Mike Goetz has added bill collector to his list of responsibilities as mayor of Merritt in British Columbia含羞草研究社檚 Interior.

In June, Goetz sent the province an invoice for $103,831.87, the cost, he said, for closures of the Nicola Valley Hospital emergency room.

He said the bill for the 19 closures last year and the first five closures this year includes a partial refund of what the city paid for hospital services, as well as the cost when firefighters respond to medical calls because paramedics are busy transporting patients to Kamloops, about 85 kilometres to the northeast.

And GST, of course.

Goetz said the costs would be equivalent to a one-per-cent increase in taxes for the community, unless the province picked up the tab, and came on top of the more than $600,000 the municipality already pays the province annually for its hospital.

含羞草研究社淭hat含羞草研究社檚 unacceptable to ask our taxpayers to pay for this system twice. We含羞草研究社檝e paid for it once, we expect 365 days of coverage, because that含羞草研究社檚 what you charged us for,含羞草研究社� he said.

The mayor isn含羞草研究社檛 alone in his frustration with the state of B.C.含羞草研究社檚 health system. Temporary emergency room shutdowns have hit rural and urban hospitals, hundreds of cancer patients have been sent across the U.S. border for radiation therapy, and there含羞草研究社檚 a shortage of nurses and doctors.

It含羞草研究社檚 a central issue ahead of the Oct. 19 provincial election, with the B.C. Conservatives offering sweeping changes and at least one major change promised by the governing New Democrats not set to be fully implemented until after the election.

Dr. Rita McCracken, a family doctor and assistant professor at the University of British Columbia, said fixing the province含羞草研究社檚 health-care system will require systemic changes, beyond hiring more employees.

含羞草研究社淲e don含羞草研究社檛 have enough people doing the jobs, but at the same time, we have a system that is made out of Scotch Tape and wet paper that we含羞草研究社檙e trying to graduate people and hire people into,含羞草研究社� she said.

B.C. Conservative Leader John Rustad made health care the focus of his first major platform commitment in July, long before Opposition Leader Kevin Falcon suspended his BC United Party含羞草研究社檚 campaign and threw his support behind the Conservatives.

The Conservatives say that if elected they will pay to send more people outside the province for health care and expand the use of private clinics. Rustad has also promised to compensate health workers who lost their jobs for refusing to get the COVID-19 vaccine.

含羞草研究社淥ur health-care system in B.C. is in crisis. More than that, it is failing. More money into the system is not the solution,含羞草研究社� Rustad said in July.

Rustad faced criticism Monday over a video, circulated by the NDP, in which he tells a group of former public service employees who lost their jobs for refusing to be vaccinated against COVID-19 that he wishes he hadn含羞草研究社檛 received three shots of the 含羞草研究社渟o-called vaccine.含羞草研究社�

In the video from June, Rustad said he含羞草研究社檇 realized vaccination campaigns weren含羞草研究社檛 about trying to stop the spread of COVID-19 but rather were 含羞草研究社渁round shaping opinion and control on the population.含羞草研究社�

The BC Greens have said they want to establish community health centres in all 93 ridings in B.C. to replace the current network of urgent and primary care centres, saying they had failed to retain staff and provide patients with primary care connections.

Leader Sonia Furstenau said the plan would put 含羞草研究社渢imely, comprehensive care all in one place含羞草研究社� and streamline referrals by giving access to doctors, nurses, mental health professionals and specialists within a patient含羞草研究社檚 community.

As health minister, Adrian Dix has acknowledged the province含羞草研究社檚 struggles with health-care staffing that he said was a problem across the country.

In an interview with Global News over the Labour Day long weekend, when several emergency rooms were closed, Dix said the government was 含羞草研究社渄oing absolutely everything we can含羞草研究社� and that 含羞草研究社渨e don含羞草研究社檛 consider it ever acceptable含羞草研究社� for emergency rooms to close.

The province does not compile a public tally of emergency room closures but there have been dozens over the summer, in the Interior, north and elsewhere.

In the Interior Health region alone, there were 66 emergency room closures in the first half of 2024 because of a lack of either nurses or doctors.

Dix has said the province added 250,000 nursing hours 含羞草研究社渋n the last number of years含羞草研究社� and had 831 net new family doctors.

The NDP is promising that if re-elected it will expand when pharmacists can prescribe medications, reduce paperwork for doctors, add more physician assistants and expand the range of services they provide.

Leader David Eby said a re-elected government would provide immediate provisional licences for doctors, nurses, and midwives trained in Canada who stepped out of the system, and offer the same licences in six weeks for professionals trained in some regions outside of the country.

But McCracken said whoever wins in October will have more to worry about than hiring. She said the next government has to do a better job of quantifying exactly what is required, and understanding the system so that doctors want to stay where they are most needed.

含羞草研究社淲e haven含羞草研究社檛 really been addressing 含羞草研究社� and it echoes over into nursing and emergency rooms and in all the different places 含羞草研究社� that we have not created a sophisticated-enough assessment of what we need to be providing care,含羞草研究社� she said.

Ahead of the election the The BC College of Family Physicians and BC Family Doctors published a series of requests for its members from the next government, including access to extended health and dental benefits, sick days and a pension plan.

They say the government needs to reduce paperwork and fund additional supports like nurses in family medicine clinics.

The organizations estimate more than 700,000 British Columbians don含羞草研究社檛 have access to a family doctor and nearly 40 per cent of family doctors are set to retire or reduce clinical hours within five years.

McCracken said under the NDP government there had been 含羞草研究社渟ome very significant shifts in the right direction,含羞草研究社� pointing to a new payment model for doctors launched in 2023, but added such moves represented 含羞草研究社渢he first two or three steps of probably 100 that we need to take in order to stabilize the system.含羞草研究社�

Adriane Gear, president of the BC Nurses含羞草研究社� Union said working in an emergency room was a particularly challenging role.

含羞草研究社淣urses have tried their very best to hold up the system. But you can only work short staffed so often. You can only know that you含羞草研究社檙e actually not providing the care that people need so many times. And then you look around and you go, 含羞草研究社榶ou know what? This is killing me,含羞草研究社櫤�羞草研究社� she said.

She said the union wanted a promise from political leaders to continue working on meeting nurse-patient ratios.

In March, B.C. announced it would be the first province to implement such a policy, something Gear said had helped retain and recruit nurses in other countries.

In the days leading up to the election campaign in September, the NDP government announced a series of agreed-to ratios including one nurse to three patients for general emergency room visits, 1:1 for trauma, and 1:4 for short surgical stays.

It said implementation would begin this fall.

Gear said she wanted a similar promise from the other party leaders if they are elected.

McCracken described health care as 含羞草研究社渨hack-a-mole these days含羞草研究社� with multiple serious issues popping up that affect voters.

含羞草研究社漌hen you含羞草研究社檙e having a health crisis and you realize you need to drive for 3 1/2 hours in the middle of the night, that just brings up a lot of feelings, and I think it含羞草研究社檚 going to get transmitted to active discussions during the campaign,含羞草研究社� she said.

In Merritt, Goetz said in an interview near the end of August that he had not received a response to the bill from Dix. But if he doesn含羞草研究社檛 get one, he said he was 含羞草研究社渟ending it to collections.含羞草研究社�

含羞草研究社淚含羞草研究社檝e called it a house on fire, and that含羞草研究社檚 exactly what it is,含羞草研究社� he said.