Sixty-year-old Adrian Dix took his first political job 33 years ago. After working in the backrooms, he was elected to the Legislature in 2005 and served as NDP leader between 2011 and 2014. He became BC’s Health Minister when John Horgan formed government in 2017. Now Dix moves to be Minister of Energy and Climate Solutions, a position that has its own problems since the NDP’s commitments to fossil-fuel expansion directly conflict with climate solutions.
After more than seven years of responsibility for the sector, Dix is blamed for healthcare inadequacies. Indeed, real challenges abound. Yet solutions to apparent problems can take much time.
Consider the new St. Paul’s Hospital now under construction in Vancouver’s False Creek Flats. Plans had been in development for a few years before BC Liberal Premier Christy Clark announced the project in 2012. Construction is still underway in 2024 and the first patients are expected to be served in 2027.
This is a major tertiary facility, but more than 15 years passing from conception to realization shows that long-term planning is essential to provide effective medical services to the public.
Adrian Dix may be the current focus of problems but that does not relieve BC Liberals who preceded him as Health Minister. There were four from 2011 to 2017: Mike de Jong, Margaret MacDiarmid, Terry Lake, and Mary Polak.
Health problems existed during the six years that Christy Clark led the BC Liberals:
- Underfunding,
- Long surgical and treatment wait lists,
- Inadequate mental health facilities,
- Inadequate training facilities for doctors, nurses and technicians,
- Botched computer systems,
- Contracting-out problems,
- Repetitive disputes with paramedics, RNs and other healthcare workers, and
- Scandalous treatment of health researchers.
Delivery of healthcare in British Columbia is difficult and expensive. Our population has been growing and aging. Advanced diagnostic services and treatment techniques improve patient outcomes but strain the system.
BC has relied on medical practitioners trained in other countries and many of the most qualified choose to live and work in urban regions where people from their homelands have settled. Ethnic enclaves offer support networks and cultural familiarity.
Successive BC governments decided that recruiting physicians from other regions was easier than training our own. According to Simon Fraser University, its School of Medicine is “the first new medical school to be built in western Canada in more than 50 years.” SFU has applied for preliminary accreditation from CACMS but will not accept students before 2026. UBC remains the only accredited medical school in British Columbia. Newfoundland and Labrador, with one-tenth the population, also has a single accredited medical school.
I have been frequently involved with BC’s healthcare system in the recent past and the services provided me has been near faultless. Perhaps Vancouver’s North Shore where I live is among the best served communities and I might not have fared as well in another place.
An articulate IN-SIGHTS reader described his own recent experience in an email to me. His call for increased funding is worth repeating:
Mr Farrell,
Prior to yesterday I intended to thank you for your report on Geothermal and suggest some links.
A trip to Royal Jubilee’s Emergency Ward intervened.
Having worked in high-stress environments, what I witnessed was familiar. Grossly overworked people trying to work under absurd conditions that made them appear resentful of interruptions, upset by incomplete data, short tempered and impatient.
Why so vexed? While I sat and watched it was Staff who were blamed for patients waiting for ten hours before they left the Emergency Waiting Room.
Arriving around 3PM I entered a room already full of angry patients. I was lucky to leave after midnight. Four others in wheel chairs, all elderly, sat in place until 10 PM. This after arriving at 9AM.
The surprise? Several behind-the-counter nurses wiothout hestitation apologized for absurd wait times, while explaining that no doctor, nurse or orderly, in fact no one on staff had any control or influence over government or administrative Policy.
Who does have control?
Various above-the-fray regional crown corporation bureaucracies grossly under-supervised by Adrian Dix. A leader who perfected the kind of evasion I now think of as resort to political glossolalia. Mindless recitation of irrelevant data employed to avoid any link between reality and political responsibility.
Routine rural Emergency Room closures? Got to save money! The collapse of the provincial system? Let a different government handle that!
The day following my ER visit my doctor confirmed that the hospital had emailed results.
The possibility that replacing Mr Dix with Ms Osborne will make a huge difference? Not bloody likely. Nothing will even begin to happen before January. He sees what’s coming. More of the same.
The point? There needs to be a shout out about what medical personnel face. And concerted efforts to get politicians to recognize the damage their continuous dithering has done.
Note: UBC’s Faculty of Medicine MD Undergraduate Program is available at sites other than Vancouver but only UBC is accredited with CACMS. SFU School of Medicine is expected to have its first students in 2026 and its permanent campus is slated for completion in 2029.
Categories: Health
in-sights.ca 
Hi Norm. You must live in healthcare utopia on the North Shore because it is certainly a different story out here in Surrey. A couple of months ago I had the unfortunate experience of having to pay a visit to Surrey Memorial Hospital’s Emergency Ward. When I arrived through the main entrance there were at least 30-40 people in front of me. I have no idea how many people were arriving at the back door via ambulance. Looking around the main entrance waiting area it quickly became clear that most people were not there because of an emergency situation. Expecting a long wait, people were eating pizza, McDonald’s burgers & fries and Tim Horton’s coffee & donuts. Most of them likely did not have a family doctor and were using the emergency ward as a walk-in clinic. I have experienced this at Langley Hospital as well. After an 8 hour wait I was finally seen by an emergency room doctor. Ten minutes later I was out the door with a referral. This is the reality in the valley.
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I believe I am fortunate. After our long term (and spectacularly good) family physician retired, we struggled to find acceptable care. Luckily, we eventually hooked up with a doctor who had moved to North Vancouver from Manitoba. He is excellent and reasonably accessible.
It is truly unfortunate that luck is a determining factor in finding a family doctor. In May 2024, SFU formally approved the establishment of BC’s second school of medicine. It will be the first new medical school in Western Canada in 50 years. Should we wonder why there is a doctor shortage?
Quebec and Ontario have a bit more than quadruple our population, but 10x the number of medical schools.
I hold the Campbell, Clark and Horgan governments responsible for the failure to train more physicians and medical technicians. There is one other factor that may be at work. At times, professions have encouraged shortages as a way of driving up remuneration levels. That could affect BC but governments need to push that resistance aside.
By the way, I did have a similar experience at Lions Gate Hospital where there were two loaded waiting rooms. The first was the initial triage station and then I moved inside to another holding area. It was many hours before I returned home and I suspect you’re right in saying many emergency room patients were there because they lack primary healthcare, which should be the point of first contact for most people.
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Norm, I think you are being far to forgiving on successive governments management of our healthcare system. Demographics, population growth and workforce requirements are all completely predictable. We also know how many healthcare professionals need to be graduating each year to fill vacancies through retirement, population growth etc. This isn’t rocket science. Decade after decade, governments have failed to keep up with the demands on healthcare.
Adrian Dix will certainly go down as the worst minister of health in history. During his tenure, $12 billion/year was added to the healthcare budget and delivery of healthcare services continued to plunge. How do you add $12 billion/year and get worse results? This guy should have been fired a long time ago. I can’t imagine the destruction he will inflict in his new role as Minister of Energy and Climate Solutions.
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You are right that I was too forgiving for failures in the healthcare system. I hope alterations to the inital post and these comments clarify that.
Reality is that an individual Minister has limited power. Overall budgets and general priorities are determined by the Cabinet. I don’t know how the Eby administration is working but in the past, Ministers have not had a free hand in the appointment of senior bureaucrats, the people most responsible for ministerial operations.
Stephen Brown retired this month as BC’s Deputy Minister of Health. He has been in that position for more than a decade. Brown followed Graham Whitmarsh who departed in 2013 with a golden handshake because of his part in the wrongful dismissal of six drug researchers. The researchers were serving the public interest, not the corporate interests favoured by Clark’s corrupt government.
Stephen Brown worked as Deputy to five Health Ministers. He retired with applause from his colleagues but those outside the bureaucracy are likely to see him as directly responsible for the current state of healthcare.
Josie Osborne, the new Health Minister, trained as a marine biologist. She may or may not be qualified to lead the department. Osborne has never managed a large organization. The most important action she can now take is to employ a competent team of senior administrators. The Health Ministry has not had that in recent memory.
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And one researcher died
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The deficiencies in the health ministry attract a lot of attention for good reason; the size of the budget and the real, personal, and immediate consequences of system (non)delivery. But are the obvious failures to properly plan and execute core responsibilities unique to the health ministry? I think not.
I can’t remember when any BC government ministry has been put in the hands of a strong, competent, committed individual who took control with a vision that shone through to the public and excited and motivated ministry staff. Someone who really put their stamp on a ministry and whose name became synonymous with excellence. Someone who would challenge moribund or corrupt Cabinets in advocation of their ministry.
Instead we have allowed a succession of place holders to pass through, playing politics first, and remembered for their inadequacies, if at all. For the most part they’ve let things happen, rather than make things happen.
We’re being led by followers.
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As he always is, Lew is articulate in expressing comments about the shortcomings we suffer in government. Health services and transportation are issues that need 10 to 20 years advance planning. Politicians too often look forward only to the next election.
We have lacked physicians for years but training an adequate number of doctors was constrained by governments’ unwillingness to plan for and invest in the future. It is unfortunate that a province of almost 6 million people has only one medical school. Oregon has a population of 4.2 million and FOUR medical schools.
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Your comments about senior civil servants in the health ministry and their longevity is interesting. We constantly blame the elected politicians for our concerns about government.
I strongly believe it is because we don’t demand that our politicians hold the civil service responsible for the disgraceful procrastinations and cost over-runs that governments tolerate at every level.
The BC Ministry of Health employs approximately 1,830 staff directly within its central operations. These employees are involved in a wide range of activities, including health policy development, program implementation, and oversight of the province’s health system. However, the Ministry’s influence extends to tens of thousands of healthcare professionals across the province, employed by regional health authorities that deliver most frontline care and services.
When newly elected politicians first arrive in Victoria, they are basically indoctrinated into how to interface appropriately with the bureaucracy so as not to make themselves the target of “complaints” and potential “disciplinary action” brought about by well protected employees of the civil service. It is very interesting that the seminars these politicians must attend are delivered largely by either the bureaucrats themselves or by contractors hired by the bureaucrats.
A recent example that I am aware of demonstrates how the politicians are manipulated to insure the status quo is not impacted by mis-guided zealotry
A newly elected city councillor spoke up at the first financial planning review session to comment on whether or not a detailed analysis of the multi-million dollar budget was required. The gist of the response was that the person had recently attended a seminar on how to manage their new position. The person stated that “we were advised that our job is like that of a helicopter pilot, we should not engage in the mundane activities of budget planning but should trust the professionals to do their jobs. Therefore there is no need to do a detailed analysis of this 200 page financial plan.
This came from a newly elected city councillor who probably has never read an audited financial statement or budget plan in their life.
We have to figure out how to empower our elected officials with the information they need to hold the bureaucrats accountable.
GG
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