May 26 2025 – BC Rural Health Network – Paul Adams
Last week, we issued the following press release in response to the ongoing emergency room closures affecting rural communities in British Columbia. Unfortunately, these challenges have not abated. Over the weekend, four more ERs were forced to close in Lillooet, Vanderhoof, Mackenzie, and 100 Mile House.
This crisis has persisted far too long. Immediate action is needed to protect the health and safety of rural residents and travelers across the province.
Please review the press release below, and take a moment to watch and listen to the two interviews conducted last week by the BC Rural Health Network.
Communities across rural and remote British Columbia are raising urgent concerns about access to healthcare, as ongoing emergency department closures, long travel distances for care, and critical shortages in healthcare staffing put residents at risk.
While recent provincial investments in long-term healthcare solutions are welcomed, needed and appreciated, residents and local leaders are emphasizing that the immediate needs of rural populations remain unmet. These communities are calling for emergency measures to ensure basic access to emergency care and stabilize healthcare services.
Attachment to Primary Care
In many rural communities, access to primary care from a family physician has become a luxury rather than the norm. The ongoing challenge of retaining healthcare professionals undermines the continuity of care and erodes the meaningful, long-term relationships between patients and their providers.
“Personally, I’ve been attached to five different doctors in the past six years, this is not attachment, and I’m one of the lucky ones who are attached.” – Paul Adams, Executive Director of the BC Rural Health Network.
Sustainable, team-based care models are needed, along with places of care that residents can be permanently attached to. Decentralizing lower acuity services where possible and enhancing rural surgical programs would not only increase access to local care; but also improve recruitment and retention of healthcare professionals in rural communities where both office and emergency care are often provided by the same healthcare professionals.
Emergency Room Closures
Residents are clear: emergency room doors must always remain open. In the absence of a nurse or physician to fill a shift, all resources must be deployed to keep doors open. “The chance of harm is far greater with a closed sign than with someone on-site who has emergency training, Every minute matters!” – Tom Zeleznik, Mayor of Nakusp. This may include paramedics, industrial first aiders, physician assistants, and others in an all-hands-on-deck approach. All emergency departments should be additionally supported with full Real Time Virtual Support (RTVS) extending all emergency teams in our rural hospitals, virtual care should not replace people but can enhance the team and improve the outcome.
Moreover, communication about closures, or potential closures, is lacking. A centralized and transparent system must be established to inform the public of real-time emergency service availability. Time lost arriving at a closed facility and then travelling hours more to the next can have tragic consequences.
Physicians also highlight that the privileging process in BC, governed by the BC Medical Quality Initiative (BCMQI) and the Credentialing and Privileging Oversight Committee (CPOC), has become an unnecessary barrier. Evidence-based reforms have been proposed but ignored. Immediate action is needed to reduce paperwork and procedural barriers that prevent willing physicians from contributing.
“We know from preliminary primary research in BC that there are unintended consequences to the Provincial Privileging Process in rural BC, such as reduced scope of practice due to low procedural volume, despite positive health outcomes” Dr. Jude Kornelsen, Co-lead Centre for Rural Health Research, UBC.
Travel and Accommodations
Vital services delivered by non-profits and charities are helping rural and remote residents access care. Organizations like Hope Air, the Canadian Cancer Society, Angel Flight East Kootenay, Helicopters Without Borders, and Housing is Healthcare offer compassionate, cost-effective, and personalized services. However, their funding is sporadic and lacks long-term security. These groups efficiently stretch their resources through volunteerism, grants, donations and collaborations with commercial providers to lower costs for flights and accommodations. Government investment must match the demand and value of these services with stable, long-term support. Each dollar invested in these groups represents more than a dollar in services provided.
“On our way to Prince Rupert, we came upon a motor vehicle accident. I called 911 to report it and request an ambulance, but due to multiple crashes that night (it was dark and snowing), both the RCMP and paramedics were delayed. As we waited, the elderly woman behind the wheel shared that she was driving her granddaughter to the airport to see her specialist in Vancouver through Hope Air. What really stayed with me was when she said she had deep reservations about driving the highway in winter but felt she had no choice. In our region, ground transportation options are so limited that this risky journey seemed like her only choice. People are forced into unsafe choices; we need all forms of transportation supports.” – Michelle Martins, Kitimat, BC
Reaching care is one challenge and being housed when you reach the destination is another significant out-of-pocket cost that many just can’t afford. Some residents face massive expense in seeking the care they need to save their lives. Evidence supporting these costs is well documented and our governments needs to act to ensure health equity for rural residents. “I was able to access my specialist through programs provided by Hope Air but now the accommodation is no longer available and getting to the appointment and returning home in a single day isn’t even possible. I am a pensioner and have very limited resources, the change in the program has been devasting” – Dianne Starkewski, Resident, East Shore Kootenay Lake.
A Crisis Demands Emergency Response
The rural healthcare crisis demands immediate, coordinated action from all levels of government, professional colleges, unions, and healthcare representatives. “Do no harm” must be more than a guiding principle, it must be a call to urgent action. Currently, great harm is being done due to professional silos, bureaucratic inertia, and politicization. It’s time to break out of the ‘business as usual’ mindset, come together, and deliver real, immediate change. Solutions exist; they must be acted upon.
“911, what is your emergency?”- EMS Dispatch
“I live in rural BC!” – rural residents across the province!
