Update – July 7, 2025
Over the weekend, three more emergency rooms in rural British Columbia were temporarily closed. Fort St. James, Oliver, and Lillooet, adding to a growing and deeply concerning pattern in 2025. These closures come just days after a national investigation by The Globe and Mail into the state of rural emergency care across Canada.
Canada’s Rural ER Crisis
A recent article by The Globe and Mail, titled The toll of Canada’s ER closure crisis (note: article is behind a paywall), reveals the staggering scale of temporary emergency room closures since 2019. Across the country, ERs have been closed for more than 1.1 million hours. These closures are not evenly spread. They are concentrated in rural communities where healthcare staff are in short supply and where patients must often travel long distances to access care.
While the article focuses on communities in Newfoundland, Ontario, Quebec, and Manitoba, the situation in British Columbia follows the same national trend. The Globe noted that BC’s data was released only two days before publication, following a seven-month delay under a freedom of information request. It was too late to be included in their analysis. However, independent monitoring suggests that BC is now approaching 250 ER closures in 2025 alone, the vast majority of which are in rural areas.
These closures are not just inconvenient. They can be deadly. The Globe recounts the story of a man in Bonavista, Newfoundland, who suffered a serious chainsaw injury and found his local ER doors locked. He was eventually transported to another hospital over 100 kilometres away, where his hand was saved through emergency surgery. Another man, suffering an asthma attack, died during a closure in the same community. Here in BC, we have seen similarly devastating outcomes.
Communities such as Port Hardy, Oliver, Lillooet, Keremeos, Grand Forks, Clearwater, Merritt, 100 Mile House, Fort Nelson, Vanderhoof, Burns Lake, Mackenzie, Fort St. James, (and many others) have experienced closures for the same reasons. These closures often occur with little or no warning. Compounding the issue are other service impacts, such as in Stewart last week, there was no ambulance available and the nearest unit was three hours away. Patients and paramedics are left to manage the fallout while neighboring hospitals become overwhelmed. For many residents, there is a growing fear that help simply will not be there when it is needed.
The Globe’s investigation confirms what rural advocates have been saying for years. These are not isolated incidents or temporary diversions. They are symptoms of a system-wide failure caused by longstanding staffing shortages, uneven investments, and a lack of meaningful planning for equitable access. Authorities continue to attempt to manage the results of a system that is outdated and overly centralized. In British Columbia, several aspects of healthcare delivery are now under review. This creates an important opportunity to redesign the system for the 21st century.
When rural ERs close, the impact is felt across the entire health system. Urban hospitals become more crowded. Ambulance wait times increase. Outcomes worsen. In small towns, the local hospital is more than a healthcare facility. It is a vital part of the community’s identity and survival.
Rural health challenges can be solved. We already have many of the tools we need. These include strengthened team-based primary care, expansion of community health centres, support for full-scope rural practice, physician extenders such as peer-to-peer supports and physician assistants, expansion of rural surgical centres, non-medical system navigators, universal electronic personal health records, and guaranteed travel and accommodation support for patients. Redefining what attachment means in a rural context is also essential. These improvements are possible through public healthcare investment and do not require and would not be improved through privatization.
Fixing rural healthcare helps the entire system. When rural care is strong, urban ERs are less strained, patient outcomes improve, and overall costs are reduced. Rural healthcare is not just a rural issue. It is a national issue with economic, social, and health impacts that affect everyone in Canada. Reducing healthcare spending can only be achieved by focusing on outcomes and treating the patient as a customer, not as a cost to be minimized.
It is time to listen to rural communities. It is time to move away from urban/provider focused systems that have failed to deliver real solutions at the local level in rural BC.
This is not a problem for one province alone. It is a national crisis that requires federal leadership. The Government of Canada must stand behind the principles of the Canada Health Act and ensure that provinces and territories have the resources to address this emergency. This cannot be another case of throwing more money at the same problem in the same way with the same results. It must be a rural health system redesign for the 21st century and beyond.
