Early results from a large-scale, multi-year study of rural health care in B.C. have shown transportation and access to care are major challenges.
The Rural Site Visit Project, which is believed to be unique in its size and scope, is aiming to interview health-care providers and stakeholders in all 201 rural communities in the province about every aspect of their services.
Since 2017, researchers have visited over 100 rural communities and spoken to over 300 local representatives including First Nations leaders, municipal councils, health-care providers and businesses.
The outgoing project leader, Dr. Stuart Johnston, said the research has backed up “what many of us working in the rural areas have always thought and said.”
Johnston said transportation was repeatedly flagged as an issue in each community the Rural Site Visit Project visited.
“During the time of this study, Greyhound withdrew the services. We had some amazing situations. There was one patient who was attending radiotherapy for their cancer and the only way of getting to it was Greyhound. So when that happened, the treatment stopped. We have had mothers who’ve had to drive from Fort Nelson to Fort St. John and stay in a hotel for four to six weeks prior to the delivery of their child with no family around them, no support,” said Johnston.
Johnston said transportation remains a very big challenge for rural health care despite other services being set up in the wake of Greyhound’s departure.
“On the bright side, we’ve found some amazing solutions that have been developed around British Columbia. Seabird Island, which is a First Nations community, has introduced a bus service and done a number of other things to improve access for the community, which has been both very practical and very successful,” said Johnston.
Johnston said access to care, including the ability to see a doctor or nurse practitioner, was also identified as a challenge.
Researchers also heard that communities wanted to stop the centralization of health services and return those services to rural areas, Johnston said.
“Those communities that had great relationships with their health authorities had managed to preserve services to a large extent. Those communities that had been granted some autonomy as to how they spent their money had done so in a manner where it was entirely contextually appropriate within the communities and they were very successful as well,” Johnston said.
The researchers aim to complete visits to the remaining rural communities in the coming years and continue providing the information to the province and provincial committee on rural issues.
Johnston said the work is already informing policy.
“To the government’s credit, as a result of the early information that we brought back on transportation issues, the government has brought in more ambulances and more air transportation available to the rural areas of British Columbia,” Johnston said.
Johnston says the research has already led to collaboration between communities and policymakers and he hopes that further collaboration will be a major takeaway from the research.
“The person sitting on Blanshard Street in Victoria really doesn’t understand the realities of some remote community in rural British Columbia. For all that their intentions are good, the reality is that whatever they think might work often has not worked,” Johnston said.
Johnston suggests policymakers and those providing and receiving health care should sit down together and collaboratively work out solutions.
“That has proven to be a very successful model … Those who are at the coalface (providing and receiving health care) need to understand the constraints that the government works under. Those in the government need to understand vice versa,” he said.
The Rural Site Visit Project is being conducted by the Rural Coordination Centre of B.C., a government-funded but physician-led group.
The project has published the early results of its research in the British Medical Journal.