GABRIOLA ISLAND -- Two doctors and representatives of the Nanaimo Regional General Hospital say upgrades for the facility are long overdue.

At the March 9 committee of the whole meeting, the directors of the Regional District of Nanaimo heard from Dr. David Coupland, president of medical staff at Nanaimo Regional General Hospital, and Dr. Arun Natarajan, one of two cardiologists at NRGH, on why a full-service hospital and capital projects like a new patient tower and cardiology lab are needed.

“We have not matched medical need and population growth in Central and North Vancouver Island in the last 15-20 years,” Coupland said, citing a 2010 consultant's report that called for the replacement of the current tower, deeming it structurally unsafe and functionally deficient.

“It's been extremely difficult for our staff to deliver care during a pandemic in that hospital,” he said, saying a full-service hospital in Nanaimo would “restore a historical inequity” compared to the Victoria area.

Island Health and local healthcare providers produced a five-year services plan for the hospital in 2017 which addressed five areas: care for the critically ill, specialist recruitment, cancer care services, pediatric and adult mental health and substance abuse.

While there's been some progress in areas like critical care – a new ICU has broken ground – currently the hospital cannot provide an adequate standard of care for the population size it serves, Coupland said.

In the presentation, he said 50 per cent of the population situated in Island Health boundaries lives north of the Malahat, yet access to care compared to Victoria, including specialist doctors, is staggeringly low.

“We have no oncologist north of the Malahat for a bigger, older population,” Coupland said. Victoria has 40, according to the presentation.

Some specialist hires have been made over the last few years, but Coupland and Natarajan said better facilities need to be in place in order to attract specialists to work in Nanaimo.

“Once we improve resources, the word spreads and you have people wanting to come,” Natarajan said.

Some practices utilized at NRGH are no longer part of the training newer doctors receive, he said. Because NRGH lacks a catheterization lab, where a patient who's experiencing a “big jammer” heart attack would be fitted with a stent to open blood flow through the blocked artery, cardiologists in Nanaimo must administer a “clot buster,” which involves giving an injection to rapidly thin the blood. The procedure can cause permanent damage to organs or even death.

With a catchment area for cardiac care of 350,000, Natarajan said NRGH is “one of the few places in the developed world to not have this facility.”

Coupland said a new patient tower to replace the current one built in 1963 is required for the catheterization lab. Island Health estimates a new patient tower will cost $1 billion.

RDN directors were supportive of capital needs but were hesitant about the tax burden placed on the Nanaimo district's residents. Director Ed Mayne, Mayor of Parksville, wondered if other regional districts should share the cost if the upgrades are meant to serve both central and north Vancouver Island.

Ultimately, directors unanimously passed two motions at the committee of the whole meeting.

The first motion is to advocate to the province to commit to building a new patient tower within five to eight years. The patient tower would include a diagnostic treatment centre with a cardiac catheterization lab, and a cancer centre, which Premier John Horgan announced in the last election campaign as part of the party's 10-year cancer action plan.

The second motion directed the NRHD select committee to begin discussions with relevant groups regarding advocacy for funding of capital projects for NRGH.

According to Island Health, between April 1, 2019 and March 31, 2020, 1,512 individuals from Gabriola Island went to NRGH for at least one health-care service.