Abbotsford's police force turns to private medical company to avoid long ER waits for prisoners

Ongoing emergency room delays at Abbotsford Regional Hospital have prompted the city’s police department to turn to a private health company to handle basic medical needs for jail prisoners.

The move is meant to free up police officers who are required to wait with prisoners in the hospital’s emergency department—sometimes for as long as eight hours. But one expert notes that the use of private medical services by public bodies, if it becomes widespread, could further aggravate the issues facing Canada’s health system.

‘We’re just trying to risk-manage’

The Abbotsford Police Department, like every police detachment, has its own jail where arrested people are held—always for only a matter of hours or days—before they are either released or moved to a provincial jail. And sometimes those prisoners need medical assistance—including, relatively frequently, prescription medications.

Historically, the department would take those prisoners to Abbotsford Regional Hospital, where a patient could talk to a doctor for an assessment or new prescription to tide them over until they were released. But in recent years, wait times in the ARH emergency room have stretched and those trips have become an increasing headache for prisoners and time-suck for the cops who must guard them.

Abbotsford’s police chiefs and politicians have called attention to the problem on numerous occasions during budgeting discussions about police resources. But with no end in sight to the long waits for prisoners and their minders, in August the Abbotsford Police Department signed a five-month trial contract with Rockdoc, a private medical company. (The name stems from the company’s origins providing medical services at events and concerts.) The department says it is using Rockdoc for virtual medical appointments to handle prisoners’ non-urgent medical needs like fulfilling a prescription, addressing drug withdrawal systems, or assessing an injury or illness.

Officers are still transporting prisoner-patients to Abbotsford Regional Hospital if and when they need immediate hands-on assistance from a doctor or nurse. But for cases in which a prisoner’s needs can be met through a virtual appointment, the force is now using Rockdoc.

The move is a direct response to persistent and lengthy delays in accessing treatment at the hospital’s emergency room.

APD spokesperson Sgt. Paul Walker told The Current the APD has long relied on the hospital’s emergency room to facilitate medical treatment for prisoners—especially those needing some assistance during the evening or night.

While Walker said the facility once provided relatively timely care, that’s no longer the case, especially for relatively minor needs. For years now, department heads have complained about officers being pulled off duty to wait for a prisoner to see a doctor—delays that can be as long as eight or nine hours.

And the inability of those officers unable to respond to the public’s calls has an impact on public safety, Walker said. The delays also impact the prisoners.

“It comes down to patient care,” he said. “The people we have in our cell blocks, we have obviously a duty to be responsible to care for them and we want to do that as quickly as possible.”

But one health care expert warns that while the move may make sense for those immediately impacted by delays at Abbotsford’s hospital, the use of private medical companies by public bodies risks exacerbating some of the challenges that can make visiting Fraser Valley’s hospitals so time consuming in the first place.

Andrew Longhurst, a health researcher at the Canadian Centre for Policy Alternatives, noted that for-profit companies have been used in the past by agencies ranging from WorkSafeBC to provincial jails. Such services can be used either to try to lower operating costs, or avoid capacity challenges facing hospitals and public care. But the use of private companies can further aggravate those problems and start a vicious cycle of higher health care costs.

“It’s really no different than a [nursing] staffing agency, which have been wreaking havoc across the country,” Longhurst said.

Hospitals facing a worker shortage can fill positions with contracted agency nurses. In the short-term, the nurses—who are paid far more than those employed full-time by health authorities—can address immediate worker shortages. But the use of private agencies can also make the problem even worse—and much more expensive—over the long-term as those same agencies hire nurses away from hospitals.

Longhurst said that the BC government has tried to reign in the use of such agencies, but that their continued existence speaks to an ongoing and immediate need at health facilities. The use of private medical services like Rockdoc could create a similar issue if those agencies hire critical medical staff away from public facilities and hospitals.

Longhurst said the APD’s use of hospitals and Rockdoc also raises the question of why jail operators have traditionally turned to hospital ERs to refill prescriptions for prisoners—and what needs to be done to improve co-ordination in a way that could reduce demands on hospitals, get cops back on the street quicker, and facilitate faster access to medication for prisoners.

The provincial government has created urgent and primary care clinics (UPCCs) to improve access to less-serious medical needs for the general public. But they are unlikely to work for prisoners-patients, Walker said.

He noted that some patients require care outside of the hours of the local UPCC, which remain relatively limited. Abbotsford’s UPCC, for instance, is only open between 2 and 8pm on weekdays and 9am to 8pm on weekends. The limited hours reflect staffing challenges that have afflicted UPCCs since the NDP began to create them.

And while waiting to see a doctor, a prisoner-patient must be held in a secure area away from the general public, Walker said. Hospitals have such spaces but UPCC facilities, he said, probably don’t.

For the Abbotsford Police Department, Walker said the force sees the program as a stop-gap measure and new tool to avoid emerging problems.

Walker said the Rockdoc contract doesn’t allow him to disclose the cost of the program. He said it is balanced by reducing the societal cost of having police officers sitting in emergency departments rather than responding to the public’s calls.

The force will review the Rockdoc trial at the start of December and decide whether to continue in 2025. Walker says the APD has used the company’s services 13 times since its contract began in August.

Walker said he wasn’t aware of other police departments using private agencies, but that others likely had similar issues. He said the Surrey RCMP have long employed a nurse in its jail to address medical issues. Abbotsford’s use of Rockdoc reflects the smaller scope of medical needs in its jail.

“I think in the short-term, as we all—not just police but everyone in the community— navigates where our health care system is at and waiting on the provincial government to kind of come to the table and fix some of these issues, we’re just trying to risk-manage and provide the care to those folks the best we can.”

On Nov. 12, The Current asked Fraser Health, which operates Abbotsford Regional Hospital, for comment on the Abbotsford Police Department’s choice to use private medical services to avoid long emergency room wait times. We also asked about whether there had been any discussions between health officials and other local public agencies (like police departments) that use emergency services to create more-efficient systems. Although a Fraser Health communications staffer initially suggested a response was forthcoming, a communications officer for the Ministry of Health emailed Friday afternoon to say they would be providing a response in place of Fraser Health. Neither body had responded to The Current’s inquiry by Sunday.