JOHNSON – Proposal for City owned healthcare clinic is a smart idea

THERE’S AN INTERESTING motion going to Kamloops Council on May 6.

Its being forwarded by Coun. Kelly Hall, and this one just may be the smartest idea we will have heard coming out of the Chamber, in a long time.

Its about the City of Kamloops building, opening and operating a municipally owned Health Care Clinic, and billing the Province for the doctors and the Medical Office Assistants labour costs.  The doctors and staff will be actual city employees, receiving full medical benefits, vacation and a pension.

The City would receive funding from the province via the Longitudinal Family Physician (LFP) payment model which was launched in 2023.  This funding model is one of the replacement models for the old ‘fee for service’ billing plan which many called broken and which perpetually underpaid doctors to the point where they started leaving B.C.

While some are hailing this new payment scheme as an improvement, there are others who will tell you that success of the LFP funding model is still up for debate, as doctors still need to open private offices, shouldering all infrastructure, office purchase or lease costs and pay for staffing themselves as well as the full administration of running a private practice and business.

It’s a lot to take on, making leaving for greener pastures where this is all handled for them and all they have to do is show up and provide doctoring care … a very attractive draw.  The working phrase here is ‘quality of work life balance’.

This new idea is more towards satisfying this need.

This municipality based clinic idea is not new.

Colwood, A city on Vancouver Island, part of the extended Victoria region has pulled off this ‘first-in-Canada’ pilot project with what appears to be early success.  They advertised to initially hire two doctors, with a plan to expand it to eight doctors in five years … and received 113 applicants.

113 applicants … for two jobs.  These are doctors applying.

When was the last time we heard about such a competitive competition for ANY doctor positions?  That’s a shocking result.  Obviously, Colwood hit on something here with this idea and their clinic opened in February.  Doctors saw the opportunity of this and jumped at it.

Coun. Hall sees a clinic in Kamloops with between 15 and 20 doctors eventually, so a clinic with a much larger scope than Colwood, yet with these applicant numbers, it looks like it won’t be too hard to staff it fully.

What will it cost Kamloops residents?  Obviously, the purchase or lease of the space, the initial infrastructure building and setup costs, and month to month utilities, insurance etc. as well as the staffing administration costs … something that can be incorporated into the existing City human resources umbrella.  In other words, not much in the long term.

The main and the largest ongoing cost, that of labour, would be covered by the province under the existing billing processes.

For the Province it’s a good deal, as any time they go out and set up one of those provincial Urgent Primary Care Centres, they have to cover all costs, both initial as well as ongoing, and we all know that if the Province does it … it ain’t gonna be cheap.

With this new alternative City owned scheme the province is just responsible for labour costs under the LFP billing model.  For Colwood, the Province jumped at it; the mayor of Colwood received a go ahead from Health Minister Adrian Dix within a couple of days after introducing the project.

The doctors like it because they don’t need to take the headache or risk of assuming all these infrastructure and office staffing costs and administration.  Clearly the 133 applicants for two to eight positions speaks to the magnetism towards the idea.

And, clearly the big winner is the patients and residents of Kamloops.  Obviously 15-20 new doctors in Kamloops won’t make the hugest dent in the dearth of doctors here, but it’s a good idea and a reasonable start.

My ‘Hot Take’ is that it’s about time someone actually thought outside the box, to deal with the doctor shortage issue here.  Clearly just sitting around waiting for the Province to solve it and incentivize doctors to come work here under existing models, just isn’t working.

Is it the City’s job to provide healthcare? No, of course not, way too expensive. But can the City play a role in attracting doctors and opening patient spaces in Kamloops?  Well … yes, it quite likely can, as long as the Province agrees and plays along.

Here’s the problem; this model might work out with an NDP government in Victoria and an amenable council here in town, but elections happen and should, let’s say, a Conservatives  win a future election and decide they shouldn’t be funding doctors and healthcare staffing in this way, preferring the older private practice model … this could end far more quickly than it would take for a clinic to open.

If only there was a way to provincially legislate a healthcare funding model … therefore locking it into law that you can’t close or defund any public healthcare clinic held by a municipality.  That ain’t gonna happen either.

Most important in the short term is to see how Kamloops council deals with this motion on May 6. Apparently, City staff are positive about the idea and may advocate for it, and we know how this council tends to follow any suggestion by staff here.

If certain council members just can’t let go of the “but it’s the Province’s job … so no” argument, in our eyes this should be a choice that would draw a direct line towards not getting re-elected next time.  This one may actually be that important.

What I can imagine is seeing it being thrown at a committee for a few months to ponder.  Then maybe, eventually … a consultant or two might be hired to opine on it … to think about a system that seems to be working fine on the Island, before it comes back to a process and a vote.

At this stage I would take any positive movement towards this idea.

This may just become the most important decision made by this council. A decision with the longest and widest range of effects and consequences potentially of any recent council, and one that could impact a large number of Kamloops residents for the long term.

David Johnson is a Kamloops resident, community volunteer and self described maven of all things Canadian.