A new chapter for British Columbia

With 56 new faces elected to the provincial legislature, there will be significant work ahead to help new Members of the Legislative Assembly understand issues important to health care and pharmacy. 

By Michael Mui, Communications Manager, BCPhA

It might not seem like it from the dispensary counter, but the success of community pharmacists depend on the outcome of provincial elections.

Like other Canadian provinces, the provincial government in British Columbia is responsible for the management, organization and delivery of health care services within its jurisdiction. This oversight includes the administration of the provincial public drug plan, the amount of funding for different pharmacy services, the scope of practice for the profession, and much more. 

On Oct. 19, the public headed to the polls in the 2024 British Columbia general election. This was a highly contested and close election. It was one where the incumbent New Democratic Party, which has been in power since 2017, is expected to return to government with a narrow lead of 47 seats out of a possible 93, trailed by the resurgent B.C. Conservative Party’s 44 seats, and the B.C. Green Party’s two seats. 

The results, while close, signal that health care in B.C. will again be led by the same government that guided the province through the pandemic, and a government that has contributed significantly to expanding the pharmacists’ scope in recent years. 

But while the name of the party leading B.C. will remain the NDP, more than one-in-three of its MLAs-elect are new to provincial politics. Across the three parties, there are 56 new faces. 

This means that, despite the work of the Association for more than 10 years to educate sitting politicians about the community pharmacy sector, more than half of the political representatives who could soon be voting on critical issues might have very little knowledge, or no knowledge, about pharmacy at all.

In the lead up to the election, more than 260 candidates across the major political parties competed for the public’s vote. As part of preparing for the election, the Association prepared and distributed letters to all these candidates, regardless of party affiliation, informing them of the types of services available to British Columbians through community pharmacies, along with information on proposals on the topics of the dispensing fee, on support for rural practices, and on additional expansion of scope. The BCPhA also conducted meetings with leading candidates from both parties, including candidates responsible for health care.

With the results in, there is now substantial work ahead to introduce the pharmacy profession to the newly elected officials. 

To help pharmacists be informed about the Association’s advocacy efforts, in October 2024, the Association relaunched its Advocacy Guide. The guide is available to all members at bcpharmacy.ca/advocacy/guide.

The guide contains useful information such as an introductory document on how health care and politics intersect, a tool to help members find the MLA that represents your pharmacy’s electoral district, details on the Association’s current advocacy focus, key facts and statistics of importance to the pharmacy profession, a list of answers to frequently asked questions and more.

Members also have access to a 5-minute video that shows an example of an MLA visit to a pharmacy, and a written tour outline that breaks down the goals of a tour, how to prepare for a tour, key moments during an actual visit, and contacts in the BCPhA staff that members can reach out to for questions. 

Return financial sustainability to community pharmacists

While community pharmacists in B.C. have seen an increase in scope and additional sources of revenue related to the scope increase, one key element that has continued to fall short is the foundational funding from the government: the pharmacy dispensing fee, which has remained at $10 since 2011. Pharmacy is the only health-care profession in B.C., which receives much of its income from government, which has not received any increase to its base rate during this 13-year period.

Providing help to community pharmacies in rural and remote areas

In many areas of B.C., a pharmacist may be the only health-care provider a patient can readily access. The BCPhA is proposing that the province introduce a new rural incentive program, similar to that provided to physicians, that would provide much-needed funding to pharmacies operating in rural areas. As part of this proposal, the Association is also asking the province to develop a student loan forgiveness program for pharmacy graduates who practice in rural and remote areas.

Providing funding for in-pharmacy Point of Care Testing

Pharmacists have now been enabled as referring practitioners in B.C.’s Laboratory Services Regulation, which means patients would visit a pharmacy first before being sent to a different lab location. The BCPhA’s Point of Care Testing proposal asks government to fund tests that can be done within the pharmacy itself. These tests can include group A streptococcal tests, tests for blood sugar levels and cholesterol testing, as a few examples.

Making the case for these asks will be the focus of the Association’s coming political advocacy efforts. 

Each year, the BC Pharmacy Association’s Government Relations and Advocacy Program hosts dozens of tours where MLAs are invited to visit a community pharmacy in their electoral district. Through these visits, the Association connects members directly with elected officials to show political decision-makers how community pharmacy fits within the health system, and how boosting the profession can benefit both the public and the health sector. 

With 56 new MLAs, there will be much work ahead.

Jennifer Kim, a pharmacist who hosted Green Party candidate Wendy Hayko for a visit of her pharmacy in the Vancouver-Little Mountain electoral district, was one of several members who participated in advocacy efforts in the lead up to the 2024 election.

Despite being in the middle of a busy fall respiratory illness immunization campaign, Kim said she decided to host the candidate because she believes educating political decision-makers is crucial to advancing the profession.

“A lot of the newly elected MLAs are new – they’re rookies to government. They may be familiar with some issues, but health care may not be top of mind for many of them,” Kim said. “The way for us to advocate for change, for our profession, is to make the time for these people. To get the news out there on what pharmacists are able to do, and what we should be fairly compensated for.”

Kim said it’s her hope that when government forms again to pass legislation, that pharmacists would be consulted for any decisions impacting health care.

“We all have a role in advocating for our profession, for the sustainability of our profession, and for the expansion of our profession,” she said.

Kim’s pharmacy was just one of several tours the Association hosted ahead of the election. The Association will be preparing additional community pharmacy visits throughout the province, with a focus on political newcomers. 

The NDP, which will form a majority government when the provincial Legislature resumes sitting, has led consecutive governments in B.C. since coming to power in 2017.

As part of the NDP’s election platform, one of the party’s promises is to allow pharmacists to prescribe for more common conditions, and offer testing for routine conditions such as strep throat.

On Nov. 18, Premier David Eby appointed MLA Josie Osborne, representative for Mid Island-Pacific Rim and former minister of energy and mines, to the Ministry of Health portfolio — the first time this government has changed its health minister since 2017. Previously, the post was held by MLA Adrian Dix. 

Prior to the election, Health Minister Dix spoke with and answered questions from community pharmacists during the BC Pharmacy Association’s Annual Conference in May 2024. In his opening remarks, he recognized community pharmacists for their contributions to health care, and applauded the profession for administering more than 80 per cent of COVID and flu vaccines in B.C. He also thanked pharmacists for helping hundreds of thousands of British Columbians who have received care through the minor ailments and contraception services program. 

Dix acknowledged that the expanded scope of practice has created new challenges for the profession.

“How do we support rural pharmacy? How do we deal with issues of recruitment? If we're expanding the scope of practice, effectively expanding the work, how do we deal that, not just for pharmacists, but everyone working in the pharmacies, from technicians to assistants to everybody? How do we deal with those issues? How do we deal with historic issues around dispensing fees?” Dix said. 

“And these are issues that we’re going to continue to work together on and engage on, and we're going to do that because the BC Pharmacy Association has had, I think, in the last number of years, the most successful relationship with the government and the community of any association in any health care group in the entire province.”

Since the NDP formed government in 2017, the Association has been working to build a strong, collaborative relationship with the provincial Ministry of Health. Many of the recent significant advancements in the profession were made during NDP government rule, especially after the start of the COVID pandemic. 

Early on, as restrictions were announced in 2020, community pharmacists were already being called upon by public health to contribute much-needed human resources to help administer vaccines. As the months passed, the bulk of the work of immunizing the public – and providing boosters – shifted almost entirely towards community pharmacies. 

By the time the pandemic moved into its second year, more than 1,000 community pharmacies joined the public COVID vaccine effort. Compensation beyond the standard injection fee of $12.10 was successfully negotiated, and starting in March 2021, pharmacists were compensated $18 for every COVID-19 vaccine administered. Later that year, a further $4 top up was negotiated for vaccines provided on weekends. The increase and additional fee top-up were substantial signs that the extra hours pharmacists put in are recognized. 

In 2022, the demand for pharmacy services only grew. In January that year, a provincial order was issued to include pharmacy technicians into the list of professions that could prepare and administer COVID vaccines. By June that year, pharmacies accounted for eight out of every 10 COVID vaccines provided in B.C. In October, government expanded the pharmacists’ scope for adaptations, injections, and extended prescription expiry dates.

The next year, in 2023, the profession saw a significant increase in long-term care fees. As with dispensing fees, long-term care fees had not seen movement in more than a decade. On Mar. 1, 2023, the long-term care per-bed fee was increased by 50 per cent, to $65 per bed/month, up from $43.75. 

In June 2023, the profession saw a significant jump in its scope with the introduction of minor ailments and contraception services (MACS). This was something the Association has long called for. As of May 31, 2024, the service has benefitted more than 300,000 British Columbians. 

While MACS was being implemented, the Association was already moving forward with additional proposals that explore the question of what comes next beyond the pandemic, and beyond the health human-resources crisis that had gripped B.C. for much of the pandemic.

One of those proposals was delivered on June 13, 2023 by Association CEO Geraldine Vance, who presented to B.C. government’s Select Standing Committee on Finance and Government Services in advance of the government’s 2024 Budget. The Association drew attention to how patient care can see further benefits by enabling pharmacists to order lab tests, and secondly, by providing public funding to point-of-care tests within community pharmacies. 

In the June proposal, the Association also asked the province to allow pharmacists to initiate Opioid Agonist Treatment (OAT) and adapt the same. As done in the case of COVID-19 rapid test kits, the Association proposed that pharmacies be looked at as potential distribution sites for drug checking strips as a harm reduction service.

Lab test ordering authority was granted in August 2024 and the Association is currently working to advocate for fair compensation for this new service.

A second proposal was made to government in late 2023 – this time, on more funding for community pharmacies located in rural areas of British Columbia. This proposal followed a consultation process involving 77 pharmacies, a mix of chains, banners and independents located in rural areas throughout the province, and resulted in a comprehensive document that outlined eight recommendations government should consider. The proposal was then discussed directly with MLAs responsible for rural areas, and work continues today to move these latest asks forward.

With a new government in place, moving into 2025, the Association will be continuing to advocate for increases to pharmacy compensation, support for rural practice, in addition to further expansion of the pharmacists’ scope.

As a member, you can become involved. Several times a year, the Association organizes pharmacy tours to invite MLAs to visit a community pharmacy within their electoral district. These tours often take place during the fall respiratory illness vaccine season or during Pharmacy Appreciation Month in March. You must be a BCPhA member to be invited to be part of these tours.

In preparing for a tour, the Association will first identify MLAs who may benefit from learning more about community pharmacy services. These MLAs may have important decision-making responsibilities due to their parliamentary portfolios or cabinet responsibilities. Other MLAs may be new to their job, or for other reasons have not previously attended a pharmacy visit. 

During these opportunities, Association staff will identify all member pharmacies who are within the targeted MLAs’ electoral districts and reach out by email or phone to members to gauge interest. Pharmacies are shortlisted based on the number of members who are interested in each district to host their MLA. Typically, only one or two pharmacies in each district will host a visit during each round of tours. 

Association staff may interview pharmacy team members to learn more about your pharmacy’s values, what makes your pharmacy unique, the population that you serve, the services you provide, and as a way to learn more about you and your pharmacy team members. Finally, hosting pharmacies are selected based on the sum of the above factors, your pharmacy team’s availability, and to ensure a fair representation of chain, banner and independent pharmacies.

Express your interest in participating by reaching out to communications@bcpharmacy.ca.