Vital agency or unnecessary bureaucracy? B.C.'s $10M department you've never heard of

Planning for and co-ordination of medical resources during natural disasters, pandemics and other emergencies is important, but is a separate agency required when B.C.'s health authorities still have to do the heavy lifting?

That’s the question arising from a CTV News analysis of Health Emergency Management BC, an agency that few in emergency preparedness or the health-care system have ever heard of, but has been costing taxpayers nearly $10 million a year in operating costs alone.

The agency's mandate is described as largely advisory – co-ordinating and planning – with the health authorities making decisions and executing responses that require redeployment or reconfiguration of medical resources. If there’s wild weather on the way, for example, HEMBC will make sure the relevant health authorities, ministries, emergency response leaders and meteorologists discuss the risks and options.

HEMBC is referenced in some health authority documents involving planning for heat events, and the Provincial Health Services Authority has an informational video on its website, but even that branch of the provincial health system is poorly understood. Questions around the actual role that HEMBC plays on the ground – and whether it's even needed – led to an exclusive interview with the agency's executive director. 

In a wide-ranging discussion, John Lavery explained that HEMBC’s role traditionally focussed on disaster training simulations at hospitals and airports, as well as planning and co-ordination of health-care resources, personnel and patients during natural disasters. The agency has been performing a secretariat role during the COVID-19 pandemic, which resulted in allegations of obfuscation of hospital outbreak reporting.

“We had over 75 emergency operation centres or EOCs activated throughout the pandemic,” Lavery said, insisting it wasn’t HEMBC's role to determine why outbreaks happened, nor what to do about them.

“It's the health authority that takes the lead on the after-action reviews.” 

Several sources have told CTV News there’s a “challenging” relationship between the province’s five health authorities, with competition for resources and funding. Established in 2013, HEMBC appears to be designed to overcome that inherent friction by getting everyone in the same room together and acting as a third-party to mediate how to proceed in an emergency.

“We can make recommendation on actions, and then bring them together to have those discussions,” said Lavery. “It's ultimately their decision, but we provide them the best information we can and provide them support.”

ROLE UNCHANGED DURING HEAT DOME

CTV News asked Lavery why HEMBC didn’t take a more active role during the heat dome, when more than 600 British Columbians died after what the provincial health officer acknowledged was a typical response to a very exceptional forecast and weather pattern. 

“We do notify the health authorities when there are things happening and start that conversation around what the response should be,” he said, again insisting that actions are up to health authorities and HEMBC is just a facilitator.

“Our communications department circulate information to staff, usually to their leadership team, to let them know there's a possibility a heat warning is coming in two or three days and reminding them of actions they should take.” 

That communication did not reach everyone who needed it. Few knew the “level 2 heat alert” issued as the heat dome was ramping up was unprecedented, and even within health authorities, staff dramatically underestimated how bad it would be. 

Lavery pointed out HEMBC rented fans and air conditioners, which they distributed to unspecified locations during the heat dome.

UNECESSARY BUREAUCRACY OR VITAL CO-ORDINATOR?

HEMBC is responsible for four “hospital in a box” units that can be deployed to flooding or fire-ravaged areas of the province to be unpacked and set up in gymnasiums or other temporary locations. A mobile medical unit used during the 2010 Olympics is also in their arsenal.

They also set up the temporary field hospital in the Vancouver Convention Centre at the start of the pandemic, which was never used and the subject of criticism, since health-care workers said there simply weren’t enough of them to operate it in the event of hospitals overwhelmed with COVID-19 patients. 

Whether it’s the equipment, training or co-ordination efforts, the question is why HEMBC is needed when the health authorities have to staff and implement plans when required – particularly at a time when health-care funding is one of the top issues in the province.

CTV News asked Lavery whether HEMBC is good value for money for taxpayers, when its role seems to largely duplicate services and roles. 

“The work we're doing is providing support directly to the health authorities,” he said. “If it wasn't being done by our program, the health authorities would have to hire people to do the same work.”