Editorial: Langford clinic just a start on the crisis

Health Minister Adrian Dix has announced the opening of a new urgent primary care centre in Langford. The facility will provide 5,300 residents access to a family doctor once it gets up and running. Dix plans to open 10 of these clinics across the province by next spring. One is already operating in Quesnel.

Although the announcement is welcome, it must be taken in context. About 500,000 British Columbians have no family doctor. Even if the government is successful in opening 10 clinics, that will solve only a small fraction of the problem. It is also unclear what is meant by “urgent” care, since it appears anyone who needs to see a GP will be accepted.

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Calls to GPs’ offices around the capital region suggest there are hardly any family physicians accepting new patients. Some have waiting lists that run into the thousands.

The provincial Health Ministry operates a phone-in service called HealthlinkBC. It is supposed to connect callers with a GP who will accept them. Except it knows of none.

Walk-in clinics, already hamstrung by provincially imposed limits on the number of patients they can see, are at their wits’ end. Some are calling the situation in Victoria an emergency, which it clearly is.

It would be unfair to place all, or even most, of the blame on the current government. This is a crisis that has been years in the making.

But wherever the blame lies, the responsibility for dealing with the crisis rests with Dix. And there’s no point pleading poverty.

The Health Ministry just announced it will provide free medical care to international students at a cost of $50 million annually. We bear no ill will to foreign visitors, but when the government cannot provide adequate health care its own citizens, this decision makes no sense.

What then is to be done? Clearly, we need to train more GPs.

Although the intake at the University of B.C.’s medical school has been expanded, we are far short of the numbers required. But that means building more lab space, recruiting more staff — in short it means embarking on a project that will take years to complete.

A more immediate solution is to change the payment model for GPs. The current arrangement, decades old, is based on a fee-for-service system in which physicians must either buy or establish their own practice, pay rent, hire receptionists and purchase equipment.

The result is that many find themselves overwhelmed by administrative burdens that limit the time they can spend providing patient care.

Walk-in clinics emerged as an alternative to this system, but while they are essential as things stand, they are not an ideal option. Many patients who attend these clinics have no prior history with the doctor who sees them.

Several highly regarded family physicians have written to the Times Colonist proposing far-reaching reforms. They believe a younger generation of GPs would be more comfortable working on a salaried basis in the kind of clinics Dix is setting up. The problem is, 10 of these facilities won’t even scratch the surface.

What might it cost to provide family-medicine clinics for everyone who lacks a GP? The minister has said the price of operating the Langford centre will be $4.45 million a year.

There is no way of knowing whether this is a representative figure. The Quesnel clinic, in comparison, costs only $1.1 million to run.

However, using Langford as a model, it would cost in the region of $400 million to provide service for the 500,000 patients in need.

This is the roughest of estimates. It is intended merely to suggest the scale of the challenge.

Nevertheless, $400 million represents just two per cent of the Health Ministry’s budget.

If that’s what it costs to ensure that every British Columbian has access to a GP, the money is well spent.

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