Vaughn Palmer: Key MLA committee focuses on health and housing issues in budget recommendations

Opinion: NDP Committee and Liberal MLAs focus on areas expected to be David Eby’s priorities if he becomes PM

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VICTORIA — The NDP government was urged this week to launch an immediate overhaul of primary health care, including the controversial primary and urgent care centers.

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The call was the most pressing to come out of the legislature’s finance committee during its pre-budget consultations with the public.

The committee’s six NDPs and three Liberal MLAs “agreed that more needs to be done to improve primary care in BC,” according to the report released Thursday.

They called on the government to “carry out an immediate review of primary care, including walk-in clinics, primary and urgent care centers, family doctors and community care centres”.

The review must “determine how the existing system can more effectively serve the community, increase access, identify and resolve problems, and identify opportunities to improve navigation for the public.”

The recommendation was prompted by what committee members heard through written submissions, an online survey, and several weeks of public hearings.

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The findings echoed media reports about the failures of primary and urgent care centers, a key element in the government’s new primary care model.

The New Democrats have spent tens of millions of dollars opening more than two dozen primary care and urgent care centers to provide team health care and relieve pressure on emergency rooms.

“Members noted that some of these call centers are performing extremely well and easing the strain on the system,” according to the committee’s report. “They also pointed out that in some areas of the province they are not as effective and have problems retaining doctors.

“Members discussed how the current model of primary and urgent care centers can be confusing for British Columbians,” the report continued.

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“More education may be required to inform people about how the system works in relation to outpatient clinics, family doctors and community care centers.”

Additional remedies could include “integrating more nurse practitioners, physician assistants, and midwives into primary and urgent care centers to help ease the strain on the system.

“Members stressed that BC must ensure improvements are based on clear data and that GPs with links to patients are incentivized to work on the new model.”

Those findings amount to a significant critique of the governance model for primary care because legislative committees generally proceed by consensus.

When members of the government and opposition cannot reach an agreement, the lack of consensus can be recorded in the final report.

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For example, this year: “Members discussed how best to improve business models to increase economic performance and the merits of greater carbon tax flexibility, but were unable to reach consensus.”

Clearly, all six New Democrats and three Liberals on the committee agreed that primary care and struggling primary and urgent care centers need immediate attention.

In total, the committee made more than 200 recommendations regarding the budget that will be presented in the legislature next February.

In particular, the committee acknowledged the lack of progress in making housing more affordable, which was a key promise in the NDP’s 2017 and 2020 election platforms.

Members “noted the significant interest in housing affordability and agreed that this is the biggest driver of unaffordability, that the current time required to build a house is unsustainable, and that something must be done urgently to accelerate housing construction.” .

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The MLAs also echoed David Eby’s call as housing minister for accelerated housing approval in local government.

“Members suggested that provincial mandates for municipal zoning coupled with advanced regional planning could accelerate housing construction,” the report said.

“They added that the current permitting and consultation process is long, complicated and hampers development and that the process needs to be reviewed.

“Members also noted that it is important to ensure that communities are actively involved in developing their official community plan and that housing aligns with the principles outlined in the plan.”

The recommendations stopped short of endorsing Eby’s call for legislation that would allow the province to override local government and push through needed housing.

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But even without that specific recommendation, the committee’s findings tend to reinforce what Eby has been saying all along.

Eby resigned as housing minister and attorney general to seek leadership of the NDP.

Lately he has also expressed skepticism about primary and urgent care centers, saying it would be better to advise the government to put more resources into financial and other incentives to address the shortage of family doctors.

“We need to support physicians in choosing to provide long-term care for patients from birth to death; those family doctors who build that relationship,” Eby told Rob Shaw of CHEK news.

“Primary and urgent care centers are not that and they are important.

“But what we need are family doctors who support families and individuals in our province, especially with an aging population, to manage their care.”

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“I know,” Eby said, citing a key influence on his thinking on the matter. “My wife is a family doctor and I hear about the challenges in that job.”

Although Eby will not be at the cabinet table this fall to begin digesting the committee’s recommendations, he is likely to oversee the entire government before the end of the year.

If past practice is any guide, he will do like other prime ministers and pick the committee recommendations he likes while ignoring the rest.

But I hope that an Eby-led government will act on the committee’s findings regarding the shortcomings of primary care and housing affordability.

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