Is there really nothing anyone can do to solve the ER closures crisis?

BC Conservative rural health critic Brennan Day is frustrated and flummoxed.

"It's definitely a crisis," he said about the alarming escalation of temporary emergency room closures at hospitals in small communities such as Lillooet, Merritt and Oliver.

"We keep asking questions of this (provincial) NDP government and we keep getting deflected. We're no closer to any solution."

Temporary closures of ERs started to become big news in 2024 when, for example, the ER at Nicola Valley Hospital in Merritt was closed 24 times in the last half of the year.

That pace is expected to only get worse this year in not just Merritt (population: 8,000), but Lillooet (population: 2,200) and Oliver (population: 5,100) as ER closures become epidemic.

In fact, it's almost impossible to keep track of what ERs are closed when because they are so frequent and are sprung on communities with little or no notice.

The hospitals in Lillooet, Merritt and Oliver don't want to go the way of Port Hardy (population: 4,000).

Port Hardy's hospital had many temporary closures at its 24/7/365 ER because of staff shortages before the province decided, in January 2023, to scale back ER hours to 7 am to 5 pm daily.

Outside of those hours, people needing emergency care in Port Hardy are asked to make their way to Port McNeill, which is a half-hour drive away, or call 911 to have an ambulance to take them there.

Island Health says it remains committed to reopening the Port Hardy ER 24/7/365, but it hasn't happened in over two years.

"There's absolutely no consistency," said Day, who is also the MLA for Courtenay-Comox.

"In the North, people are getting notice of ER closures on Facebook. Interior Health notifies on Facebook, X and its website, which is a little better. But, more and more often now people are getting their information on Rant and Rave (the platform on Facebook by and for citizens that covers the gamut from pet peeves and complaints to praise for a local bakery)."

Interior Health used to give a reason for closures, usually a doctor or nurse shortage.

But Interior Health tends not to bother with giving a reason anymore, according to Day.

Day said ER closures aren't just a health care issue.

"People don't move to communities with a health crisis," he said.

"So, it's also an economic and social issue. It's a concerning long-term trend."

Day's colleague, Gavin Dew, the Conservative MLA for Kelowna-Mission and critic for jobs, economic development and innovation, is also weighing in on the topic.

"ER closures are unacceptable, but they are happening all over rural BC," said Dew.

"It's a sign that this BC NDP government has utterly abandoned rural and remote communities. We need to use every tool in the tool kit to keep people safe. British Columbians deserve a healthcare system that works properly, not one that's patched together with duct tape and super glue."

The absence of just one doctor or nurse can trigger an ER closure at a small hospital, often on short notice if the doctor or nurse calls in sick.

NowMedia reached out to Interior Health to find out what the solution is.

No official was made available for an interview.

Instead, Interior Health sent a statement by email, which could be attributed to Interior Health, but not to any particular Interior Health official, executive or decision maker.

"Ultimately, emergency department coverage is directly connected to a global shortage of available physicians and staff rather than how to move those health-care professionals to hospitals that have unfilled shifts," said the statement.

"Interior Health partners with the GoHealth BC program to support rural and remote communities across the Interior region. Staffing at Interior Health hospitals is also supplemented by the GoHealth BC travel nurse program, which covers the cost of travel, meals and accommodations for nurses working in these rural locations."

However, GoHealth is designed to support hospitals when a doctor and-or nurse shortage is known in advance, such as holidays or pre-arranged leave.

Unforeseen shortages, such as a doctor and-or nurse calling in sick or having a personal or family issue, are not covered by GoHealth.

"When we have a need for coverage quickly, we prioritize offering overtime to local staff, utilizing casual employees or redeploying staff from neighbouring communities, whenever possible," continued the statement.

If none of those stop-gaps works, the ER is closed temporarily, sometimes for six hours, sometimes for two days, sometimes with 24 hour notice, sometimes with no notice.

In such cases, people needing emergency care -- anything from injuries from a car accident, burns, heart attack or stroke -- are redirected from the ERs in Merritt, Lillooet and Oliver to the ERs at bigger hospitals in Kamloops, Kelowna and-or Penticton.

If someone can't drive the patient to that hospital an hour or more away then they need to call 911 and get an ambulance to rush them there.

"There have been close calls in the Interior where patients have barely made it to another hospital because the ER in their home community has been closed," said Day.

"And, I've heard of deaths in the East Kootenays while a patient is being transported to another hospital because the ER in their home community is closed."

Interior Health has stated that its priority is to recruit additional permanent physicians and staff to communities where coverage has been challenging, to support long-term sustainability.

Mayor Laurie Hopfl of Lillooet, which seems to be the hardest hit with ER closures currently, isn't really doing interviews with media on the subject right now.

"I feel I've said all I can at this point," she told NowMedia.

"The issues behind these closures are complex and vary from community to community. What's clear is that Interior Health needs to take meaningful steps to fix what isn't working and realign their approach with the unique needs of rural communities like Lillooet. I believe it's important to give Interior Health the opportunity to address this situation clearly and decisively."

Back with rural health critic Brennan Day -- he isn't holding his breath for a solution.

"The government is being obtuse about the scale of the problem," he said.

"The solution lies in being transparent about the problem and then planning to solve it."

However, Day admits it's a complicated issue and lack of doctors and nurses means there is no short-term solution.

Even big communities have staff shortages, which is why there are long wait lists to see specialists, have elective surgery or even get treatment for cancer in cities like Kelowna, Kamloops, Vancouver and Victoria.

But, small communities are definitely harder hit.

It's hard to recruit and retain doctors and nurses to small communities because professionals want the career and lifestyle that a bigger hospital in a bigger city offers.

It begs the question: Is it viable to have 24/7/365 ERs at smaller hospitals?

Day said BC has to consider "all other delivery options."

One of those options could be more ambulance stations staffed 24/7/365 in smaller communities so people with emergencies can be rushed to a regional centre.