BCRHN executive director says province needs tailor solutions to individual communities’ needs

Prince Rupert city council has joined the BC Rural Health Network (BCRHN), a group that advocates health care solutions to rural and remote communities.

A tumultuous March which saw nine emergency room closures due to physician shortages in Prince Rupert has caused grave concern to many residents, who fear they are not being offered adequate health care services.

BCRHN executive director Paul Adams presented to city council at the March 25 committee of the whole meeting. The city applied to join the organization later in the week. City council has promised to work with relevant authorities to improve the desperate emergency room situation.

The healthcare challenges Prince Rupert has faced are a common occurrence in rural areas across the province. However, Adams said understanding each community’s unique needs is the first step in providing more equitable care.

“We’ve lost that connection to the community voice to cater to the specific community,” he said in an interview with The Northern View.

“One size does not fit all. We don’t have a situation where we can duplicate the model in every community around the province and have something which is going to work for everyone.”

While Prince Rupert and Fort Nelson in Northeast B.C. have similar emergency room problems, Adams said different solutions are needed for the two communities.

“If you go to the other side of the province up into Fort Nelson … they’ve got a four-hour commute to Fort Saint John and the stretch of highway between the two locations has no cell phone service,” said the Princeton, B.C. resident.

“Their issue isn’t physician supply. Their issue is nurse supply, so each individual community is having their own individual problems, but we’re trying to treat everything as one size.”

According to Adams, the province’s overall physician recruitment system has worked well, but rural communities are not seeing the same benefits as urban areas.

“We do have actually more physicians in BC per capita than we did a decade ago,” he said.

“But a lot less of them are willing to work in the rural environments because of the workload demand. So there is always onerous on-call obligations for physicians working in rural environments.”

Solutions to the province’s health care struggles have generally come without the input of rural communities according to Adams, who said the creation of the parliamentary secretary for rural health in February 2023 — currently North Coast MLA Jennifer Rice — was an encouraging shift toward listening to rural communities’ needs.

“The alarm has been going off for decades and we’re now into the late-stage panic mode,” he said.

“But we’ve known these challenges for years and years and we haven’t addressed it with the rural vision. We’ve looked at it from a very urban-centric point of view.”

Encouraging more rural youth into healthcare positions would drastically improve recruitment and retention in rural communities according to Adams.

“I think that we also need to do a much better job of recruiting students from rural backgrounds into education for health care,” Adams said.

“Because if you come from rural B.C. or you come from Rupert, there’s a fairly good potential that you’re going to return to a community in the North or to a rural place because that’s comfortable, it’s your home. But for an urban person who’s lived their whole life in Vancouver or a large urban centre, their movement to a rural place is a lot less likely. They’re going to want to be back where they’re comfortable, which is in an urban environment.”

Adams said physician assistants — who perform similar duties to nurse practitioners — should be used more in rural hospitals to improve emergency care. The province amended a bylaw in September 2023 to allow physician assistants to obtain practicing licences.

The BCRHN is also looking to address financial challenges rural residents face when needing organ transplants. Adams estimated that transplants can cost rural residents $50,000 to relocate to the Lower Mainland for the duration of their treatment, a barrier that he believes contradicts the Canada Health Act.

“If you don’t live in Greater Vancouver, you’re looking at … $50,000 in order to receive a transplant surgery in what is supposed to be a public healthcare system,” he said.

“You have to be there for three to six months post-surgery. And you have to have a care provider with you 24/7 throughout that period. None of that is covered. For example, if you live in Rupert, you’re going to maintain your home in Rupert, you’ve probably already lost your job because of your health, your care provider is probably your partner or your spouse, and [they’re] now losing [their] job because they have to take care of you for three to six months. You have to relocate to Vancouver, where you have to find accommodation and the notice that you’re given is literally a phone call that you need to be here now.”

Adams said he is speaking to Premier David Eby this month, where he will bring up the financial hurdles rural B.C. residents have to face during transplant operations.

”It’s written into the Canada Health Act and we need to make sure that it’s actually adhered to, because a lot of people that I‘ve spoken to are no longer with us because they couldn’t afford to get the surgery and they chose to take themselves off the list,” he said.

Prince Rupert became the 30th B.C. municipality to join the BCRHN, which also hosts regional districts, individuals and organizations as members.

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