Health advocacy and health politics don’t often go hand-in-hand.
After a heavy duty first half of the year budgeting and lobbying for Kootenay Boundary Regional Hospital’s emergency improvements – then committing $6.3 million toward the $17 million project – the regional board recently returned to the table after a three-month hiatus.
Taxpayer costs and responsibilities remained front and center, especially after the board funded 100 per cent of the planning costs for Arrow Lakes Hospital upgrades then were stonewalled by the Interior Health Authority (IHA).
“There has been some frustration and a bit of a disconnect between our board, IHA and the Ministry of Health,” began Kathy Moore, Rossland mayor and district director.
“About two years ago our board determined that the Arrow Lakes Hospital project was our number one priority but we could not get the project to move forward with the province.”
She couldn’t recall if the Arrow Lakes project was on the ministry’s priority list at that time.
“This was annoying,” she pointed out.
“Because it seems pretty basic that the people in the various regions would have the best insight into the needs of the hospital district and should be consulted and seriously listened to when it comes to priority setting.”
To get wheels rolling for the Nakusp hospital, instead of funding the usual 40 per cent, the West Kootenay-Boundary Regional Hospital District board authorized a 100 per cent contribution for the cost of planning documents.
“This was accepted and the initial planning work was done at a cost of $100, 000 if memory serves me,” Moore said. “At the last meeting (Oct. 25), the planning work was presented and a price tag of a bit over $2 million was presented for the project – this is small potatoes relative to other projects around the province.”
With the planning funded 100 per cent by taxpayers, the 30-member board reasonably questioned IHA, “When will the actual project get underway?”
Moore says the board was willing to authorize its 40 per cent contribution on the spot.
“We were met with an uncomfortable silence,” she emphasized. “It actually was not on any action list with a commencement date or construction timeline.”
It was then suggested the project could begin right away if the board was willing to pay for 100 per cent of the project.
“This rubbed the board the wrong way,” Moore told the Trail Times.
“First off, it’s important to remember that health care is not a local government responsibility,” she stressed. “Personally, it has always irked me that we are expected to pay 40 per cent of capital expenses at all. Not only that, but the definition of what is capital versus operational costs has gotten a bit fuzzy too.”
Moore says the directors heard of other projects that move forward within IHA because boards are funding them 100 per cent.
“This is offensive to us because the delivery of health infrastructure improvements appears to now be partially determined by ability to pay,” she said.
“Our hospital board in rural B.C. does not have the financial resources of a larger urban center. If this becomes a bidding war, we will lose and continue to fall farther behind.”
This latest impropriety led to a firm directive for district staff to contact other Regional Hospital Districts and stakeholders “to establish a framework for discussion on changing the funding level that Regional Hospital Districts have historically been responsible for.”
Within the current Hospital District Act, there is no mandated cost-sharing formula per se.
“It’s just been the norm to get things done,” said Moore, mentioning a point was made that in certain instances, other hospital districts contributed less, about 20 per cent, toward capital projects.
”It seems as though it’s a ‘suggested amount’ but commonly ‘offered,’” she said. “Much like when you see a ‘suggested donation’ for a charity event but in the case of hospital capital projects, if the board doesn’t come up with the money, the project just might not happen.”
Moore says she has no idea how this ‘custom” came to be.
“I understand that the ministry has its own financial pressures,” she said. “But, speaking on my behalf and not on behalf of the board, this still feels gently extortionist to me.”
The situation with the Arrow Lakes Hospital is perhaps the straw that broke the camel’s back.
“Health care in rural areas needs to be re-thought,” Moore continued. “Expecting local government to cover even more of the costs is unconscionable.
“But we are being held over the barrel on the issue,” she added.
“If we don’t pay, 40 per cent or more, we might not get the upgrades we need.”
Canada’s healthcare system is “universal,” meaning everyone has a right to good, quality health care even if they don’t live in a major metro area.
“We don’t expect to have specialists everywhere, we are willing to travel for that sort of care, and we are pragmatic after all, but basic services should be provided,” Moore concluded.
“The improvements to the Arrow Lakes Hospital are primarily for their emergency room – that’s about as basic as you can get.”