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Baldrey: Will B.C.'s new patient ratio system help ease health care pressures?

Columnist Keith Baldrey believes the province's recent policy announcement regarding nurses have promising potential.
A nurse walks through a hospital patient ward.

B.C.’s beleaguered public health care system got a much-needed shot in the arm last week when the provincial government and the BC Nurses Union unveiled a first-in-the-country nurse to patient ratio system.

On top of that, millions of dollars will now be spent on more signing bonuses to attract nurses to work in rural and high-vacancy areas.

Along with last year’s overhaul of the physician payment model and the expansion of scope of practice for pharmacists, the unprecedented (in this country) move to create patient ratios ranks as one of the biggest changes in the public health care system in decades.

The question now is: will the impact of these two historic measures be significant enough to ease pressure on the health care system, or will they merely ensure a somewhat chaotic status quo is maintained?

The health care system is under siege in much of the province because of three main factors: record population growth, a rapidly aging population and ongoing challenges stemming from shortages of health care workers.

On the face of it, the policies announced last week regarding nurses should go a long way to fixing some of the human resource challenges.

At the very least, the new ratio system should improve working conditions for nurses working in hospitals, where the ratios will be implemented.

The most patients a nurse will be responsible for is seven, in overnight rehab. But for general care, the ratio is four patients to one nurse, and the numbers are lower for more serious forms of care.

Many of the shortages of health care workers are in remote and rural areas. To that end, the signing bonus program is being expanded to include up to $30,000 to work in the North and up to $20,000 to work in other rural and remote areas.

Also, a nurse who joins the GoHealth program (which involves nurses travelling to small communities) will be eligible for a $15,000 signing bonus. And the number of communities where nurses are eligible for an annual $8,000 bonus will be expanded from 15 small towns to 48.

If the impact of the overhaul of the physician payment model is any indication, the shift in nursing strategies should pay off. So far, almost 5,000 doctors have opted to join the new model.

The Doctors of BC now say the number of people without a family doctor has dropped from about one million two years ago to about 700,000 today. Still an unacceptably high number, but at least the trend is heading in the right direction.

Pushing against this progress, however, is the ongoing pressure coming from population growth. The Medical Service Plan expands by about 150,000 new registrants each year.

The impact of that phenomenal growth can be seen in the significant increase in the number of people occupying hospital beds on any given day. For years, the norm was 9,000-9,500 patients a day.

In recent weeks, that number has frequently been over 10,000. One day last week, there were more than 10,300 people in hospital even though we are nearing the end of the respiratory illness season.

The overhaul of the health care system may be transformational. Then again, it may simply end up being a case of not having enough fingers to plug all the holes in a steadily eroding dike wall.

Here’s hoping the former statement wins out.

Keith Baldrey is chief political reporter for Global BC.