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<\/a><\/p>\nAt Directions Youth Services, support begins with asking what we can learn together.<\/p>\n
Last year, a local physician warned Grand Forks\u2019 council that two of the town\u2019s five doctors were planning to leave the community. In response, the municipality, alongside a local non-profit and the region\u2019s electoral area directors, committed hundreds of thousands of dollars to cover the costs of operating the local medical clinic. <\/p>\n
Local officials were told that paying for the medical clinic\u2019s costs would help attract and retain physicians. And the advice panned out: since they took over rent, utilities and licensing, Grand Forks has welcomed three new physicians to town. <\/p>\n
Similar efforts have taken place, and shown promise, in Colwood<\/a> and Sicamous<\/a>. <\/p>\n But municipally funded health-care efforts raise thorny questions for both local and provincial politicians \u2014 and one expert warns that \u201chaphazard\u201d local health-care initiatives could set off counterproductive bidding wars for physicians.<\/p>\n
A town\u2019s dilemma<\/p>\n Grand Forks is a small town of about 4,000 people located just north of the U.S. border in the West Kootenay\u2019s Boundary region.<\/p>\n Last year, Dr. Mark Szynkaruk visited Mayor Everett Baker and his council to warn about the departure of physicians from his clinic \u2014 and the potential for upcoming retirements.<\/p>\n The medical clinic\u2019s physicians shared the cost to rent the aging, 60-year-old clinic where they saw patients. As doctors left, those who remained had to shoulder a greater cost of the rent. Grand Forks faced its own version of a common story, in which the loss of one or two physicians reduces the happiness of remaining doctors and makes it harder to recruit replacements.<\/p>\n Local governments, however, are limited in how they can respond to health-care challenges. Municipalities cannot, for instance, directly finance private businesses, including doctors\u2019 offices. And the province and its health authorities are traditionally the ones who pay physicians and set rates for incentives like those designed<\/a> to fill vacancies in rural communities. <\/p>\n Municipalities also have limited finances that are dwarfed by the scale of health-care spending; the provincial health-care budget<\/a> of $35 billion is more than double the combined spending<\/a> of every municipality in B.C.<\/p>\n But that hasn\u2019t stopped some municipalities from innovating. The Victoria suburb of Colwood, for instance, directly hired<\/a> doctors, as it would other specialist employees. Sicamous, meanwhile, helped<\/a> build a brand new medical clinic for its health-care professionals.<\/p>\n Mayor Baker and Grand Forks found a similar workaround. <\/p>\n Earlier this year, the municipality began funding<\/a> the clinic\u2019s hard costs: its rent, utilities and licences. <\/p>\n The Grand Forks arrangement increased the financial incentive for physicians to choose to move to Grand Forks. It also amounts to a health-care subsidy. <\/p>\n In exchange, the municipality got doctors to sign an agreement in which they pledged to provide sufficient and ongoing care both in the local hospital and in the medical clinic. The doctors would also cover the cost of staffing the clinic. A year later, Grand Forks has recruited several new doctors and Baker said they should provide family doctor coverage for about 7,900 residents \u2014 roughly the number of people living in the town and surrounding rural regions.<\/p>\n \u201cIf you come to Grand Forks, you are guaranteed to have a family physician,\u201d Baker said. \u201cI don\u2019t know how many communities can guarantee that.\u201d<\/p>\n Grand Forks has an aging community and is seen as an affordable destination for retirees. Baker said health care is needed to ensure the continued vibrancy of the town.<\/p>\n \u201cThis is not only a health issue, but it\u2019s an economic driver for our community,\u201d he said.<\/p>\n The annual costs for the municipality, the local non-profit and the regional district amount to $187,000. That\u2019s not a small sum for a community the size of Grand Forks. But Baker said he recently told Health Minister Ravi Kahlon the cost is well worth the expense, especially in the context of the cost of other health-care spending.<\/p>\n \u201cThis goes to show,\u201d he said he told Kahlon, \u201cfor $200,000 you could pretty well guarantee that you\u2019ll have a clinic operating, you\u2019ll have your emergency ward open.\u201d <\/p>\n Baker, who owns a Grand Forks funeral home, calls himself a \u201cfree-enterpriser\u201d and previously served as the constituency assistant for a BC Liberal member of the legislature. But he was complimentary toward the BC NDP\u2019s help and says he doesn\u2019t blame the party for health-care problems that predate the government.<\/p>\n Still, he and others note that the contribution of municipal funding to health care is a band-aid solution that doesn\u2019t fix deep, systemic challenges.<\/p>\n \u2018I don\u2019t think it\u2019s sustainable\u2019<\/p>\n \u201cI personally would not want this to be a permanent solution,\u201d Baker said, adding that the partnership in Grand Forks will cover the costs \u201cuntil government gets their shit together.\u201d<\/p>\n Baker\u2019s challenger for mayor in this fall\u2019s election, Kirk Duff, is less convinced of the program\u2019s future, even as he hails its current success.<\/p>\n \u201cI don\u2019t think it\u2019s sustainable in the current model,\u201d said Duff. A longtime councillor in Kimberley and Castlegar, Duff served<\/a> as mayor of Castlegar between 2021 and 2022 after winning a byelection. (Health concerns stopped him from running for re-election, and he subsequently retired in Grand Forks. He said his health is now improved.)<\/p>\n Duff said he would have preferred Grand Forks to have undertaken a project like their neighbours\u2019 in Castlegar, where local doctors and the municipality signed an agreement to create<\/a> a new health centre within a larger mixed-use building.<\/p>\n However, that project has since been reshaped<\/a> because of a lack of funding for the medical component of the building. <\/p>\n Duff said Castlegar\u2019s planning laid the stage for a long-term facility when funding is available. The Grand Forks effort, Duff said, \u201cis better than doing nothing\u201d but isn\u2019t his preferred approach.<\/p>\n \u201cI\u2019m always concerned with casual downloading that becomes permanent,\u201d Duff said. <\/p>\n The experiences of the two Kootenay communities highlight a common concern for local officials: when they wade into health care and other issues that fall under provincial jurisdiction, it can strain local resources and let the province off the hook for its own responsibilities. When municipalities contribute funding, it can also result in unequal distribution of critical services that are supposed to be accessible throughout the province. But sometimes, if municipalities don\u2019t intervene, it can take years for a more systemic provincial solution to materialize. <\/p>\n \u201cTo take property tax money and use it for health care is a bizarre concept,\u201d Duff said. Grand Forks\u2019 contract with the clinic expires in the spring, and he said council will have to consider it and ensure it is working and actually responsible for the increase in local doctors.<\/p>\n
Provincial parties\u2019 responses<\/p>\n The NDP\u2019s Josie Osborne, who served as health minister until August 2026, said the examples in Grand Forks, Colwood and Sicamous are positive developments.<\/p>\n \u201cThese are examples of the kind of collaboration that really is required to attract and retain doctors, particularly in smaller communities,\u201d she said. <\/p>\n A former mayor of Tofino, Osborne said she has frequently heard complaints that they represent downloading of costs onto municipalities, but she disagreed, framing the contributions as business investments. <\/p>\n \u201cCommunities of all sizes have long made investments into local economic development, whether it\u2019s through an economic development officer, supports for small businesses, undertaking local business retention and expansion strategies,\u201d she said. <\/p>\n \u201cA strong health-care system in a small community is also an economic strategy; businesses and families aren\u2019t going to move into smaller towns if they\u2019re uncertain about whether they\u2019re going to get a family doctor.\u201d<\/p>\n She said Grand Forks\u2019 program wasn\u2019t an indictment of the province\u2019s own efforts to help keep doctors in small communities.<\/p>\n \u201cThere\u2019s at least eight specific physician recruitment programs supporting rural communities,\u201d she said. \u201cWe know there\u2019s a role for local communities to really express themselves as to what they have to offer. The province can\u2019t do that for communities. I don\u2019t think it would be appropriate for the provincial government to tell local communities that this is exactly how you need to do things.\u201d<\/p>\n Green Party candidate Lisa Lapointe told The Tyee that municipal health-care efforts signal trouble for the provincial system.<\/p>\n \u201cPlaces like Grand Forks are having to step up and fill the gap,\u201d she said. \u201cThat is not their responsibility, but they feel an urgent need to respond to what their communities are experiencing.\u201d<\/p>\n Lapointe said the Greens are proposing that each riding have an \u201cintegrated community health-care centre\u201d that would address burnout challenges. She also cited the \u201cdownward spiral\u201d that can arise when health-care practitioners start to burn out.<\/p>\n The Conservative Party of BC declined The Tyee\u2019s request for an interview, with its communications director writing in an email: \u201cOur candidates are laser focused on door knocking and speaking with voters right now.\u201d<\/p>\n A long-term problem<\/p>\n Recruiting and retaining physicians is a long-term, systemic and demographic challenge, said Steven Lewis, a health-care researcher and adjunct professor at the University of British Columbia.<\/p>\n The challenge is connected to larger urbanization trends that can make it hard for smaller communities to recruit professionals who are trained in big cities and may not want to leave. The issue is also linked to the way doctors are usually paid in British Columbia, he said. Lewis said a \u201ccapitation\u201d model, which would pay doctors to serve a specified population, would incentivize doctors to move to smaller communities better than the current fee-for-service payment structure, which is largely based on physicians receiving fees for one-time services.<\/p>\n Lewis said smaller regions would also be served by the creation of robust and well-staffed primary care clinics that offer more support to individual doctors \u2014 like that pitched for Castlegar. He said the province should also focus on training existing nurses to become nurse practitioners who can effectively treat the most common ailments that local family physicians encounter. <\/p>\n The fact that municipalities have begun to wade into health care \u201cshows a certain amount of desperation,\u201d Lewis said. <\/p>\n He cautioned municipalities against setting the precedent of contributing funds to address their community\u2019s doctor deficits. <\/p>\n <\/a> <\/p>\n ABC Wants More Involuntary Care. No, Say Vancouver Liberals<\/p>\n
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