B.C. health-care crisis: Bigger bureaucracy, longer waits and calls for an overhaul

British Columbia’s health-care bureaucracy is growing while the front line thins, prompting fresh calls for attention to physician recommendations and even a complete overhaul of the healthcare system.

The BC Green Party pointed to the crisis at Surrey Memorial Hospital, and a legal battle between a health authority and an urgent care centre that was too efficient and blew past its meagre diagnostic budget as examples of serious issues that can’t be handle by piecemeal tweaks to the current system. 

“It has become clear that a suite of reforms is required to bring our health-care system out of crisis,” said leader Sonia Furstenau at a press conference Wednesday.

She pointed to a bloated and growing bureaucracy as contributing to the crisis, saying with “64 vice presidents across the health authorities, we have just an absolute multitude of managers and project managers.”

In the first five years of the NDP’s tenure, B.C. saw an increase of nearly 12 per cent in costs for hospital administrators, according to data from the Canadian Institute for Health Information. That’s triple the growth in Alberta (3.6 per cent) but half of Ontario (21.8 per cent).

Dr. Sanjiv Gandhi, the former head of heart surgery at BC Children’s Hospital, pointed out that “Clearly there would be resistance from the inside in reducing the levels of bureaucracy that exist,” but that growing the administrative ranks doesn’t serve patients.

“They're not just not helping them get better,” he said. “They're making it harder to access care and to navigate the system.”

SPECIALIST WAITS GETTING LONGER AS RED TAPE PERSISTS

The province’s specialist doctors point to bureaucracy and red tape contributing to long waits. They tell CTV News, since last year’s analysis that one million British Columbians are currently waiting to see a specialist, anecdotal evidence leads them to believe that’s only worsened.

“There's a lot of inefficiency in our system and we can remove a lot of that, but that takes work between the government and physicians to find creative ways to do that,” said Consultant Specialists of BC’s former president, Dr. Chris Hoag.

He believes the fastest way to address that is empowering doctors and funding their ability to work in clusters to maximize the insufficient number of specialists we currently have, while boosting training spots in the future.

“With team-based care I think there's the opportunity to make every physician essentially 1.25 to 1.5 physicians by allowing us to expand our ability to serve patients,” Hoag said.

EVIDENCE THE SYSTEM IS IN SHAMBLES

His comments come on the heels of Vancouver Coastal Health’s takeover of an urgent and primary care centre that’d been providing team-based care and was processing so many patients, it quickly blew past the health authority’s meagre diagnostic budget and continued to see patients until it was millions in debt and facing receivership.

“We're able to see a lot of cases that would otherwise go to overburdened emergency rooms,” said Seymour Health chief medical officer, Dr. Eric Cadesky on Monday.

Vancouver Coastal Health told CTV News the clinic should’ve sent patients away when it ran out of its approved budget, which stunned healthcare workers who pointed out the province pays for all patient services anyhow and should’ve authorized the fastest available care.

“The amount of money you're actually saving by not having those patients go to an in-patient facility (like a hospital) totally makes up for what you're spending at the UPCC,” said Gandhi, who agreed with sources who spoke to CTV News on the condition of confidentiality as they feared professional repercussions for speaking out.

30 patients waiting to be seen when I came on shift at 11pm last night. Highest #ERwaitTime for more stable pts was 12 hours. I'm the only doc from 1:30-6:30am. Worst wait time I've ever seen at #DeltaBC Hospital. Colleague remarks, "I have never seen it this bad in 25+ yrs." 1/

— Anthony Fong MD👨‍⚕️🇨🇦 (@fongafriend) June 14, 2023