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B.C. plan for urgent care centres, more doctors unveiled

Funding to hire up to 200 new family doctors part of big shift in primary health delivery
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Premier John Horgan: “In Chilliwack, one in four people don’t have access to a primary care provider. For families, it often means if they need service in the evenings or weekends, they often find themselves in an emergency room.”

Premier John Horgan’s government will create new “urgent primary care centres” across the province, and hire more doctors, in an attempt to redirect sick British Columbians who don’t have family physicians from long waits at hospital emergency rooms.

The three-year plan represents a major shift in how the provincial government will deliver primary health care, and will come with $128 million in annual funding increases once the system is phased in.

It will start with new “primary care networks” with websites to help local residents find the right physician or care provider, with pilot sites in Burnaby, Richmond, Prince George and South Okanagan-Similkameen.

From there, the government will create at least 10 new urgent care centres in the next year, with “the locations to be announced in the weeks ahead,” Horgan said.

They will be spread so that there are at least two in each of B.C.’s five regional health authorities in the north, Interior, Fraser Valley, Vancouver Island and Lower Mainland.

The proposal was a promise by the B.C. NDP in the 2017 election.

Horgan said the goal is to shift B.C. toward team-based health care, where doctors, nurses, pharmacists, dietitians, mental health professionals, social workers, physiotherapists and others are grouped together in one spot to treat patients.

“They will meet their needs where they need it, when they need it,” Horgan said.

“Far too many British Columbians cannot find a family doctor. In Surrey alone … 78,000 do not have a primary care provider. That’s [equivalent to] the entire city of Prince George. Imagine that, that there’d be no family doctors in Prince George,” he said.

“In Chilliwack, one in four people don’t have access to a primary care provider. For families, it often means if they need service in the evenings or weekends, they often find themselves in an emergency room.”

The urgent primary care centres will be open on evenings and weekends “to take the pressure off emergency rooms where families often find themselves because they have nowhere else to go in the community,” Horgan said.

The centres could accept appointments or walk-in patients, depending on the preference of the local community. The Ministry of Health said the goal is to have people seen within the same day they ask for help.

In the hypothetical example of a parent with a sick child on an evening or weekend, the ministry said the nurse or doctor at the centre could diagnose the child and then help get the parent get any X-rays, tests, blood work or diagnostics that need to be done that same day at a nearby location, or even within the centre.

That way, the parent would not have to sit for hours in a hospital emergency room, where they would be treated as a non-urgent case and could face long delays.

More than 780,000 people in B.C. — almost 17 per cent of the population — don’t have a family doctor, despite promises from the previous B.C. Liberal government to link every person who wanted a family doctor with a physician.

The Ministry of Health said 44 per cent of B.C. residents can get a health-care appointment within a day, and only 27 per cent can get care in the evenings, weekends or holidays outside of visiting an ER.

In hospitals, it’s estimated 36 per cent of patients who last visited the ER had a condition that could have been treated by a family physician if they had had one.

Health Minister Adrian Dix said the changes will not happen overnight and the government is willing to listen to ideas to improve the plan as it is being rolled out.

“We do know the model of primary care that has existed in British Columbia since the creation of medicare is in need of change,” he said.

The government will provide funding to hire up to 200 new family doctors, with money available for them to take salaries instead of billing fee-for-service payments if they would prefer.

The new urgent care centres could be owned by local health authorities, the province or groups of physicians, thus relieving new doctors of the administrative workload of staffing, leasing space and running a business.

“Not everyone who comes out of med school wants to buy into a practice and take on all those responsibilities,” Horgan said.

Doctors of B.C. president Dr. Trina Larsen Soles said physicians support the premier’s plan.

“I find his plan to be bold and extremely ambitious,” Soles said. “All of us here, and I speak particularly for doctors, want to ensure patients have access to the right care at the right place at the right time.”

The government also announced funding this week for 200 new nurse practitioner positions.