Committee delves into rural health care
There are standing committees of the legislature that go years on end without doing anything. They are standing only in the sense that they are standing still.
Committees on education, aboriginal affairs and Crown corporations seem to exist only on paper, since they rarely get assigned to do anything.
But the legislature’s health committee — 10 MLAs from both sides of the house — has been unusually active for the past couple of years.
It’s kicking off another study tour next month, fresh from an earlier examination of end-of-life care. It’s too soon to tell if the work will amount to anything. Lots of committees compile reports or recommendation that go nowhere. (The end-of-life report was a good example. Although the report covered a variety of end-of-life topics, some Liberals balked at the assisted-death portion out of personal convictions. Rather than risk a split vote within the Liberal caucus, the report was simply shelved without being formally accepted.)
But the committee is at least going through the motions of exploring ideas in a field that consumes more than a third of the provincial budget.
Last week, it invited people to submit their ideas in answer to four specific questions.
They are: How can health care in rural B.C. be improved? What are the long-term solutions for recruitment and retention of health-care professionals in rural B.C.? How can a costeffective care system built around interdisciplinary teams be created? How can the effectiveness of addiction-recovery programs be enhanced?
It will be holding day-long hearings during the first week of July at various locations and is open to submissions in any form. (See committees at leg.bc.ca)
The above ideas and many more were tackled 10 years ago in the monumental Conversation on Health, a $10-million exercise that rounded up thousands of viewpoints on B.C.’s health-care system. For all the work that went into it, and the ideas it produced, it’s hard to find evidence that it accomplished anything. Former health minister George Abbott later conceded it didn’t achieve much.
MLAs now on the health committee are trying to take a more focused approach and concentrate on specific issues. Reading between the lines of the terms of reference, there is an implicit recognition that the earlier effort to find or train more doctors didn’t get the job done.
The government committed in 2010 to supplying enough GPs for every British Columbian by 2015. It renewed the goal as an election promise in 2013. Some progress was made, but there are still about 200,000 people without family doctors, and the government conceded last year the target was missed.
So the committee is left looking again at improving health care in rural areas — where the shortage of GPs can be acute — at the same time it’s looking at recruitment and retention. Including interdisciplinary teams is another implicit recognition of the doctor shortage. It’s a good concept all by itself, but the shortage of doctors elevates the urgency of the need for such teams.
Nurse practitioners were officially recognized in B.C. in 2005, much later than elsewhere. The concept was widely endorsed, but there are still only about 300 of them practising.
The committee is made up of six Liberals and four New Democrats, with matching co-chairs. It was given broad terms of reference and basically writes its own ticket. The latest terms of reference in March were simply to “identify potential strategies to maintain sustainable health care … and consider health capital-funding options.”
The latter aspect could be fraught with argument, as it seems to hint at looking at privatization of some sort. But the committee has worked up enough issues looking at sustainability, it doesn’t look like it will tackle funding questions in the foreseeable future.
In the past, it has also looked at the baby boomers’ impact on a sustainable health-care system, suggesting that the predictions of strain on the system are overblown.
The kicker in the latest effort is the look at addiction-recovery programs. It was written in as a result of the current wave of overdose deaths. It’s unlikely to conclude the current recovery programs are sufficient.