to services such as healthcare, said Peace River North MLA Davies, who organized the rally to show the need for an audit.
“We need to get back to making healthcare about the patients.”
Dan Davies
The Peace River Regional District has called for an audit to understand how Northern Health services are administered. Local politicians have been calling for an independent audit for years, only to be told the B.C. government does its own audits. Some residents started a petition calling for an independent investigation into the repeated ER closures.
“The government just keeps going on about how good things are in healthcare in the province, but all of us know that it is not good. Previous government was not perfect, it made mistakes, but prior to this government we were leaders in healthcare,” said Davies.
“We need to get back to making healthcare about the patients, about people, not the health authorities. Patients need to be at the centre.”
For more news on BC North Peace, read Tania Finch‘s independent news source, The Broken Typewriter.