Health-care boost or profit-driven bureaucracy? B.C. offers virtual care contract

The provincial government is offering a service contract for a company that can provide physicians or nurse practitioners to field up to 1.5 million virtual appointments for British Columbians, CTV News has learned.

The application package for “British Columbia (BC) Access to Episodic Virtual Care Services” requires at least 150,000 appointments per year, which would exclude all but the largest health-care providers and corporations in the province.

Several physicians have spoken to CTV News about the move, describing it as a surprise strategy outside the usual bounds of negotiation and policymaking – and one that corporatizes health-care and adds unnecessary bureaucracy while centralizing control with the Ministry of Health. They spoke on background, fearing reprisal for questioning government policy. 

One pointed out that virtual appointments are quicker and much more profitable than in-person care, which often involves physical exams and treatments that require more time and supplies. 

The goal, applicants are told in the package, is to “add additional dedicated access to episodic virtual primary care services coordinated at a provincial level in support of the province’s primary care strategy,” it reads in part. Physical assessments or exams would then need to be referred to a clinic or primary care practice with a family doctor or nurse practitioner registered and accredited to practise in B.C.

Under their current agreement with the province, family doctors are limited in how many unattached patients they can see as part of their practice, with a cap on the number of appointments per day.

Patient and public health-care advocate Camille Currie, co-founder of BC Healthcare Matters, suggested that access to medical care may not improve for patients, with a middle-man profiting in a unnecessarily complicated system, if the plan goes ahead as proposed.

“This money could've been used in a very different way,” she says. “It could help bolster our community practices versus now how many millions of dollars – perhaps billions of dollars, I don't know – will be funnelled into corporations, instead of the clinics that are struggling.”

In an email statement, the Ministry of Health defended “the need to expand short term solutions to complement these long term efforts, because people need these services here and now” while they work to recruit more nurse practitioners and family doctors to provide long-term care.

“This will help people get access to health-care services they need when they need it, and help relieve stress on emergency departments, where we know people turn to if they don’t have after hours access to a primary care provider, even if they don’t require emergency care,” wrote a spokesperson.

The application package was issued Dec. 8 with a Jan. 11 deadline for submissions, which sources describe as being a remarkably quick timeline, particularly over the holidays when there’s less attention on news and government policy.