Health Minister Adrian Dix stunned the health care sector Monday by announcing he will send thousands of cancer patients to the United States for treatment because the provincial system is so overwhelmed that wait times have become unsafe.
It is a bold move, to be sure.
Some will appreciate the extraordinary measures the government is taking to ensure they get timely radiation treatment; others will be appalled that B.C.’s much-vaunted universal public health care system is in such bad shape we have to turn to private American hospitals.
“Right now I look at these numbers and say we have to take immediate action,” said Dix. “I strongly believe we had to do it, to take action immediately.”
It comes after the Globe and Mail’s Andrea Woo reported wait times to see an oncologist in B.C. were so bad — one in five patients referred to an oncologist were seen within the recommended two weeks — that some people were dying before their first appointment.
Only 82.9 per cent of B.C. cancer patients start their radiation therapy within 28 days — the poorest performance in Canada by a wide margin, and well below the national average of 97 per cent. The system was sideswiped by years of underinvestment, the COVID-19 pandemic, resignations, retirements and burnout.
“We will be strongly focused on retention and recruitment over the coming year to close the gap, to expand our capacity and add more hours of service to patients,” Dix said Monday.
“But for British Columbians dealing with a cancer diagnosis right now, today, in May of 2023, that's not fast enough. For them, for those they love and love them back, it's not acceptable. And it's not acceptable for me. We must do more. We must do it now. And we are.”
B.C. will spend $35 million over two years sending as many as 4,800 patients to PeaceHealth’s St. Joseph Cancer Centre and the North Cascade Cancer Centre, both located in Bellingham, Wash.
The government will focus on breast and prostate cancer patients first, because they are the largest population receiving radiation therapy and have waited the longest. They are also the most mobile, to travel across the border.
Travel, hotel and meal costs will be covered by the province, as will expenses for an accompanying caregiver, along with any testing and medication required, said Dix. The radiation treatment cycle is usually five days.
The Opposition BC United both slammed the NDP government for the unacceptable wait times and praised the move to take extraordinary steps to get people immediate care.
“What’s most important is people get the care that they need,” said health critic Shirley Bond.
“When you get a cancer diagnosis, the last thing you want to do is be sitting on a waiting list, because literally your life could be at risk.”
On that front, there is much to commend in what Dix has done, because it pushes the ideological boundaries of public health care that can sometimes blind the New Democrat government.
Buying capacity in private American hospitals to prop up the Canadian public health care system is no small concession for the NDP. Nothing on this scale has ever been done before in B.C. (it dwarfs the handful of times patients with high-risk pregnancies and those who needed PET CT scans were sent over the border in the last decade).
On the other hand, it took eight months after the Globe story to get this program into action. And B.C. faces a long, uphill battle to address the staffing crisis in BC Cancer that started under the previous Liberal government and worsened under six years of the NDP.
“I've talked to so many families over the last couple of months where a cancer diagnosis has been devastating, but what's even more devastating is the wait — the wait to have those phone calls, the wait to have the consult, the wait to start therapy, and that is devastating for people,” said Bond.
“So, do I think British Columbians will be very surprised that they're going to end up in Washington? Yes, I do. And I think it is an acknowledgement by this minister, finally, that we have a system that is in crisis in British Columbia.
“I raised this specific issue about cancer outcomes, and we've had cancer specialists ringing the alarm bells for months now.”
It’s unclear if the NDP government’s recently-announced cancer treatment action plan is up to the task of addressing the problem. Dix said it is a $440-million, 10-year proposal, which has already hired 348 people — but at a certain point all the numbers become meaningless if wait times fail to improve.
“What we need in this case, we need to take action while those improvements are taking place,” said Dix.
“Because with cancer and radiation treatment, we are not prepared to have people wait. That's why, as we searched out this option and opportunity, saw that it was available, we did not hesitate to offer this and are not hesitating to offer this to British Columbians.”
B.C. has roughly 14,290 patients receiving radiation therapy per year, and is expecting to add another 1,000 net new radiation patients over the next two years, as the population ages and grows. Adding 4,800 treatment spaces for patients in the United States during that period will help, said Dix.
Still, the optics are not good.
You won’t see Premier David Eby campaigning on this issue — buying up space in private American hospitals to prop up B.C.’s crumbling healthcare system — nor will you see many New Democrats contorting themselves publicly to try to square their commitment to Tommy Douglas’ universal healthcare system by paying for U.S. services with Canadian tax dollars.
Dix knows this full well. But he’s doing it anyway. He said he believes strongly that people deserve cancer treatment, regardless of the optics.
“It’s not ideal,” he told me. “But on the other hand, it's the right thing to do.”
Rob Shaw has spent more than 15 years covering B.C. politics, now reporting for CHEK News and writing for Glacier Media. He is the co-author of the national bestselling book A Matter of Confidence, host of the weekly podcast Political Capital, and a regular guest on CBC Radio. firstname.lastname@example.org