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Baldrey: Court victory won’t cure health care system’s ailments

Appeals court decision to block expansion of private health care at the expense of public health care was welcome, but won’t improve access.
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Access to health care is increasingly strained in British Columbia.

The Canadian public health care system scored an historic and vitally important court victory last week, but it was a rare bit of positive news for a system that is facing huge and mounting problems.

In fact, the decision by the BC Court of Appeal to uphold a ban on doctors’ extra billing and a limit on private health insurance, while a win for the public health system, will have no impact on things like rising surgical wait times and emergency room closures.

For example, just one day after the decision was released, more small communities found their local emergency rooms either closed for the weekend or facing curtailed operating hours.

Places like Port McNeil, Port Hardy, Oliver, Chetwynd, Clearwater, Ashton and Hazleton have experienced the consequences that can result when even a small portion of their medical staffs book off sick (many with COVID-19) or simply leave their jobs.

And it is not just small towns that are facing major health care challenges. Royal Inland Hospital in Kamloops has been overcrowded with patients for months and emergency room wait times in pretty well every hospital in B.C. have been increasing steadily.

More than one million people in B.C. do not have a family doctor to provide them with longitudinal care through their lifetimes. As a result, they will likely face more health care-related problems later in life.

These are not problems unique to British Columbia. All provinces, particularly the most populous, are all facing similar issues.

There is a growing crisis in many sectors when it comes to a lack of human resources. Not only do we not have enough doctors and nurses, but we do not have enough health technicians, qualified ferry workers, skilled construction workers or even restaurant workers.

When these shortages occur in non-health care sectors, they result for the most part in inconveniences, delays and annoyances for those affected. When they occur in health care, however, the impact can be more serious.

There is no easy or quick fix here.

It is not like a heck of a lot of money is not being spent to address the problems. The B.C. government hiked this year’s health ministry budget by $1.6 billion, opened hospital operating rooms in the evening and on the weekend, hired dozens of health care professionals and still the situation seems to be deteriorating.

Some structural changes seem required: ending or limiting the fee-for-service payment model for family doctors and hiring more nurse practitioners have been suggested by some.

Canada’s premiers continue to clamour for the federal government to increase health care spending by more than $25 billion a year, but it is far from clear whether even that kind of increase will solve the crisis that is building in health care.

To be clear, the court of appeal’s decision to block the expansion of private health care at the expense of public health care was a welcome one for the vast majority of Canadians.

If the court had allowed the private system to further raid the public system of doctors and nurses (thereby greatly increasing wait times even more) the result could have had disastrous consequences for the public health system and those it serves.

The court decision will undoubtedly be appealed to the Supreme Court of Canada.

It will take time for the issue to make its way to the top court, but in the meantime it appears to be a safe bet that the problems in the system we all have a vested interest in protecting will continue to grow.

Keith Baldrey is chief political reporter for Global BC