Comparing the Parties’ Health Promises

On Wednesday, the day after the televised leaders’ debate where the BC Conservatives were criticized for not having released a costed platform, the party changed the name of its “ideas” website so that it read “our platform.”

This is not the same as releasing an official platform, which would include an explanation of what a party is proposing to spend and how it plans to get that money.

But last Friday, with eight days left before the Oct. 19 election and advance voting already underway, The Tyee rolled up its sleeves to compare the health-related pledges in the BC NDP’s official platform with the BC Conservatives’ piecemeal set of ideas, released through individual press releases.

The NDP’s platform says the party will spend $6 billion on health care to “ensure services are there when people need them,” including $400 million spent in 2025-26 on new investments in health and mental health care, and $411 million in 2026-27.

The Conservative “patients first” web page says the party will increase health-care spending and deliver care through public and non-governmental facilities, but it doesn’t cost out the promise or provide much detail.

Neither party directly addressed ER closures or the challenges of accessing health care in rural parts of B.C.

Recruiting and retaining health-care workers

The Conservatives say they will expand existing programs that fill positions in high-need communities and increase security in health-care settings, thereby improving workplace safety. The party also says it would train more doctors and nurses in B.C. schools and offer incentives for students to stay in the province and work in high-demand positions.

The party says it will support health-care assistants and licensed practical nurses to “upskill their credentials,” repeal the Health Professions and Occupations Act and “rehire the thousands of health-care professionals that were forced out of work due to personal health-care decisions.”

This seems to refer to the more than 2,496 employees, representing a small fraction of the health-care workforce, who refused to be vaccinated against COVID-19 and were “terminated for non-compliance” with the vaccine mandate. The vaccine mandate ended this July when the public health emergency was lifted and those workers would have been allowed to reapply for work at that time. In response to questions from The Tyee, the Health Ministry said it wasn’t currently able to provide an estimate of how many workers have been hired back.

The NDP platform promises to bring an additional 45,000 health-care workers on board over the next five years, pointing to overseas recruiting and a bolstered education system as its strategy to get there.

Last year the NDP hired 835 family doctors and 6,300 nurses, which will help the party continue to work towards implementing nurse-to-patient ratios. The BC Nurses’ Union says this will improve patient care and workplace safety for nurses and reduce burnout.

When The Tyee asked Conservative candidate for Surrey-Cloverdale Elenore Sturko at an all-party debate discussing seniors issues if her party would commit to implementing nurse-to-patient ratios, she was not able to provide a response.

To speed up delays between health-care workers finishing training and entering the workforce, the NDP platform says it will require health regulatory colleges to immediately license Canadian-trained providers, and license providers from approved jurisdictions within six weeks. It also pledges to enforce employment standards to protect workers from exploitation, and offer targeted tuition assistance for critical health-care professionals such as psychologists, pharmacists and imaging technologists. It says almost 900 foreign-trained doctors were registered in B.C. last year, thanks in part to an advertising campaign in the United Kingdom.

Nine out of 10 medical school graduates who study in B.C. go on to practise in the province, but the NDP says it will increase that percentage by forgiving tuition loans in exchange for long-term B.C. residency guarantees.

The NDP says that in 2024 it “doubled” the number of nurse practitioner students at the University of British Columbia and increased the number of students at the University of Victoria’s program by 33 per cent. The platform also says the NDP would add 48 new residency positions to accommodate new medical school seats and says the Simon Fraser University medical school will be accepting students by 2026.

Finding efficiencies

Both parties have big plans to improve how health care is delivered in B.C.

The NDP pledges a full review of the health authorities “with the goal of driving down costs” and reducing overlapping administration. The role of the health authorities is to provide a regional lens on policy without duplicating bureaucracy, the platform says.

The NDP is also promising a system to unify health-care resources like rehabilitation, imaging and procedures that would “reduce wait times and give better access,” especially for rural areas. It also says it will clear congestion in doctors offices by banning employers from requiring a sick note for short absences due to illness.

Home health care is also in the platform, such as home self-screening kits that can test for the human papillomavirus. These kits and the HPV vaccine, which prevents cancer, have put B.C. “on track to end deadly cervical cancer within a decade,” the NDP says.

The NDP points to the Health Connect Registry, which, since July 2023, has connected more than 248,000 people with a family doctor and is anticipated to match another 160,000 in the next six months — meaning everyone registered as needing a family doctor will be connected with one by 2025.

The party also says it will keep expanding how pharmacists can deliver health care, letting them prescribe more medications and refer and offer testing for routine conditions like strep throat and urinary tract infections. The government expanded the role of pharmacists in July 2023, allowing them to diagnose and prescribe for minor ailments.

The Conservatives pledge to improve the efficiency of health care by changing how hospitals are funded and by partnering with non-governmental health-care providers to close service gaps.

The party says it will fund hospitals, regional health authorities and non-government facilities using activity-based funding for the care and services provided. The party says B.C. currently uses a “block grant” method and switching to activity-based funding “incentivizes providers to be more efficient and treat as many patients as possible.”

But data shows that the stress on the health-care system is complex and not necessarily due to a lack of “incentives.” According to reporting by the Fraser Valley Current, for example, two dozen health-care facilities across B.C. are operating at occupancy rates above 110 per cent, with many beds filled with patients waiting for beds to open up in other facilities like long-term care homes.

A 2017 explainer on health-care funding from the auditor general says the province already uses some activity-based funding for the health authorities.

The Conservative plan says it will “expand publicly funded partnerships with non-governmental clinics” for “services like MRIs and priority surgeries.”

The NDP platform says B.C. surgeons “completed more surgeries last year than in any previous year.”

B.C. already has some for-profit, investor-owned companies providing health care, such as LifeLabs, which collects bodily fluid samples, and Initio, which does PET and CT scans and radiation therapy. These services are largely paid for by the government through B.C.’s Medical Services Plan.

The Conservatives say they will maximize the number of people a family doctor can see and use AI to reduce administrative burden and optimize staffing.

Mental health services

The Conservatives’ press release about mental health says the party would establish an “Independent Representative for Mental Health”; review the Mental Health Act, which allows people to be involuntarily detained while in a mental health crisis; improve mental health services in schools; and speed up access to care by regulating maximum wait times for patients with “critical mental health conditions,” such as disordered eating or schizophrenia, or who are experiencing psychosis.

The party would build out mental health infrastructure in rural communities with the “greatest unmet needs,” expand peer-assisted care teams and add a mental health response option into the 911 system, which the Union of BC Municipalities is also asking for.

The Conservative platform says it will ensure individuals who pose a threat to themselves or others would receive treatment in secure facilities. Under the existing Mental Health Act, anyone can be involuntarily detained for care if they pose a threat to themselves or others, or risk deteriorating if they leave care, due to a mental impairment such as psychosis, mania or depression.

The NDP says it will expand counselling services across the province with a new $50-million “Community Mental Health Resilience Fund” and put a mental health counsellor in every public school in the province. This would require hiring around 1,571 counsellors.

Its platform says it would also build 10 more Foundry centres for youth across B.C., which currently provide 17,500 people aged 12 to 24 and their families with critical mental health, addiction and physical and sexual health services. The Foundry website says it currently has 17 centres and another seven are “coming soon.”

Drug use, addiction, harm reduction and treatment

The NDP’s platform focuses on expanding access to treatment centres across the province, including First Nations treatment centres and Indigenous-led programming and at-home addiction treatment services.

The Conservatives focus on institutional treatment, including removing evidence-based harm reduction services and prioritizing involuntary treatment, which experts have told The Tyee is not an effective strategy.

The NDP platform says it will establish a phone number to call for addiction treatment, support, detox and after-care services and “strengthen drug prevention in schools” to educate kids about the risks of toxic drugs. The Conservatives also want to expand drug education in schools.

The NDP says it will fund home addiction treatment and establish residential treatment options that provide direct supports to parents undergoing addiction treatment. The party pledges to bolster local recovery homes so patients have smaller distances to travel to access services.

The NDP has also pledged to build mental health and addiction facilities.

The party says it would build a second θəqiʔ ɫəwʔənəq leləm’, or Red Fish Healing Centre for Mental Health and Addiction, which has 105 beds and offers six-to-nine-month programs for people with concurrent mental health and substance use disorder, and additional “satellite” facilities for specialized care.

It says it would build an addictions treatment centre for construction workers, who make up one in five unregulated drug deaths; improve access to mental health treatment for inmates with a 10-bed facility at the Surrey Pretrial Services Centre; and provide long-term involuntary care for people with long-term concurrent mental health and addiction challenges at a Maple Ridge facility.

The NDP and Conservatives both pledged to expand the availability of nasal naloxone, which can temporarily reverse an opioid overdose, to pharmacies across the province. Injectable naloxone is widely available for free, without a prescription, at more than 2,300 locations across B.C.

The Conservatives have also promised to build more facilities.

In a press release about mental wellness, the party said it would redevelop and build new secure treatment capacity at Riverview Hospital, on the səmiq̓ʷəʔelə lands in Coquitlam. There are currently two facilities on site and several refurbished buildings run by Coast Mental Health, where 289 people are receiving treatment for mental health, addictions or both, according to CTV News.

In a press release about drug use, the Conservatives said they would require anyone with a “debilitating addiction” who accesses hospital care or is taken into custody to start “evidence-based addiction treatments.” Experts have countered to The Tyee that “debilitating addiction” is not a medically diagnosable term.

The Conservatives have also promised to end B.C.’s drug decriminalization pilot project, which legalized the possession of small quantities of opioids, cocaine, meth and MDMA; appoint an addictions specialist with cross-ministerial authority; and end B.C.’s safe supply program.

Safe supply is a program for people who use drugs who are at high risk of overdose or death. They are prescribed pharmaceutical alternatives with the goal of reducing their use of the unregulated toxic supply. B.C.’s top doctor says safe supply is “largely positive” and should be expanded. (The Conservatives have promised to fire B.C.’s top doctor.)

The Conservatives say they will introduce involuntary treatment for people “who are unable to make life-saving decisions on their own” and will name the program Christian’s Law after 13-year-old Christian DeSousa, who died after using toxic drugs.

The Tyee has previously spoken with several substance use and mental health experts who warn that involuntary substance use treatment is not an effective way to stop people from using drugs. Former B.C. chief coroner Lisa Lapointe additionally has said abstinence-based programs may be contributing to the unregulated toxic drug death rate, as people leaving the programs are at a higher risk of fatal overdose from unregulated drugs, due to lowered tolerances.

The Conservatives say they will allow “some existing” overdose prevention sites to continue operating but will close sites that don’t follow a “strict” code of conduct, and will create programs at all overdose prevention sites where people can immediately access assessment, detox, treatment and recovery. There are currently long waits in B.C. for people wanting to access these services, and the press release did not provide details on how it will make these services available.

The party says it would create a program where people can connect with addiction specialists virtually to start treatment.

It also says it would make the “largest-ever investment” in voluntary treatment programs but did not provide details or a budget.

Reproductive rights

When it comes to reproductive rights, the Conservatives focus on fertility services, midwives, adoption support and support for people who experience pregnancy loss. The NDP highlights its work to provide contraceptives, the morning-after pill Plan B and the abortion pill Mifegymiso for free, and to cover the cost of one cycle of in vitro fertilization. Looking forward, the party says it will focus on midwives, menopause treatment and fighting cancer.

The Conservatives do not mention contraceptives or abortion or say if they would continue to fund free contraceptives (the current program has funding until 2026) or commit to expanding funding for abortion access. The NDP does not commit to this either but does say it would “defend and expand access to reproductive health services.”

The NDP says it would expand the scope of midwives to be able to do IUD insertion and Mifegymiso prescription, create a comprehensive strategy to improve maternity care across the province, and fast-track ovarian and breast cancer diagnosis and treatment through new rapid-access cancer clinics. It also says it would provide free menopause treatment with hormone replacement therapy, which it says protects people against heart disease and osteoporosis and reduces the risk of colon cancer.

In a press release, the Conservatives said they would fund first- and second-round in vitro fertilization treatments, work with the private sector to expand IVF services, and introduce one month of compassionate leave after a miscarriage (it says this would be available for women and does not specify if leave would also be offered to parents of other genders).

The party also says it will establish a midwife degree program in Surrey and create a two-year program registered nurses can take to transition into midwifery. It says it would also “reduce the cost” of adoption, but did not provide details. It says it would fight cervical and ovarian cancer by making the HPV vaccine free to all women and enhancing screening options. It does not say if this means maintaining the home screening service introduced by the NDP.

Sick leave, cancer plans

The NDP also says it would increase job-protected leave for major medical diagnosis to 27 weeks, up from the current eight days; “modernize” its dignified disposition options (while it did not provide details, this could include introducing liquid cremation or composting options); and continue to improve cancer care in the province with its 10-year cancer plan. It will also develop plans for rapid-access diagnostic services to make it easier for people without a family doctor to access colon, breast and lung screening services.

As of last Friday, the Conservatives had not released anything on comparable topics.

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