Local politicians push for more local health care input

As Fraser Health plots the future of health care in the Fraser Valley and asks residents to pony up millions of dollars, local politicians hope they will get a say in what is to come. But the health authority has been sending mixed messages about just how eager it is to hear from those locals.

Over the last year, Mission politicians and residents have repeatedly urged the health authority to improve services in their community. Politicians in Chilliwack and the Hope area have also expressed dissatisfaction with the health authority’s spending and approach to resource allocation.

A better balance

For more than a decade, Fraser Health has pursued a regional health care model where complicated care is concentrated in large hospitals. That, health officials note, can improve both efficiency and safety by ensuring that facilities that carry higher levels of risk take place in locations that can quickly deal with any complications.

But residents have expressed concern about access to health care in smaller centres. They have pointed to costs imposed on individuals and communities, when people are expected to travel to other communities to receive treatment.

Mission’s successful campaign for a new CT Scanner was focused on the idea that people in that community lacked access to timely medical treatment and diagnostics.

And a pair of Fraser Valley seniors are making the same argument when it comes to kidney treatment. Elaina Wugalter and Gayle Irving are campaigning for a new renal kidney dialysis centre in Chilliwack

Local politicians say they can help Fraser Health strike a better balance between efficiency, safety, and access. But how much of a say they get in health care planning decisions, the change may, in part, come down to the power of money.

In June, Mission politicians hosted Fraser Health officials at a council meeting. The meeting was friendly and far from contentious, but Mayor Paul Horn spoke about the need for more dialogue between health officials and community members. In particular, he said he hoped Mission could lead a regional planning “symposium” that would allow locals to present their views about their community’s health care needs, along with data on how the region was changing.

“We would like to invite Fraser Health to work with the City of Mission to undertake some comprehensive planning for health care in our community that thinks about the growth we have coming.”

Horn acknowledged the dilemma facing Fraser Health, which must allocate scarce resources to a range of communities all hoping for a larger slice of the health care dollar.

“We hear others describing how special they are in the [same] ways that are very similar to the ways [we believe] we’re special,” he said.

Horn said the communities could provide information and context that would help Fraser Health come up with a plan that addresses needs for the entire region.

“Basically we’re talking about sitting in a room together and sharing notes,” he said.

In late September, though, Fraser Health responded to Horn’s proposal and said, in essence: “Maybe later.”

“We are not able to immediately act on this proposal at this time as Fraser Health is still refining the 10-year clinical planning exercises and next steps shared during the June meeting,” the assistant Abbotsford Regional Hospital’s executive director wrote in an email. “We value the opportunity to work closely with the City and commit to updating you on next steps when we have a confirmed timeline.”

Those planning exercises aim to project demand for health care services over the next decade, a Fraser Health spokesperson told The Current in an email. The spokesperson said input from mayors is valuable and helps inform projects.

“We are committed to following up with the City of Mission when we have finalized the scope of our clinical service planning for the next 10 years and are at a stage in the process where we are able to further engage our communities in a meaningful way.”

Horn told Mission council Monday that he wasn’t satisfied with Fraser Health’s response to the city’s request nor the length of time it took the health authority to reply.

“We are prepared to come to the table with resources and partnerships and the spirit of getting things done and we would like to take advantage of that,” Horn said, adding that he doesn’t understand why Fraser Health couldn’t take part in a conversation with mayors at the moment.

“I think it’s to everyone’s benefit in the region to get a better understanding of the health care needs in our communities.”

In stressing Mission’s desire to co-operate, Horn alluded to protests in other communities that have sparked change there.

“We’re not at the point where we need to be holding picket signs,” he said. “We’re at the point where we need to be sitting in a room together and coming up with strategies.”

(In January, Fraser Health reversed its plan to close Peace Arch hospital’s maternity ward after protests from residents.)

Money talks

Health care, though, is firmly in the jurisdiction of the province—and the health authorities they empower to make local decisions.

Still, local politicians do have a key bit of leverage: money.

When health authorities and governments undertake new health care projects, they typically look to local hospital districts to provide 40% of the funding—in this case, the Fraser Valley Regional Hospital District.

Those districts broadly mirror regional districts and are overseen by local politicians. They raise money for capital projects through property taxes. But historically, health authorities have looked to the hospital districts to provide money, and little else.

Over the last two years, as Fraser Health planned more capital projects in the region, it has come to the members of the Fraser Valley Regional Hospital District with requests for millions of dollars more than normal.

The requests have reflected progress on long-promised projects like seniors care homes. But local politicians have also complained Fraser Health has provided little notice about the funding requests. Earlier this year, the district declined to provide Fraser Health with the amount the health authority had asked for, noting the request came in after budgets had been finalized.

That episode triggered more calls for dialogue between the hospital district and the health authority and additional calls for Fraser Health to consult with the hospital district on its plans, rather than treating it as a piggy bank.

And while Horn’s request for more dialogue was politely rejected by Fraser Health, those at head office were more receptive when the chair of the hospital district recently came calling with a similar request.

Sylvia Pranger, the mayor of Kent and chair of the hospital board, told her colleagues at a meeting earlier this month that she recently visited Fraser Health’s head office in Surrey, along with Jennifer Kinneman, the chief administrative officer of the hospital district and the Fraser Valley Regional District (the two entities are separate but basically composed of the same members).

“We invited them to become more proactive and work with us in a closer fashion and suggested a workshop setting, to which they agreed,” Pranger said at a recent FVRD meeting. “It’s a start and maybe that will be a start of something where we have more proactive planning and direct communication with communities.”

Such a meeting would involve chief administrative officers and planning directors from Fraser Valley municipalities, and could involve talks about official community plans and the acquisition of land for future projects.