Debates of the Legislative
Assembly (Hansard)
Estimates: Ministry
of Health
Committee C
Wednesday, May 16,
2012 Afternoon Sitting
---------------------
Fraser-Nicola MLA
Harry Lali:
I'm going to switch
to rural health care and rural hospitals. I'd like to ask the minister why the
B.C. Liberals are abandoning the health care needs of rural communities like
Merritt, Ashcroft, Cache Creek, Lytton, Princeton and all these small rural
communities across the province. For rural health care….
I was wondering why it
is that this government is not looking after the health care needs of small
rural towns and small hospitals or health centres. I named a few communities in
my constituency, like Merritt, Ashcroft, Cache Creek, Lytton, Lillooet,
Logan Lake, Clinton and Princeton.
Hon. M. de Jong: The
member will understand that I disagree and dispute the premise of the question and
will endeavour over the course of our discussion to highlight the basis for
that disagreement. I'll begin by talking about one aspect and admittedly one
aspect of rural health care, but it is one that I'd suspect many rural British Columbia
residents utilize as a benchmark for the
provision of health services. That is their access to a physician. Let's go
over some of the facts surrounding physician supply in rural B.C.
The concern we had around
this was revealed in the fact that we took seriously the observation that in
order to attract physicians to rural British Columbia, to northern British
Columbia, you probably had to take greater steps to ensure that there was some opportunity
to train as a physician in that part of British Columbia. That gave rise to the
northern medical program to actually educate doctors in northern B.C. It's not,
admittedly, a cheap or shortterm solution but one that we thought particularly
warranted, given some of the challenges that communities were facing and based,
of course, on the premise that if you're a physician educated in a rural area,
you're more likely to stay there.
We are beginning to
see the benefits of that strategy. The first cohort of graduates is beginning
to practice in B.C., and 40 percent of those who have graduated from the northern
medical program and are practicing have set up practice in northern B.C. Now,
it is a modest start but one that I believe will reap huge benefits going
forward. The fact that we are training twice as many physicians in British Columbia
today as was the case ten or 11 years ago…. I will ask, and I'm sure the member
will want to offer an opinion. As someone who was there at the time, he is
perhaps well positioned to offer an opinion, at least, as to why the province chose
during the 1990s not to expand by one the number of physicians we were training
here. There's one thing about demographics. They don't sneak up on you. It was
so abundantly clear as to what was going to be taking place. Yet it wasn't
until 2002 that concrete steps were taken to address what was clearly emerging to
be a physician supply problem.
Now, we took those
steps, but the length of time it takes to train a physician, move them through
residency programs and have them available to serve communities is lengthy.
Only now are those physicians becoming available. Between 2003 and 2009 the
number of doctors practicing in rural areas has increased from 1,770 to 2,269 —
an almost 30 percent increase. Here's another interesting number. B.C. has 874
rural residents per GP, according to 2009 statistics from the Society of Rural
Physicians of Canada. So 874 rural residents per GP, compared to the Canadian average,
which is 1,153. We are dramatically below, in a positive way, the national
average.
There are still
issues, however. In fact, in some communities there are serious issues around
the provision of medical services. That's why we introduced the rural recruitment
incentive fund, for up to $20,000; the rural recruitment contingency fund; a
loan forgiveness program for nurses, nurse practitioners, medical residents, doctors.
The province will forgive any outstanding B.C. student loan at the rate of 33
1/3 percent per year. After three years one of those medical professionals will
have their student loans completely paid off or forgiven as an incentive to get
people to practice. There are, despite that, situations in which we experience
shortages of specialists — ER physicians prepared to offer services and be on call
for emergency room services.
That's why we created
an additional fund of $10 million to facilitate additional emergency room
coverage in rural areas of British Columbia. A community like Princeton, for example,
can submit a plan to say: "With an extra $100,000, this is how we plan to
expand" — or maintain, for that matter — "emergency room
coverage." Communities across B.C. have availed themselves of
that.
The last thing I'll
say by way of introduction to this matter is the government a number of years
ago introduced and passed legislation establishing the nurse practitioner, a
graduate level training program that provides registered nurses with enhanced
training. We now graduate upwards of, I think, 40 or 45 nurse practitioners per
year.
…to be continued
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