A reduction in the Fraser-Fort George Regional Hospital District’s contribution towards capital projects and equipment purchases might prevent the purchase of some items on Northern Health’s list of requests, but some directors argued that their communities are running out of room for tax increases.
The discussion stems from a motion passed by the board last year reducing its financial contribution to such projects from 40 per cent to 21.625 per cent
At the Thursday, Feb. 20 meeting of the hospital district’s board of directors, Northern Health’s executive director of capital planning, facilities operations and logistics Michael Hoefer and senior critical planning officer Sherri Tillotson gave a presentation on the health authority’s 2025 draft capital plan and its funding request from the district for this year.
The list of capital projects and equipment purchases include everything from medical imaging software and network replacements to new diagnostic and surgical equipment.
Most of the projects are specifically for the University Hospital of Northern BC, while the Mackenzie and District Hospital and Health Centre urgently needs a new lab chemistry analyzer and a couple are contributions towards authority-wide IT projects.
Hoefer explained that most of the equipment purchases are to replace existing equipment at the end of their life spans or past that point. The medical imaging and network upgrades are being done to head off potential threats from cyberattacks.
Electrical rooms one and six at UHNBC need new equipment like a powerhouse, generations and transformers. Hoefer said some of the electrical panels are far past the end of their expected life, with a few dating back to the original 1960s construction of the hospital.
Both the general nurse call system used to page nurses and declare emergency codes at the hospital as well as the psychiatric nurse call system need replacement.
The psychiatry nurse call system is currently only partially functioning, having only been somewhat upgraded since it was installed in the 1960s. New parts aren’t possible to find.
The general call system was installed in 2004 and parts are “very difficult to obtain.”
Three operating room anesthesia units need to be replaced so that surgeries don’t have to be delayed due to a lack of equipment.
A Holmium laser system used to treat kidney and gall stones needs to be replaced. Hoefer said the unit is portable and can be used outside of the urology operating room if needed
A 12-year-old x-ray machine needs replacement as the vendor it was purchased from only offers minimal support at this point and it has developed issues with image quality and reduced capacity over the years.
Sometimes, the poor image quality means that more x-ray images or other studies need to take place, reducing efficiency.
A computed-tomography machine (CT) installed in 2008 needs to be replaced after exceeding its 10-year lifespan. The machine completes up to 10,000 exams per year and parts are extremely limited these days.
Since there are only two scanners at UHNBC, Hoefer said patients might need to be redirected to other facilities in Northern Health or to other health authorities should one or both go out of commission.
Four surgical towers are being replaced. Hoefer said the video and technological components in the existing units display errors, which impede desired surgical outcomes.
Alternate Director Trudy Klassen (City of Prince George), filling in for the absent Cori Ramsay, asked whether the equipment replacements are more a result of planned obsolescence or rapidly changing technology.
Hoefer said that in the Lower Mainland, equipment gets replaced every five to seven years. In Northern Health, the replacement rate is every 10 or more years.
Changing technology is also a factor, especially for medical imaging. For example, Hoefer said that as machines that use x-rays evolve, they utilize lower doses of radiation as detectors improve.
He said Northern Health is trying to find the balance between wanting to adopt the latest technology and having the capital to purchase it.
“We are starting to experience this issue across the entire capital plan where we have more and more projects and more and more equipment that is at end of life and is being risk-managed,” Hoefer said. “Parts availability are challenges.”
While other health authorities in the province have similar challenges, but they don’t have to deal with as big a geographic area as Northern Health does.
For the items discussed at the meeting, Hoefer said the bigger factors was existing equipment reaching the end of its usable life.
In total, the net new funding being requested by Northern Health is $10,487,224. At the 21.625 per cent funding total, the hospital district would contribute $5,862,970, leaving $4,624,254 of expenses being unfunded.
Due to the large unfunded amount, Hoefer said Northern Health is proposing that to come forward with additional details on each of the budget bylaws it will be requesting this year at the previous 40 per cent amount and then the hospital district board can decide how much it wants to spend.
Director Art Kaehn (Woodpecker-Hixon) expressed concern about the impacts of the district’s spending cap and what projects might have to be shelved as a result.
“As much as it’s a struggle and we’re short of money and everyone is, it sounds like we’re creating a nightmare out there on the medical side,” Kaehn said.
“It disturbs me that we’ve got people on the front line who are working their guts out to get people looked after and we’re struggling with a decision around funding and whether or not we should do this stuff so that people are properly cared for.”
Hoefer said that if Northern Health’s spending requests aren’t granted, the authority and potentially its board will have to decide on whether certain projects can proceed.
Vice-chair Kyle Sampson (City of Prince George), who helped lead the push to reduce the spending cap, said he “strongly rejects” the idea this is a problem of the district’s creation because health care is the sole responsibility of the province.
“That’s not going to be some responsibility that I hold on my shoulders,” Sampson said. “And I would encourage the rest of this board not to as well.”
He argued that regional hospital districts are not required to contribute a specific amount of funding, calling the existing legislation outdated an in need of updating and the board “trailblazers” for pushing towards reform.
Sampson added that he didn’t think it was fair for Northern Health to ask for the board to essentially have to decide which projects should go forward and that the province will have to make up the funding gap.
Discussing Sampson’s points, Hoefer said Fraser-Fort George is the only hospital board in Northern Health to have identified the 40 per cent capital contribution as a problem and subsequently reduce it.
Director Dannielle Alan (Robson Valley-Canoe) agreed with Sampson that the board is unable to make informed decisions about which medical projects should proceed and wondered if a lump-sum payment to Northern Health for these projects would be more appropriate than bringing individual funding bylaws to the board since directors lack the specialized medical knowledge to make informed decisions.
“We need major provincial reform when it comes to funding capital projects within our various health authorities and we need to keep pushing for that,” Alan said. “But we also can’t afford to be on the bleeding edge when the lives of our residents are at stake. I don’t agree, quite frankly, with being the first in the province to do something when it comes to health care and when it comes to lives and safety of our residents.”
Director Victor Mobley (Salmon River-Lakes) said he could see both sides of the argument. Fraser-Fort George is getting slim pickings, he said, because of its limited tax base and high tax levels compared to more populated centres like Vancouver and the Fraser Valley.
He said that financial burden can’t be placed at the foot of the district’s residents, but they still need medical services.
Hospital district chair Joan Atkinson, the mayor of the District of Mackenzie, said the tax base in her community has shrunk dramatically to a breaking point in the wake of mill closures.
She said the district is facing a shortfall of greater than $1 million for its 2025 budget, which might not seem huge in the grand scheme of things but is a big deal for a community with a $12 to $15 million annual budget.
“We’re looking at cutting services to balance the books,” she said. “Resource-based communities in Northern Health, especially forestry … we have lost millions of dollars in tax assessment.”
With the real estate situation and property assessments so different in the north compared to the Lower Mainland, Atkinson argued that a blanket policy for health-care funding across all of BC makes no sense.
Kaehn pointed out that the remainder of the funding going to health authorities not providing by hospital districts still comes from the taxpayer through provincial property taxes, gas taxes and other sources.
Addressing the early work being done for the construction of the new acute care tower at UHNBC, Hoefer said the new parking structure is about 28 per cent complete, calling it “more than on time” and on budget.
Except for the two-week cold snap early this year, he said this winter has been conducive to getting work done on the parkade, with more than 1,500 cubic yards of concrete getting poured so far.
The parkade is expected to be complete by November.
Another part of the early work is tenant improvements at Parkwood Mall so that the existing health unit building can be demolished to make way for the acute care tower.
That work is also underway and is expected to be complete by June 2026, when the programs inside the existing building will move to their new home and that building will be demolished.
Klassen asked about how cost overruns will be handled under the “alliance” development model being used for the tower.
The hospital district is contributing $318.7 million towards the overall $1.579 billion cost of the project.
Hoefer explained that contractors will have a maximum amount of money they can spend on their portion of the build and if they go over that level, they lose money.
“They’re incentivized to solve the problem and stay on budget and deliver the entire quality and scope that we’ve procured,” Hoefer said.
The hospital district’s budget is set to be discussed at its next meeting on March 20.
