Fraser Health is threatening to fire all 28 of its anesthesiologists unless they provide dedicated, 24-hour care for the maternity ward at the Surrey Memorial Hospital.
The vice president of medicine for Fraser Health, Dr. Roy Morton, says Surrey Memorial has the health authority's busiest birthing unit — with 4,300 births a year. But he says only half of women who request an epidural there receive one.
"We have been trying to put in place greater anesthesia services in the family birthing unit, allowing women a more timely access to pain management during labour," Morton said.
The hospital gets at least one complaint a day about epidural services, he says, with many mothers waiting too long to get one.
Morton says on evenings and weekends there is only one anesthesiologist on call at the hospital, and that person has to service the emergency surgery ward as well as the family birthing unit — which leads to delays.
He says the hospital has been trying to reach an agreement with the group of anesthesiologists for the past five years to no avail.
"We felt we had no other alternatives of taking this step basically revoking privileges," Morton said.
The letter issued to the hospital's anesthesiologists says the termination would be effective March 1, 2017.
"I'm fully confident that we will be able to replace the group," he said.
But B.C. Anesthesiologist Society CEO Dr. Roland Orfaly says anesthesiologists are in high demand everywhere in B.C., and the issue needs to be resolved beyond just one hospital.
"We're trying to look for positive solutions on a provincial level," he said.
Orfaly says epidural rates are considered to be a marker of the availability of anesthesiologists, and B.C. has the lowest epidural rate in the country — half the national average.
To resolve the issue, Orfaly says the province has to tackle recruitment, training and retention.
"There isn't a simple solution," he said. "The only way that we're going to improve patient safety in the long term is to put all these pieces into place."
Province backing hospital
B.C. Health Minister Terry Lake is backing the Fraser Health Authority.
"There are anesthesiologists across the country who would love to live and work in the province that's leading the country in economic growth," Lake said, adding Surrey Memorial Hospital is a new facility.
He acknowledged that anesthesiologists are a "hugely important" part of health care and the 28 doctors have accordingly been offered a "very, very generous" remuneration package to compensate for the extra hours of service.
But he says the province needs to move towards patient-centred service.
"It is what women in Surrey deserve and expect," Lake said.