Efforts to recruit and retain more health-care workers are proceeding according to plan, and more improvements to health-care services in B.C. will be announced in the coming months, Health Minister Adrian Dix said Tuesday.
The province launched its Health and Human Resources Strategy last fall, and while criticism of resource and staffing shortages in clinics and hospitals continues, every sector of the system has seen a “dramatic increase” in staffing, the health minister said.
Since the start of the year, for example, 6,258 new nurses have been hired and 666 international medical graduates have registered in B.C. Another 320 relational security officers have been deployed to 26 health authority sites across the province, and 3,882 family physicians registered for the new longitudinal family physician model.
Between 2017 and last year, Dix said B.C. has gained a total of over 38,000 health-care workers.
“What we’ve seen in the last year is, by any standard, significant and radical change in many areas of health care to make things better, and we’re going to have to continue to do that,” Dix said at Vancouver General Hospital.
The minister also teased a number of upcoming improvements and changes to the health-care system, including a new peer support and mentoring program for new health-care workers, new clinical management supports in high-needs areas, and new professional practice and clinical educational roles that “bridge the gap between academic knowledge and clinical practice.”
The province also plans to expand GoHealth BC, which provides transportation for patients in rural and remote communities, launch a new provincial recruitment campaign next year and expand training opportunities for high school students interested in health care.
The progress report comes after a year of headlines about temporary emergency department closures, particularly in rural parts of the province, and urgent letters from doctors, nurses warning of “unsafe conditions and adverse outcomes” at Surrey Memorial Hospital.
Hundreds of thousands of British Columbians remain without a family doctor.
Dix has repeatedly said B.C. is hiring “record” numbers of doctors, nurses and paramedics, noting a growing and aging patient population that — in combination with the COVID-19 pandemic — has put significant strain on the health-care system. When it comes to cancer care alone, the minister said the province is forecasting a need for “50 per cent more of everything,” in addition to improvements and efficiencies in the system.
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Earlier this year, the province committed to waiving up-front application and assessment fees for internationally-educated nurses and reducing barriers in the regulatory assessment process that make it challenging for them to work in B.C.
It has also made financial support available to cover eligible costs associated with nurses reentering the workforce. Nurses returning to the practice can access up to $10,000 in bursaries for any additional education or training required as well.
Two significant changes were introduced this year to improve the recruitment and retention of doctors and nurses, billed as a “transformational” by Dix.
In February, the province moved away from the longstanding fee-for-service model for doctors, implementing a new system that considers the time a doctor spends with a patient, the number of patients a doctor sees in a day, and the number of total patients a doctor supports through their office.
The model, developed in collaboration with Doctors of BC and BC Family Doctors, is built around a full-time equivalent, full-service family physician providing 1,680 hours, seeing 1,250 patients of average complexity, and having 5,000 encounters or visits each year.
Based on those targets, doctors could earn $385,000, up from an average of $250,000.
While not yet fully implemented, B.C. is also poised to become the first Canadian jurisdiction to enact a nurse-to-patient ratio, following negotiations with the BC Nurses’ Union. That announcement came with $750 million over three years to address the nursing shortage.
The new ratios will be one-to-one for critical care patients, one nurse for every two mental health patients, one-to-three for specialized care patients, and four-to-one for palliative care patients.
The B.C. government has also expanded the scope of practice for pharmacists and shifted the staffing model for paramedics in certain communities in an effort to improve service levels and alleviate pressure on the system.
In the spring, dozens of doctors and midwives penned letters to health-care officials and the public stating that quality of care in at Surrey Memorial Hospital was in real jeopardy and had compromised public safety.
One letter from women’s health-care providers stated that the strain on resources had resulted in outcomes that “fall sharply below the standard for a tertiary level maternity care centre in our province,” and even suggested it had contributed to one infant’s death, “countless near misses” and grave “moral injury.”
Another letter from emergency room doctors warned of “unsafe conditions” and a failure to communicate the breadth of the “crisis to patients and the public,” while the former medical director of Surrey Memorial Hospital said the crisis had reached a “boiling point,” marked by a shortage of house doctors and acute care beds.
In September, Dix provided a progress report on measures taken specifically to address the care issues at Surrey Memorial Hospital.
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