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Health minister expects even bigger demands on health-care system in 2024

But Adrian Dix says the province is moving in the right direction, with new hirings of doctors, nurses and other health professionals, as well as more surgeries and tests

B.C. will see more people in hospital beds in January than ever before, as post-pandemic fallout combines with the peak of respiratory illness season, says Health Minister Adrian Dix.

The increased demand for hospital beds comes amid challenges including the ongoing toxic-drug overdose crisis, now in its eighth year, a shortage of nurses and family physicians, and a population that’s growing and aging.

But in a year-end interview with the Times Colonist, Dix noted that thousands of workers, including doctors and nurses in everything from maternity to cancer and long-term care, have been added to the system.

He pointed to increased capacity and output in surgeries, primary-care visits and diagnostic tests, and the number of new hospitals and cancer-care centres that are planned.

“Whether that meets the test or not is, of course, always going to be for people to judge and we’ve always got to do better,” Dix said.

“What we know is that there’s going to be a bigger challenge next year than this year that we’ve got to continue to try to meet,” he said in late December.

Lack of access to health care — largely due to staffing shortages — became a defining concern last year, resulting in ER and clinic closures, and increases in wait times for orthopedic surgery and cancer care.

Port Hardy Hospital, where overnight emergency-room closings began a year ago, saw additional daytime ER closings over Christmas despite a $30-million plan, announced last January, to stabilize health care in the North Island.

Saanich Peninsula Hospital’s emergency room remains closed overnight after a “temporary” summer closure implemented when not enough physicians were available to fill shifts.

Despite a new payment model for family doctors and extra funding provided for primary care walk-in clinics to remain open, many still closed last year, urgent and primary care centres (UPCCs) didn’t always have doctors to staff them, and orthopedic surgeons in Greater Victoria warned patients of months- and years-long waits for elective surgeries.

Some patients facing long wait times for care opted to pay for surgery in other provinces or the U.S., or even, in the case of a cancer patient, for medical assistance in dying.

Dix said he’s not satisfied with the cancer-care system, which he said was underfunded “year after year every year” before 2017 — when the B.C. NDP formed government — and had “notoriously chaotic leadership” during that period.

The experiences of patients reporting waiting six to nine months to see an oncologist or for chemotherapy treatment — way beyond the four-month benchmark — are not the norm, said Dix. He said he always has the “longest waiters” for care on his mind.

That was why the province offered breast and prostate cancer patients who had waited too long for radiation therapy the option of getting treatment, all expenses paid, in Bellingham, Washington, he said. About 400 people took up the offer.

Dix said more chemotherapy has been provided through the province’s 42 chemotherapy sites and about 16,000 people have received radiation therapy in B.C.’s six cancer centres in the fiscal year 2023 to date.

“This is a hard story and if you have family members — and I surely do and a lot of people do — who are going through this process, it’s hard,” said Dix, pointing to the estimated 45,000 people a year who are expected to require cancer care in a decade, versus the 30,000 diagnosed in B.C. this year.

“In chemotherapy, we’re making improvements in terms of delivery against benchmarks, and we’re going to continue to do that and expand out.”

The province has hired 61 cancer-care doctors and about 27 radiation therapists since April 1. It also announced a $440-million, 10-year cancer-care plan in February that includes plans for a new cancer-care centre in Nanaimo, and increased the base salary for oncologists to $472,000 from about $410,000.

The minister said despite the many challenges, there were several successes last year, including completing a record number of surgeries week to week all through last fall.

“We are doing so much better than we did prior to the pandemic,” he said, “because we adopted a plan, we stayed true to the plan.”

On Vancouver Island, 1,570 surgeries were performed during the week of Oct. 22-28 compared with 1,502 in a similar week last year, and 1,432 in a similar week in 2019.

Dix said the province completed “dramatically more orthopedic surgeries than we’ve ever done before” — just over 1,000 in the fiscal year 2023 to date.

B.C. has generally gone from the bottom to the top of the list in the country for surgeries completed, said Dix, who acknowledged that anyone waiting too long for surgery doesn’t care about statistics.

“It doesn’t matter what the surgery is — cataract surgery, orthopedic surgery, it could be thoracic surgery — if you’re waiting any longer than a short period of time, it’s the dominant thing in your life … so I’m committed to reducing wait times for surgeries.”

Last year, 6,258 new nurses registered with the B.C. College of Nurses and Midwives, including 578 internationally trained nurses, 3,882 family physicians registered for the province’s new pay plan, 666 international medical graduates were registered, and more than 1,000 full-time ambulance paramedics and emergency responder positions were added.

Since 2017, more training spots have also been added — 602 nursing seats, up to 322 other health-care seats, 20 for midwives and 60 physician residencies.

“You’ve got to continue to make improvements in every area of care,” said Dix. “That doesn’t mean there aren’t challenges day to day at Saanich Peninsula Hospital or Royal Jubilee Hospital or on the North Island as we’ve seen [in 2023], or Nanaimo which has huge demand for health-care services.”

Dix said the net increase of family physicians on the heels of the new payment model for doctors and the tripling of nurse practitioners — to more than 1,000 from 300 in 2017 — is remarkable.

The Health Connect registry is making gains connecting patients with family doctors, he said.

“This year (2023) has been a really significant breakthrough year for primary care,” said Dix.

But the work continues, he said, noting the addition of 150,000 people to the B.C. population last year requires about 120 family doctors with about 1,250 patients each.

“We have to do it all again [in 2024] to keep building out, but I think those are significant changes and achievements.”

Dix said there’s never been a better time to enter the health-care field, given historic changes in agreements with doctors, nurses, health-sciences professionals and pharmacists.

“This is a time when the public health-care system is responding with immense reform,” he said.

“I’m as committed as I’ve ever been to this task, this job and to public health-care, providing people the care they need.”

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