Merritt mayor plans to cut payments to province as city hospital's ER closes for 16th time this year

For the second time in three days, residents of Merritt, B.C., and the surrounding area were told to travel out of town if they needed emergency medical services. 

The latest in a long list of temporary closures of the emergency room at Nicola Valley Hospital has angered the city's mayor, who is now threatening to cut payments Merritt makes to the province for health services.

An unexpected unavailability of staff was to blame for the temporary closure, Interior Health said in a release issued at around 7:30 a.m.Tuesday morning.  

The health authority said ER services were going to be suspended until 7 p.m. PT Tuesday and, until then, patients would have to access care at Royal Inland Hospital in Kamloops, about an hour's drive north from Merritt.

A few hours later, Interior Health ended the closure early and issued another release saying the authority had secured enough staff to reopen the ER. That release was posted on the social media site X at around 11 a.m.

While services may have resumed for the day, the suspension of ER services in the region has been an ongoing problem.

Nicola Valley Hospital's emergency room services were also unavailable from 8 a.m. Sunday to 8 a.m. Monday, with Interior Health citing limited physician availability as the reason for that closure.

The department is normally open 24 hours a day, every day. 

Merritt Mayor Michael Goetz is not impressed by the latest emergency room closure — the 16th time it's happened this year. 

He says the city is going to start withholding payments to the province for hospital services for the days those services are not available.

"So, in 2024, we are going to calculate our taxes like we normally do and then we are going to pull back 15, 16, 17, 18 days — whatever it is by the time 2023 is over," Goetz told CBC's Daybreak Kamloops.

"There is no sense paying for something you didn't get," said Goetz. "You gotta do what you gotta do and that's what we are going to end up doing."

Goetz spoke to CBC hours before Interior Health announced that adequate staffing meant the local ER would be able to open before Tuesday night.

CBC has contacted the health authority for comment.

Merritt ER services 'top priority,' says minister

Upon request, Health Minister Adrian Dix provided a written statement on the situation that said he met with Goetz last month at the Union of B.C. Municipalities Convention in Vancouver to talk about the issue.

"[Goetz] knows Merritt and keeping the Nicola Valley emergency department open is a top priority for us," said Dix. 

"Like he's been saying, we're all going to need to work together to make sure it doesn't keep happening. We need to attract a larger base of doctors and nurses to Merritt so that we're not as dependent on people coming from other places."

The Ministry of Health recently announced a proposed bylaw change that could allow physician assistants to work in emergency rooms. A physician assistant is a medical professional that works under the supervisor of a physician.

According to Dix, the health sector workforce has grown by over 38,000 under his watch between 2017 and 2022.

But B.C. has seen significant population growth since then as well. There were an estimated 4.8 million people living in the province as of 2017, and quarterly population reports from the province show there are more than 5.4 million residents as of April 1, 2023.

In a written statement, Interior Health said there was a 40 per cent vacancy rate for nursing positions at the hospital, which only included permanent positions that haven't yet been filled. The health authority said it would continue to work with Goetz and the City of Merritt, and is actively hiring for new physicians and nurses.

Kathy Doull, the executive director for clinical operations in the Interior Health west region, said that a minimum of two trained nurses were needed to safely staff the emergency department — and a last-minute sick call was the reason for Tuesday's closure.

"IH recognizes Merritt is at the juncture of highly travelled highway systems, making the emergency department a vital and critical part of the community," Doull said. "We are committed to delivering stable health service for all residents in the area."

South Okanagan hospital also affected

Merritt is not the only community in the health region affected by insufficient staffing.

Interior Health also issued a notice of temporary service interruption for emergency room services at South Okanagan General Hospital from 8 a.m. to 1 p.m. Tuesday.

The health authority says limited physician availability is also behind the closure at that hospital, which services residents in and around Oliver, B.C.

People in the area requiring emergency care will now have to travel about 40 minutes' drive north to Penticton Regional Hospital.

Patients in the Keremeos area were also redirected to Penticton Regional on Saturday when the South Similkameen Health Centre was shuttered from 1 p.m. to 6 p.m. due to limited nursing availability.

Emergency services were also unavailable all day on Saturday at the Slocan Community Health Centre, which serves residents of New Denver, north of Nelson, B.C., and the surrounding area. 

Goetz said he is encouraging other mayors in the region to join him in holding back payments until services improve.

"Four or five communities get together and start doing it, maybe they will work a little harder," said Goetz.

Goetz said Nicola Valley is currently operating with a 44 per cent nursing complement. 

The mayor said he does not know if withholding payments will push the province to take legal action. CBC has reached out to the attorney general's office for comment.