Short-staffed urgent and primary care centres are failing to fix B.C.'s family doctor crisis, critics say

Critics say urgent and primary care centres (UPCCs), one of the province's touted solutions to solving the family doctor crisis, do not come close to meeting the needs of British Columbians.

UPCCs were first introduced in 2018, and designed to serve residents of a community, according to the province, where they'll receive team-based care from a physician, nurse practitioners, nurses and other health professionals.

However, data from B.C.'s Ministry of Health health ministry — requested by the opposition B.C. Liberals and revealed in the legislature last week — show that staffing at most of B.C.'s 26 UPCCs are far below approved levels, and only around 20,000 patients are "attached" to the clinics.

"Often people ask us, are [UPCCs] a solution or are they a part of the problem?" said Camille Currie, founder and organizer of advocacy group B.C. Health Care Matters. 

"I think that they definitely are not a solution to this crisis we're facing. And they, in fact, are possibly part of the problem."

Currie says UPCCs are often booked up as soon as they open, and that she has seen long lineups in the morning outside her local centre on Vancouver Island.

With nearly a million British Columbians without a family doctor, and the crisis having a downstream effect on the rest of the province's health-care system, Currie says UPCCs aren't doing the job the government said they would.

"They aren't providing for the primary care needs of the citizens right now in the way that the Ministry of Health had us believe that they would when they were initially introduced."

Same-day care

The clinics are designed to see patients with urgent, but non-emergency health issues, on the same day they call in.

Phyllis Schwartz, a retired teacher who lives in Victoria, says she called her local UPCC as soon as they opened at 8 a.m., after feeling sick and testing negative for COVID-19 last fall.

She says she finally got through at 8:35 a.m., but was told they were full for the day and that she would be put on the waitlist.

She was eventually seen at the centre 11 hours later, at 7:30 p.m. that evening.

"I'm disappointed because I think the concept is great," she said.

"In theory this is ideal," she adds, but "a lot of things have to be stopped and doctors have to be brought in.

"It's almost like we need Doctors Without Borders in Victoria."

Staffing below targets

Vancouver Island is particularly badly affected by a lack of staff at UPCCs and primary care facilities, according to ministry data revealed last week.

There are just over six full-time-equivalent physicians at the Downtown Victoria UPCC, despite over 22 being approved for the centre. There are also no nurse practitioners at the facility, despite being budgeted to have two.

It is a similar story for many facilities across the province: the Richmond UPCC, for example, should have 32 full-time-equivalent physicians, but on some days it has only one.

According to the data, the White Rock/South Surrey primary care network operates with only a third of the doctors it requires.

"These urgent primary care centres are grossly understaffed," said Todd Stone, MLA for Kamloops-South Thompson and opposition house leader.

"They are, therefore, not adding the capacity that is really needed in order to make sure that people can access primary care when they need it."

Stone and Currie have both said the government should invest more in existing family doctor practices, including by modernizing the fee-for-service system.

The province says over a million people have visited the UPCCs since the initiative began, and that they continue to open more across the province to meet primary care needs.

CBC News reached out to Health Minister Adrian Dix for comment on this story, who did not respond by deadline.