Government Files is The Canada Report's public-records analysis series examining government documents obtained through Canada's Access to Information (ATI) and provincial Freedom of Information (FOI) laws. These transparency laws allow members of the public to request internal government records from federal and provincial institutions. This article reviews documents released through those processes and summarizes what the records contain and what they show. While we strive for accuracy, this article represents an analysis and interpretation of the source material. For complete accuracy and full context, readers should review the original documents, which are available in full below.
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As of June 10, 2025, 1,409,513 British Columbians had no family doctor or nurse practitioner — roughly one in four residents of the province. On that same date, 384,175 people were registered on the Health Connect Registry, the provincial waitlist that matches unattached patients to a primary care provider. The difference between those two figures is the finding: more than a million people without a family doctor are not on the waitlist for one.
The numbers come from records released by the B.C. Ministry of Health under the province's Freedom of Information and Protection of Privacy Act, request HTH-2025-51315, closed on September 9, 2025. The request covered records from March 1 to June 10, 2025, and asked for the most recent Urgent and Primary Care Centre dashboard alongside figures on the Health Connect Registry and provincial attachment overall. The Ministry released the records in their entirety, with no information withheld.
What the Documents Show
The attachment figures appear on a two-line summary tab prepared by the Ministry's Corporate Services Division. They are drawn from the Provincial Attachment System, which tracks whether a B.C. resident with valid Medical Services Plan coverage is formally connected to a family physician or nurse practitioner. Against a total of 5,698,838 residents, the 1,409,513 unattached figure works out to 24.7 per cent of the province.
The Health Connect Registry number is narrower than it first appears. The Ministry's own interpretation note specifies that the 384,175 figure counts people with an Active status — currently waiting for a provider — and a Pending status, meaning they have been sent to a provider for attachment but are not yet attached. It excludes anyone already successfully attached, and anyone whose registry file has gone inactive.
Put those two definitions side by side and the arithmetic is stark. Of the 1,409,513 people the province's own attachment system records as having no primary care provider, 1,025,338 do not appear on the registry in either an active or pending state. That is 72.7 per cent of B.C.'s unattached population sitting outside the queue that exists to serve them. The records do not explain the discrepancy, and the Ministry offers no commentary on it.
There are several ordinary explanations that the documents neither confirm nor rule out. Some unattached residents may never have heard of the registry. Some may have registered, been marked inactive after a missed contact attempt, and dropped out of the count. Some may not want a family doctor, or may rely on a walk-in clinic by preference. What the records establish is only the size of the gap, not its cause — and the gap is large enough that any public figure citing the registry alone understates the province's attachment problem by a factor of nearly four.
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What Urgent and Primary Care Centre Visits Reveal About Attachment
The same release contains the Ministry's Urgent Primary Care Centre Patient Services Report for the 2024/25 fiscal year, closing with Period 13, which ran February 28 to March 31, 2025. Across 42 UPCCs, the province logged 898,329 patient visits and 1,497,444 patient encounters over the year, serving 561,338 unique patients.
The most revealing table in that report breaks visits down by attachment status. Only about 133,000 visits — 14.8 per cent — were made by patients formally attached to the UPCC they attended. Roughly 407,000 visits, or 45.3 per cent, came from patients with no most-responsible practitioner at all. Another 358,000 visits, close to 40 per cent, came from patients who do have a family doctor but sought care at a UPCC instead. Taken together, more than 85 per cent of UPCC visits in 2024/25 were made by people the centre does not consider its own patients.
That distribution says something about what UPCCs have become in practice. The centres were introduced as a bridge between emergency departments and family practice, intended to both deliver same-day care and attach patients to a longitudinal provider. The Ministry's own footnote acknowledges that some UPCCs do not provide longitudinal care at all. The visit data suggests that for the overwhelming majority of people walking through the door, the centres function as high-volume walk-in clinics — including for the two in five visitors who already have a doctor they could not or did not see.
Demand is climbing. Visits rose from roughly 57,000 in Period 1 to about 89,000 in Period 13, a 56 per cent increase across the fiscal year, closing at nearly 2,800 visits a day. Nursing staff absorbed most of that load: registered nurses accounted for around 776,000 encounters, or 51.8 per cent of the annual total, compared with roughly 426,000 for family physicians and 160,000 for nurse practitioners. About 36 per cent of encounters occurred outside regular business hours, and 15.6 per cent were delivered virtually.
The Hiring Shortfall Behind the Numbers
The second report in the release, the Primary Care Workforce Report for the same period, records how far the province is from staffing the system it has approved. Across all primary care initiatives, 2,401.97 full-time-equivalent positions had been recruited against 3,501.67 approved — 68.6 per cent, leaving roughly 1,100 approved FTEs unfilled. UPCCs specifically stood at 669.79 of 852.02 approved, or 78.6 per cent.
The provincial average conceals extreme variation between sites. Cowichan's UPCC, listed in early implementation with an opening date recorded only as "TBD (Nov 2025)," has filled none of its 31.15 approved FTEs. Central Nanaimo, open since July 2024, sits at 12 per cent. Kamloops North Shore, open since November 2024, is at 53.1 per cent. At the other end, North Vancouver reports 136.8 per cent of its approved complement and Campbell River 148 per cent — figures the report presents without explanation, though they suggest approved baselines that no longer reflect what the sites actually operate.
Recruitment gaps by discipline point in the same direction as the encounter data. Physicians province-wide are at 76.5 per cent of approved FTEs and nurse practitioners at 67.1 per cent. Indigenous Health positions are the weakest category in the release, at 30.1 per cent — 76.72 filled of 255.10 approved. Several First Nations-led Primary Care Centres report Indigenous Health hiring at or near zero. The report notes that its figures exclude physicians paid through fee-for-service or alternative payment plans, so it is not a complete picture of the primary care workforce.
The workforce shortfall is not unique to British Columbia, and neighbouring provinces are pulling on the same limited pool of clinicians. New Brunswick recently signed a recruitment agreement with Indonesia to bring in nurses, while Quebec's remuneration overhaul has prompted nearly 400 physicians to seek licences in other provinces. B.C.'s unfilled 1,100 positions sit inside that national competition for staff.
What's Missing from the Records
The request asked for the UPCC dashboard "with pivot tables showing hiring progress and period/visit data." What the Ministry released are two static PDF reports generated from Power BI, plus a two-line summary tab. No pivot tables, no underlying spreadsheets, and no data at a granularity that would allow independent recalculation. The response letter states the records were provided in their entirety, which indicates the Ministry considers these documents to be what exists in responsive form — not that anything was withheld.
The attachment figures come with no breakdown at all. There is no split by health authority, no regional detail, no age or geography, and no time series. A single number for June 10, 2025, does not reveal whether unattachment is rising or falling, or whether the million people missing from the registry are concentrated in particular communities. The registry figure is similarly flat: the records do not say how long the average person waits, how many registrations lapse into inactive status each period, or what proportion of pending referrals ultimately result in attachment.
The UPCC report carries one anomaly the Ministry does not address. Northern Health's cumulative "Unique Patients Since Opening" runs from 61,000 in Period 1 to 66,000 by Period 9, then drops to 16,000 in Period 10 before climbing to 21,000 by Period 13. A cumulative measure cannot decrease. The report's contextual note explains that all figures are self-reported by health authorities and subject to retrospective adjustment, which may account for it, but the released records contain no correction or footnote.
Finally, the two datasets do not connect. Nothing in the release links UPCC activity to attachment outcomes — there is no figure for how many of the 561,338 unique UPCC patients were subsequently attached to a provider, whether through the registry or otherwise. That is the number that would show whether the centres are relieving the attachment backlog or merely absorbing its overflow, and it is not in the documents.
Why the Gap Matters
British Columbia has spent years building attachment infrastructure: 92 Primary Care Networks, 42 Urgent and Primary Care Centres, 15 Community Health Centres, 14 First Nations-led Primary Care Centres, and three Nurse Practitioner Primary Care Centres, deployed across more than 450 clinics and regional hubs. The Health Connect Registry is the front door to that system. These records show that roughly three-quarters of the people the system is meant to serve are not standing at the door.
That has practical consequences for how the province measures its own progress. Registry counts are the most visible public indicator of the family doctor shortage, and they are the number most often cited. But a registry figure only tracks people who have chosen to register and remained active on the list. Attachment data from the Provincial Attachment System tracks everyone with MSP coverage. When those two measures diverge by more than a million people, improvements in the smaller number can occur without the larger one moving at all.
The UPCC visit data supplies the other half of the picture. Nearly half of the visits to these centres come from patients with no provider, and another 40 per cent from patients who have one but could not use it. Both groups are, in effect, being served outside the attachment system the province has spent years constructing — one because it has not reached them, the other because it has not delivered timely access. The records document both conditions clearly. They do not say what the province intends to do about either.
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Support The Canada Report →All figures referenced are from the British Columbia Ministry of Health, request HTH-2025-51315, obtained through a Freedom of Information request. The records comprise the Urgent Primary Care Centre Patient Services Report and the Primary Care Workforce Report for FY2024/25 Period 13, together with a Ministry summary of Health Connect Registry and provincial attachment figures as of June 10, 2025.
