News

Jun 09, 2023

Opinion: B.C. sending patients to the U.S. for cancer care is another disturbing sign of a collapsing health system

There’s good, bad and ugly in B.C.’s decision to send about 4,800 cancer

There's good, bad and ugly in B.C.'s decision to send about 4,800 cancer patients to the U.S. for radiation treatment over the next two years – with a touch of déjà vu thrown in for good measure.

The good news is that breast cancer and prostate cancer patients who need radiation treatment are going to get care in a more timely manner when they travel to two private clinics in Bellingham, Wash.

B.C. Health Minister Adrian Dix deserves some credit for putting patients first even though he had to know the move was going to garner a lot more criticism than praise. An NDP government buying private care, in the U.S. no less, is a political egg-on-the-face moment.

The bad news is that accessing treatment is going to be a lot more inconvenient than it should be. Being sick is bad enough, and being away from family and friends makes cancer treatment more challenging, even if the province is picking up the tab.

Still, it's better than waiting, which causes patients anxiety, and increases the risk of death.

The cost of sending patients to the U.S. – about three times what it would cost for identical treatment in Canada – is also a bitter pill to swallow. The $78-million required to buy this overpriced for-profit care in the U.S. could no doubt be better spent domestically, invested in more permanent solutions.

But what's really ugly is seeing an essential health service, cancer care, buckling before our eyes.

Last year, there were 233,900 new cancer cases diagnosed in Canada. It remains the No. 1 killer, with 85,100 deaths in 2022. Cancer prevention and treatment have to be priorities.

If fairly routine cancer treatments can't be delivered in a timely manner, it's an alarming bellwether that the larger health system is crumbling around us.

The real tragedy here is that the demand for radiation treatment in B.C. was largely predictable and the crisis happening now mostly was preventable.

The purchase of new linear accelerators used for radiation treatment and the hiring of staff – radiation oncologists, radiation therapists and physicists – should have begun long ago.

The Baby Boom started more than six decades ago. That the incidence of cancer would grow has been widely known for years.

At some point, we have to stop pretending that the aging of the population, and the shift in care that needs to accompany it, are a surprise.

We have to be aggressively pro-active, not pitifully reactive.

If there is one thing that we should have been able to prepare for, it's a rise in cancer cases. Cancers are, after all, largely diseases of aging, with fairly predictable progressions.

What's tragic, too, is to see how BC Cancer, once a leader in care, has descended into mediocrity.

Globe and Mail reporter Andrea Woo has written extensively about the agency's woes, chronicling growing waiting lists and staffing shortages under a backdrop of burgeoning bureaucracy and short-sighted policies.

Local (and national and international) hero Terry Fox has to be turning in his grave.

Mr. Dix, the provincial Health Minister, said he was prompted to act by some harsh data, namely that only 77 per cent of cancer patients who require radiation in B.C. were getting the care within 28 days.

That's well below the national average of 97 per cent, and down sharply from 93 per cent in B.C. in 2019.

This problem didn't happen overnight, but over time – with a little bit of a shove from the pandemic.

Nor is it the first time this has happened. From 2018 to 2020, B.C. sent cancer patients to Bellingham while it was waiting to purchase PET scanners.

Ontario sent patients to Buffalo, Detroit and Cleveland. Quebec sent theirs to Vermont.

It's as if we never learn from our failures.

And the government has excuses for this latest contretemps, of course: There's the aforementioned aging population, the long process for replacing aging medical machines (especially at a time when there are supply chain issues), and human resources challenges – notably, that every jurisdiction in the world is vying for the services of oncologists, technicians and physicists.

"We must do more. We must do it now. And we have," Mr. Dix said solemnly.

Not exactly "Veni, vidi, vici."

There's an expression that holds: "The best time to plant a tree is 20 years ago."

The same is true of health care investments. You can't wait until a crisis has begun to react. You need a long-term vision.