Many people in B.C. do not have a family doctor, which has led some to wonder why municipalities aren’t doing more to try and address the shortage.
Denise Blackwell, Langford councillor and chair of the Capital Regional Hospital District Board with the Capital Regional District, says the Municipality Act prohibits municipalities from providing support to businesses.
In B.C., since most family doctor clinics are considered privately-owned businesses, municipalities are not allowed to provide them financial assistance.
Specifically in regards to providing assistance to businesses, the act prohibits assisting in industrial or commercial undertaking, giving or lending money, giving the use or ownership of immovable property, guaranteeing borrowing, granting an exemption from taxation, or gifting property owned by the municipality.
“In Langford, we’ve had a couple of times where doctors have contacted us. We’ve provided them with all the information about what a great city it is,” Blackwell said. “But because they’re in private practice, the government views any assistance we would give them as an assist to business.”
Blackwell says sometimes residents contact the City of Langford and don’t understand why the municipality isn’t doing more to attract doctors, but there are limits on what the city can do.
The Ministry of Municipal Affairs says municipalities are limited in providing assistance to businesses as a safeguard to ensure fairness and protect communities against possible conflicts of interest.
“Local governments can enhance the well-being of their communities and regions through a variety of approaches, programs and services for supporting economic development,” the ministry said in a statement to CHEK. “Municipalities may also enable business promotion through business improvement areas and specified tax exemptions.”
The ministry says municipalities can grant an exemption to the municipal portion of property tax if it is to encourage economic, social or environmental revitalization in the municipality.
Colin Plant, chair of the CRD board, says the shortage of family doctors puts pressure on the local health care system.
“Clearly our region has a shortage of doctors,” Plant says. “The challenge for local governments and the regional district is that health care is largely a provincial issue supported by the federal government through complex funding relationships.”
In 2019, 66 per cent of people living in Island Health were attached to a general practitioner, according to BC Community Health Service Area Health Profiles.
The area within Island Health with the lowest percentage of people attached to a general practitioner was Downtown Victoria/Vic West, where only 53 per cent of the population had a general practitioner.
Qualicum Beach had the highest attachment rate at 81 per cent.
The Ministry of Health says it is investing in team-based care facilities, like urgent primary care centres, to try and address the family doctor shortage.
“We agree that the way primary care services have been historically organized and delivered is not working for patients or health care providers,” the ministry said in a statement to CHEK. “That is why in 2018/19, the Ministry of Health launched a transformational team-based primary care strategy intended to fundamentally change how primary care services are delivered.”
HealthLink BC says Urgent Primary Care Centres are where people should go to address same-day, urgent, non-emergency health care like a sprain, minor cut or burn.
The ministry also points to the recent announcement of the Westshore Community Health Centre as a measure it is taking to address the shortage.
The health centre, which is set to open in the spring, will have a team of health-care providers, including family doctors, nurse practitioners, registered nurses, social workers, community health workers and an Elder in Residence offering primary care and health-promotion services
Blackwell says the CRD has paid for up to 40 per cent of the capital costs to build Urgent Primary Care Centres within the region.
As of the end of 2021, the CRD has paid over $5 million towards these projects, and has committed over $3 million more towards these facilities.
Blackwell says these centres are helpful, but there aren’t enough to meet the demand.
“It was wonderful that we got that clinic opened in Langford. We were one of the first ones in the province, but they’re booked out all day,” Blackwell said. “And the other problem that they were having out here is the shortage of staff…there’s just a shortage of all sorts of different healthcare practitioners.”
Plant says he hopes to see more done at the provincial and federal level to help address the situation.
“I have concerns about the system which seems to put such pressure on doctors that they feel cannot continue to help people in this region,” Plant says. “We as a region support the local mayors’ calls for additional investments in their region.”
The Ministry of Health says it acknowledges there is still more work to do to address the doctor shortage in the region.
“The Ministry is in active discussions with the Victoria and South Island Primary Care Networks as well as with the Doctors of BC on actions that may be taken in the interim to stabilize local clinics,” the ministry says in a statement. “We realize there is much work to do and the system will not change overnight. But we are committed to working in collaboration with family physicians to address these long standing issues.”
This story has been updated with a comment from the Ministry of Municipal Affairs.