Port McNeill and Port Hardy hospitals have been crippled by doctor and nurse shortages, resulting in emergency-department closures since the spring.
Port Hardy and Cormorant Hospital emergency departments will remain closed overnight until more resources are secured and services improved with $30 million in new funding, Health Minister Adrian Dix said Friday.
Port McNeill Hospital, about 40 kilometres from Port Hardy, will remain the only acute-care hospital ER open 24 hours a day.
Start your day with a roundup of B.C.-focused news and opinion delivered straight to your inbox at 7 a.m., Monday to Friday.
Thanks for signing up!
A welcome email is on its way. If you don't see it, please check your junk folder.
The next issue of Sunrise presented by Vancouver Sun will soon be in your inbox.
Emergency department services will be available from 7 a.m. to 5 p.m. in Port Hardy, from 8 a.m. to 7 p.m. on Cormorant Island, and 24 hours a day, seven days a week in Port McNeill.
Island Health will establish daily shuttle services between Port Hardy and Port McNeill hospitals, as well as daily shuttles to Campbell River and the Comox Valley for patients and staff.
Regular hours will be restored as soon as possible, but having set hours in the meantime will stabilize the situation and let patients and families know where and when emergency services are available, Dix said.
“We believe in these three hospitals … and we believe in the region,” said Dix at a news conference Friday from the B.C. legislature, adding the ministry and health authority’s main goal is to bump up staffing.
Dix said overnight emergency department services will reopen as soon as the health authority can meet staffing levels.
In the meantime, the Health Ministry is committing $30 million in capital and operating funding to the Mount Waddington region.
The hiring of two new physicians in Port McNeill last year eased shortages there, but Port Hardy’s emergency department has lost physicians, resulting in increasing overnight and weekend closures — the ER has been closed 25 per cent of the time since October. Cormorant Hospital in Alert Bay has seen similar overnight closures.
Port Alice, which is also in the region, has an urgent care centre.
Last week, Port Hardy physician Dr. Alex Nataros said as of July 1, he will become the only ER doctor in the town of 4,000. Two physicians are scheduled to leave over the next few months.
Island Health CEO Kathy MacNeil said the health authority made the difficult decision to close Port Hardy and Cormorant hospitals overnight to provide certainty for residents of the area.
“We have heard the community loud and clear — people need to know when services are available and when they are not,” MacNeil said.
The temporary closure will allow Island Health work on upgrading facilities and recruiting staff, she said.
“We’ll have housing that people will want to live in and we’ll be able to retain a health-care workforce there that is stable and safe for the longer term.”
For almost a year, Island Health has been working on solutions for the region, but MacNeil said the $30 million from the Health Ministry will allow more of those incentives and upgrades to happen — including staff recruitment incentives for eligible staff (about $2,000 in quarterly incentives) as well as $1,500 bonuses for referring physicians to the region, and time-and-a-half plus meals and mileage for those who travel to fill shifts.
The funding will also provide for 10 additional protection service officers to improve safety, and upgraded accommodations for travelling staff, which Dix said is a huge part of attracting and retaining doctors and nurses to the area.
“These are the strongest incentives we can provide,” said Dix. “It’s an ambitious plan and the right response.”
Island Health said it will also add new 24/7 mental health and substance-use services such as additional sobering and assessment centre beds to increase access to supportive care and reduce emergency department admissions.
Additional long-term care beds are also being established in Port Hardy to ease pressure on hospital beds.
There’s also a plan to upgrade the Port McNeill and Port Hardy hospitals by renovating existing spaces, including the maternity, emergency departments, trauma and nurses’ stations.
North Island MLA Michele Babchuk said the government is providing the stability and funding the multi-pronged approach residents and staff want.
Babchuk maintains the actions announced Friday will address immediate challenges in the area and start the work of modernizing and improving health care for north Island residents for years to come.
Last week, Nataros said he is prepared to pay for a physician assistant when, as of July 1, he becomes the only ER doctor in the town of 4,000.
Physician assistants train for two years to assist doctors with multiple tasks but can’t work independently and are not regulated or trained in B.C.
Nataros has the backing of the B.C. Green Party’s new deputy leader Dr. Sanjiv Gandhi, a cardiovascular and thoracic surgeon who worked with physician assistants in operating rooms for 17 years in the United States.
The physician-assistant issue, however, has muddied the waters for Island Health, which has been working on a plan for the region for almost a year, as well as the Health Ministry, which only just announced in November it will create a new health-worker designation called “associate physicians.”
The category, proposed by the College of Physicians and Surgeons of B.C. in 2020, is for internationally trained doctors who are not yet qualified to practise as full-fledged doctors in B.C. but “could have, under supervision, a significant scope of practice,” said Dix.
Dix said the province can look at whether there is a role in the system for physician assistants, but they are not trained in B.C., there are not significant numbers of them, and they were rejected by the previous provincial government.
The province has heavily invested in nurse practitioners, tripling their numbers over five years. Nurse practitioners have a larger scope of practice than associate physicians and slightly less scope than physicians.
Dix said there is no single solution to the health-care staffing crisis on the north Island — just a number of steps in a short, medium and long-term plan.
Dix wouldn’t say potentially how many new-to-practice doctors or nurses might be added to the region, or how many other health-care professionals might complement services in Port McNeill, Port Hardy and Cormorant Island Health Centre in Alert Bay.
“I think what people in the region want is a vision of how health care is going to be better in the region, and that’s what we’re working on,” said Dix. “Obviously, the key issue in the north Island — while we talk about doctors a lot — has been nursing … but also health sciences professionals, health-care workers, and issues of housing for people who want to go there.”
In late November, Dr. Nicole Bennett-Boutilier, medical director for Mt. Waddington-Strathcona, wrote an email to Island Health president Kathy MacNeil obtained by the Times Colonist that said lab technicians “are being pulled in multiple directions,” nurses are calling in sick frequently and not wanting to pick up extra shifts, and physicians are suffering from mental and physical fatigue.
Bennett-Boutilier said consolidation of Port Hardy and Port McNeill emergency services remains key to providing safer, more predictable and sustainable services.
Dr. Granger Avery, who ran the Port McNeill primary care clinic for decades, and former Port McNeill Mayor Gaby Wickstrom told the Times Colonist previously the current model of trying to keep three acute-care hospitals plus an urgent-care health centre open in one region can’t continue.
They proposed one hospital in the north Island serving the Mount Waddington area — Port Hardy, Port McNeill and Port Alice — giving one community an upgraded hospital and the other district an urgent care centre.
Wickstrom said maintaining three hospitals in a region with 10,000 to 11,000 people is not a sustainable model.
Dix, however, said that’s not an option: “We have three hospitals there — it’s not even a question, closing a hospital, no.”