B.C. Election: NDP promises to connect more to a family doctor by 2026, but is that achievable?

Premier David Eby's health-care plan also promises to "axe the fax," hire physician assistants and grant provincial licences in six weeks

Published Sep 23, 2024  •  6 minute read

B.C. Premier David Eby campaigns in Surrey on Sept. 20. Photo by Arlen Redekop / Postmedia

NDP Leader David Eby promised more action to address health care in B.C. on Monday, stating a renewed mandate for his party would allow 160,000 more British Columbians to get connected with a family doctor over the next six months.

He also promised at a campaign stop in Burnaby to grant permission for physician assistants to work in the province, expand the scope of practice for pharmacists, streamline paperwork for doctors, and reduce the waiting time for physicians, nurses and midwives to get provincial licences.

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Reaction from the health-care community was mixed, with several physicians and researchers saying that while many of the promises laid out by the NDP are positive, they’re not enough to address the strain currently being placed on the health-care system.

At a table laden with tea, muffins and other baked goods provided by their hosts, Lou and Maxine, Eby and local candidate Paul Choi promised to continue taking steps to attach all British Columbians to a family doctor.

“We’ve connected 250,000 British Columbians to a family doctor and, with the physicians and nurse practitioners we know that are coming online, we can connect another 160,000 people over the next six months,” Eby told reporters, repeating the claim that the NDP has brought over 800 new family doctors into the system since February 2023.

“We believe that by the end of 2025 we will have worked our way through the backlog of everybody in the Health Connect registry who has registered to get a family doctor.”

B.C. Family Doctors and the College of Family Physicians estimate there are around 700,000 British Columbians without a family doctor, but the NDP have tried to tout this as a step in the right direction after numbers surfaced that there were over one million residents in B.C. without a family doctor as recently as 2022.

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Eby said the plan announced Monday will help reduce this number further, pointing to promises such as immediate licensing for Canadian trained physicians. Health-care workers trained outside of Canada in “comparable regions” will also be able to get their licence within the span of six weeks, according to the NDP leader.

“These are the kinds of solutions that will address issues of emergency room closures in different parts of the province, because the issue is a shortage of health-care workers,” said Eby.

“In the longer term, a new medical school in Surrey, the 160 additional spaces at UBC for physicians and the 600 new spaces for nurses, we’re graduating 1,900 nurses a year right now, will make sure that we have the health-care professionals we need to keep our system running.”

B.C. Family Doctors president Dr. Maryam Zeineddin said that while initiatives such as the Health Connect Registry and the elimination of sick notes are a great step in the right direction, there is a lot more that needs to be done if the province is going to attract and retain family physicians.

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She said many family physicians don’t have the resources they need in order to handle the increasing amount of overhead they face and in many instances are unable to provide patients with the care they need because other parts of the system, such as specialists, are collapsing under the weight of ever-increasing demand.

“Go back to the drawing board and figure out, ‘OK, what do family doctors need?,’ ” said Zeineddin.

“They need infrastructure. They need supports with their business costs. They need supports with their overhead. They need the team-based approach so that they can have access to resources and other allied health-care providers for their patients. We need imaging, like right now. Everything is probably at its worst, so let’s start fixing them one-by-one.”

Dr. Kevin McLeod, a North Shore-based internal medicine specialist, said he is happy to see the NDP finally recognize the importance of physician assistants after calling on the government to allow them to practise in B.C. for the last four years.

He said that what he really needs isn’t help with paperwork, but rather somebody to follow up with patients after an appointment, which is something a physician assistant could do.

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Another problem for McLeod is just the sheer volume of patients he is seeing on a daily basis.

“I’ve been doing this for 20 years, I think I’m pretty efficient. But I can see maybe 16 complex patients a day. I can tell you today I’ve got 53 people on my list,” he said.

“Part of the problem for me is that 30 per cent of the patients I see do not have any kind of follow-up primary care. They might have been referred to me from an emergency department or an urgent care centre or walk-in clinics. How do I follow up on some of that stuff? And it doesn’t need an internal medicine specialist to follow it up. That’s where a physician assistant or nurse or somebody else could do that.”

Not everyone thinks the introduction of physician assistants is the right move, however, with Dr. Sabrina Wong, a UBC Nursing professor, pointing out that the province has already double the amount of nurse-practitioners getting trained.

She said the focus should instead be on wider team-based care, a sentiment McLeod agrees with.

“B.C. has historically been fairly slow in the implementation of nurse practitioners and previous work has shown that there’s been limited uptake in the use of team-based care,” said Wong.

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“I think we could do a lot more in terms of implementation of nurse practitioners and implementation of team-based care before we go down the path of introducing a new health profession in British Columbia when we can’t even use the ones that we have.”

Wong did applaud the NDP promise to expand the role of pharmacists as a necessary step to relieving some of the burden on physicians.

The measures announced Monday are also very much a continuation of the health-care plan that the NDP have pursued since Eby became premier in November 2022 and differs greatly from Conservative Leader John Rustad’s plan to implement waiting time guarantees and use public dollars to pay for private treatment for those needing to access care right away.

Dr. Sian Tsuei, a University of B.C. clinical assistant professor in the Department of Family Practice, said the question of whether B.C. is better served by a fully public or a combined public-private system isn’t a simple one, with the government having to weigh the importance of expediency versus patient equality.

“When we talk about public versus private, I think we have to divide it into two parts. We talking about financing or are we talking about organizational delivery?,” said Tsuei, explaining that a lot of service delivery is already private.

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“If you have public forms of financing, everybody’s paying into a single pool, and if you need services, you can spend that pool. If you allow private financing to come to the equation, then people who have the money, they can jump the queue and that starts to get at the question of, ‘Is this equitable or not?’

McLeod said that at the end of the day he doesn’t believe either the NDP or the Conservatives has a solid plan to fix the health-care system and said he is unsure about who he is going to vote for, for the first time in his life.

He said he wants to see more outside-the-box thinking from the two parties in line to form the next government.

“I don’t really see great ideas on either side of the political spectrum for how we’re gonna fix some of this stuff,” he said. “If the solution was to pour more money into it, it would be fixed by now, because the NDP has dramatically increased health-care spending.”

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