The provincial government claims any B.C. resident can see a pharmacist for minor ailments, but new healthcare programs are largely inaccessible to immigrant and migrant women in sex work.
In British Columbia, many people have difficulty accessing healthcare due to the shortage of family doctors and long wait times. In addition, many healthcare providers feel overworked due to being short-staffed and having high demand for their services. In response, Pharmacist Prescribing for Minor Ailments and Contraception (PPMAC) was implemented on June 1, 2023. B.C. residents can see a pharmacist for 21 minor ailments such as allergies, urinary tract infections (UTI) and contraception. A minor ailment is defined as a condition with a low risk of masking an underlying disease, disorder, or condition, that can be diagnosed without lab or imaging tests and is expected to resolve with short-term or episodic treatment. The service aims to make healthcare more accessible by decreasing the need to see a doctor, reducing wait times, and redistributing the workload of healthcare providers.
The Ministry of Health claims that PPMAC has been successful and states that it expects further improvement in the future, except the Ministry of Health only looks at patients who are covered under MSP. While more than 312,000 patients accessed the program in the first year, with pharmacists treating over 431,000 minor ailments and providing contraceptive services, PPMAC has failed to hit some of the Ministry of Health’s accessibility targets for the program. B.C. keeps track of statistics to evaluate its performance and some of its goals for the evaluation are to determine if this service improves access to treatment, quality of care for patients, the efficiency of health care delivery, and promotes fairness and equity in accessing healthcare. Despite these goals of improving accessibility and equity, immigrant and migrant women engaged in sex work cannot easily access these services.
PPMAC has many barriers to im/migrant sex workers’ access. First, the patient is required to be a B.C. resident and show a government-issued piece of I.D. as proof. Providers generally ask for a BC Services Card sincea personal health number is required. Someone who is in the country on a temporary visa cannot obtain a BC Services Card. Additionally, im/migrant women often want to keep their identities private to avoid being outed as sex workers. Migrant sex workers may face legal consequences and/or deportation if they are outed, as engaging in sex work as a temporary resident is criminalized in Canada.
Second, the service —which can put these women at risk of being outed—must be done in person. In certain circumstances, the service may be done over the telephone or virtually, as long as a proper physical assessment can be completed, and the patient’s identity can be verified. In this case, the patient would have to pay out of pocket. Typically, a pharmacy will have a consultation room for patient confidentiality. The service must be done in a space that the patient deems private and meets their requirements for cultural safety. Despite these conditions, the requirement to share personal information that may out them as a sex worker is still a barrier for many immigrant and migrant women who engage in indoor sex work to access this service, due to criminalization and stigma relating to their work.
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