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B.C. Conservatives pitch health-care changes, more private clinics

VANCOUVER — The leader of the Conservative Party of British Columbia says as premier his government would pay to send people outside the province for health care and expand private clinics in an effort to fix a system "in crisis.
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B.C. Conservative Party leader John Rustad speaks to members of the media during a year-end availability at legislature in Victoria, B.C., on Wednesday, December 6, 2023. Rustad says as premier his government would pay to send people outside the province for health care and expand private clinics in an effort to fix a system "in crisis." THE CANADIAN PRESS/Chad Hipolito

VANCOUVER — The leader of the Conservative Party of British Columbia says as premier his government would pay to send people outside the province for health care and expand private clinics in an effort to fix a system "in crisis."

John Rustad acknowledged Thursday that if his party were to form government in October the plan would cause the provincial budget to "spike," but said in the long-term it will bring down per-capita health-care spending.

"Our health-care system in B.C. is in crisis. More than that, it is failing. More money into the system is not the solution," he said.

"What we need to be doing (is) actually be looking at models from throughout the world that work well and look at how we can be using those in B.C."

Rustad's promises, three months before the provincial election, also include compensating health workers who lost their jobs for refusing to get the COVID-19 vaccine.

The health-care plan is the first major platform piece for the party and has the governing New Democrats accusing Rustad of planning big health cuts, while the Opposition BC United claims he stole their ideas.

Rustad said expanding publicly funded partnerships with non-governmental clinics for specific procedures and diagnostic services will get people off wait-lists and that similar models in Europe prove it can be done "seamlessly."

He could not provide numbers for how much he expects the health-care overhaul would cost.

"My anticipation is that we will see an initial spike up in spending as the model comes in place, but then that will level off to a place where we'll see the cost per capita dropped over time," he said.

"I don't have the precise numbers," he said. "There are a lot of complexities that have to be put in place as we do the transition."

Documents released by the B.C. Conservatives to accompany the plan highlight a report by Deloitte that projects Canadian health spending as a per cent of GDP will grow to 13.9 per cent by 2040 and suggest "modernization" can bring that down to under 11 per cent.

The report includes calls for more virtual care and improved data collection.

New Democrat member of the legislature Ravi Parmar told reporters after Rustad's announcement the reduction would mean a loss of $4.1 billion in health spending.

"At a time when we should be investing more in health care in British Columbia, John Rustad and the Conservatives are proposing taking money away from our health-care system," he said.

A statement from BC United says it was the first party to propose to publicly fund treatments at existing private clinics to immediately clear waiting lists and hire back health care workers who were fired due to the vaccine mandate.

“The Rustad Party copying our health care platform, which was created with the input of our strong team of physicians running for BC United in the upcoming election, simply shows that BC United is leading the charge to fix the NDP’s health care crisis,” candidate for Surrey-Cloverdale, Dr. Claudine Storness-Bliss, said in the statement.

Jason Sutherland, with the University of British Columbia's Center for Health Services and Policy Research, said multiple Canadian provinces, including British Columbia, outsource some surgeries to private clinics.

He said no province does enough volume of those procedures to know what the impacts of a large program would be.

"If they can scale up and find enough surgeons, where do they find all of the other skilled people that they need for surgery? Like anesthesia nurses, post-op recovery room nurses?" he said.

"If they recruit them from the hospitals, then the public hospitals aren't going to be able to do the surgeries they were doing before. So, if they lured them away, are they harming public hospitals? I think that's an untested hypothesis currently in Canada."

Rustad said his plan to attract more workers includes speeding up the hiring process and "creating an environment where health-care workers want to be able to be here."

Sutherland said private clinic surgeries can be more expensive because the companies spend capital to build facilities, and want a return on their investment.

"Activity-based funding is a viable option. But in our experiences, it's more associated with pushing through more volume to improve access, but that in turn drives costs higher," he said.

"That's what our review of the evidence is showing. So that we would not expect costs to go down, we would expect them to go up."

Sutherland said there could be many factors contributing to the health-care spend rates in other countries that aren't related to the model of funding they use.

"(It could be) more invested on health prevention, promotion, home care, hospital-at-home programs, other programs that would be competing with elective surgery," he said.

"What is it that increases health-care spending? Hospitals is the biggest cost bucket."

Rustad said a new "wait-time guarantee" for certain procedures would mean that if patients can't been seen on time they would be sent for care outside the province.

He said his government would do away with the COVID-19 vaccine requirement for health-care workers and a committee would decide how the "thousands" of people who were fired would be compensated and hired back.

A 2024 B.C. Supreme Court decision upholding the province's vaccine rules says approximately 1,800 health-care workers lost their jobs due to being unvaccinated contrary to these mandates.

This report by The Canadian Press was first published July 18, 2024

The Canadian Press