Health and Social Development
SR1 Health Equity for Rural and Remote Communities UBCM Executive
Whereas rural and remote communities in BC experience significant health care challenges, including a lack of
access to emergency services, on-demand mental health and addictions facilities, physicians, paramedics, and
other health professionals;
And whereas the long distances, limited public and private transportation options to travel to the nearest health
care service, and high costs for accommodations to stay near those sites while receiving treatment, are
substantial barriers for people living in rural communities across the Province:
Therefore be it resolved that the provincial government introduce metrics and policy to identify reasonable travel
distances from each community to health care services and facilities, to ensure transparent, accountable, and
equitable health care access for those living in rural and remote communities in BC;
And be it further resolved that the provincial government move quickly to increase the health care workforce in
rural and remote communities by:
- creating additional licensing and training opportunities for internationally-trained medical graduates;
- establishing recruitment and retention programs for health care professionals willing to work in rural
areas; - approving physician assistants to work alongside physicians and other health professionals; and
- expanding the use of nurse practitioners and pharmacists to increase access to health services.
UBCM Resolutions Committee recommendation: Endorse
UBCM Resolutions Committee comments:
The Resolutions Committee notes that the UBCM membership has endorsed several resolutions addressing the
need for additional resources for health care in rural and remote communities in BC, including:
Rural and Remote Health Care Services and Primary Care Providers: - providing more funding or other assistances for placing medical locums in small, rural communities
(2022-EB19); - building a strategy to expand rural and remote community health care services (2020-NR64);
- ensuring equitable access to health services in rural BC with adequate funding to support that model
(2019-B62); - providing solutions to ensure medical specialists and services are available in rural BC (2019-B63);
and - requiring resources and permission for local physicians to perform minor operating procedures in
remote rural hospitals (2006-B154).
Rural and Remote Ambulance Paramedics: - managing recruitment and retention of paramedics, maintaining adequate staffing levels and delivery
of service in rural communities (2022-EB5, 2022-EB7, 2021-EB61, 2021-EB62, 2020-EB74); - more advanced care and critical care paramedics in rural ambulance stations (2017-B133); and
- restoring funding to the BC Ambulance Service so that citizens could expect a timely response from
qualified personnel throughout the province (2007-B50).
Education of Health Care Providers to Work in Rural and Remote Communities: - working with universities and communities to encourage graduates of medical programs to practice
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and stay in rural areas of BC (2011-B60); and - developing appropriate changes in the Canadian medical education system required to ensure that
general practitioners can meet the needs of rural Canadians, such as proficiency in surgery,
anesthesia and obstetrics (2010-B112).
Rural and Remote Mental Health and Addiction Services: - seeking more funding for detox and rehabilitation throughout the Province, particularity in rural and
remote communities (2019-B61); - seeking, in part, more harm reduction services, including detox and treatment beds, to be made
available in every local government in BC (2010-B145); - seeking more funding for detox centres in more areas of the Province (2007-B51); and
- seeking more regional detox centres (2006-B8).
More generally, the Committee notes that the membership has supported resolutions seeking additional
resources for health care in communities throughout BC, including:
Health Care Services and Primary Care Providers: - supporting the resourcing and strengthening of primary care as part of the health care system (2022-
SR1, 2022-EB17, 2017-B42, 2017-B43, 2016-B44, 2015-B70, 2015-B68, 2008-B162, 2006-B48, 2006-
B50, 2006-B154, 2006-B156, 2005-B146); and - improving physician recruitment and retention, and the need for more health care professionals (2018-
B143, 2017-B42, 2015-B68, 2014-B132, 2013-B47, 2012-B91, 2012-B103, 2011-B60, 2010-B43,
2009-B148, 2008-B49, 2006-B154, 2005-B41, 2003-B104).
Ambulance Paramedics:
Seeking adequate funding for province wide ambulance services (2013-B44, 2013-B142, 2010-B45, 2007-B50,
2007-B156, 2006-B48, 2003-B33).
Education of Health Care Providers:
Education and training opportunities for more health care professionals (2009-B148, 2008-B49) and removing
obstacles for foreign trained doctors and health professionals who are willing to work in BC (2009-B148).
Mental Health and Addiction Services:
Improved resourcing and facilities for mental health and addictions services throughout the province (2022-SR2,
2021-EB56, 2021-EB57, 2020-SR8, 2019-B60, 2019-B61, 2019-B171, 2019-B172, 2018-B52, 2017-B70, 2017-
B71, 2016-B43, 2015-A2, 2014-B34, 2013-B52, 2010-B42, 2008-A1, 2007-B89, 2007-B153, 2006-B50, 2006-
B51, 2005-B3).
The Committee notes that members have submitted several resolutions this year addressing rural and remote
health care services: 1.03 (attraction and retention of rural primary care providers), 1.04 (rural paramedics), 1.09
(rural physician assistants), 1.13 (rural health care shortages and closures), 1.20 (rural withdrawal services), 1.2
(rural addictions treatment), 1.25 (rural primary and allied care providers), 1.31 (rural mental health and
addictions treatment). The Resolutions Committee has attempted to capture the requests made by each of these
resolutions in this Special Resolution.
See resolutions RR7, RR8, RR9, RR10, RR11, RR12, RR13, RR14
UBCM Executive comments:
Background
The UBCM Executive is proposing 2023-SR4 given the continuing health care crisis in rural and remote
communities in BC.
UBCM received eight (8) resolutions on this issue for consideration at the 2023 Convention (RR7, RR8, RR9,
RR10, RR11, RR12, RR13, RR14) which highlight concerns around the need for access to emergency
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services, on-demand mental health and addictions facilities, physicians, paramedics, and other health
professionals.
Additional concerns raised by Executive include the long distances to access health care, limited public and
private transportation options to travel to the nearest health care service, and high costs for accommodations
to stay near those sites while receiving treatment, which are substantial barriers for people living in rural
communities across the Province.
UBCM Policy Position
In addition to the resolutions identified in the Resolutions Committee comments, the UBCM endorsed
resolution 2022 Special Resolution (SR)1 which noted:
Whereas all British Columbians, notably families, seniors, children and people with chronic and acute health
care needs are facing an immediate health care crisis due to the closure of hospitals and emergency rooms in
their communities;
And whereas there is a critical need for additional family physicians, emergency room doctors, specialists,
paramedics, and nurses across the province:
Therefore be it resolved that UBCM ask the provincial government take urgent steps to ensure hospitals,
emergency rooms, and ambulance services are open and available 24 hours a day;
And be it further resolved that the provincial government increase funding and training opportunities for health
care professionals so that all residents of British Columbia can access an appropriate and necessary level of
care.
The membership has also called for greater opportunities for Canadian internationally-trained medical
graduates to undertake postgraduate training and establish practices in BC (2018-B51, 2014-B132, 2012-B91,
2009-B148).
Current Status
At the 2022 Convention, UBCM held a plenary session on Re-envisioning Health Care in BC. The session
noted that BC communities and their residents were experiencing unprecedented challenges with the health
care system, which included the closure of emergency rooms, long wait times for surgery, difficulties in finding
a family physician, problems with the recruitment and retention of health care professionals, and inconsistent
access to ambulance service. This session explored how these issues were affecting communities in all areas
of the Province, and in both urban and rural contexts; and discussed ideas for transforming the health care
system in BC.
Presenters included Honourable Adrian Dix, Minister, Ministry of Health; Gaby Wickstrom, Mayor, Town of Port
McNeill; Merlin Blackwell, Mayor, District of Clearwater; Pete Fry, Councillor, City of Vancouver; Troy Clifford,
President, Ambulance Paramedics and Emergency Dispatchers of BC George Abbott, President, Circle Square
Solutions Inc.; Dr. Kerry Jang, Faculty of Medicine, University of British Columbia; and Dr. Ray Markham, Rural
Family Physician.
The provincial government recently created the Longitudinal Family Physician (LFP) Payment Model which is an
alternative to the fee-for-service model to support physicians in family practice who provide longitudinal family
medicine care. The model supports family physicians by compensating for time, patient interactions, and the
number and complexity of patients in their practice. On February 1, 2023, eligible family physicians in BC who
registered for the LFP Payment Model will be able to start billing under the LFP Payment Model.
