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Fraser Health


Fraser Health Authority is the largest regional health authority in British Columbia, Canada, delivering public healthcare services to over two million residents across 20 diverse communities stretching from Burnaby to Boston Bar.
Established in December 2001 through a province-wide restructuring of health authorities by the BC Liberal government, it serves more than one in three British Columbians and operates 12 acute care hospitals alongside numerous community facilities.
Fraser Health provides a broad spectrum of integrated services, including acute medical and surgical care, mental health and addictions support, public health programs, home and community care, and population-based initiatives such as immunization and early childhood development. With over 50,000 staff, medical professionals, and volunteers, the authority emphasizes system transformation to enhance health outcomes amid rapid population growth and diverse needs in urban, suburban, and rural settings.

Formation and Historical Development

Establishment and Early Years

Fraser Health Authority was established on December 12, 2001, under the Health Authorities Act of , as one of five regional health authorities tasked with managing public health services across defined geographic areas. This creation occurred amid a provincial initiated by the newly elected BC Liberal government, which consolidated fragmented health governance to enhance efficiency, accountability, and integrated care delivery. The reduced the number of health authorities from to six—comprising five regional entities and one provincial services authority—by merging smaller hospital districts, councils, and medical health officer jurisdictions into larger bodies responsible for 15 health service delivery areas. Fraser Health's initial was appointed by the Ministry of Health Services, with the authority assuming oversight of hospitals, community services, , and previously handled by entities such as the former Fraser-Burrard and / health regions. In its formative period from 2002 onward, Fraser Health focused on operational integration across a diverse region spanning urban centers like and rural areas up to Boston Bar, addressing administrative overlaps and standardizing protocols amid rapid population influx driven by growth. Key early efforts included allocating funds for capacity expansion in and addictions services, culminating in the completion of the authority's first integrated regional plan for these areas by December 2003. These initiatives laid groundwork for coordinated service delivery, though the consolidation process involved navigating transitional challenges in resource allocation and staff alignment inherent to merging disparate systems.

Expansion and Restructuring

Fraser Health was established on , 2001, through a provincial of delivery in , which consolidated services from 15 health service delivery areas into five regional health authorities to enhance efficiency and coordination. This reorganization amalgamated prior regional boards, including those serving the and surrounding areas, under the Health Authorities Act, expanding Fraser Health's mandate to oversee , community services, and for a initially exceeding 1.5 million across 20,000 square kilometers. The aimed to reduce administrative duplication and standardize care protocols, though it faced initial challenges in integrating diverse operational systems from legacy entities. Subsequent expansions focused on to accommodate projected at 32% over 15 years, with investments exceeding $7.5 billion in capital projects to upgrade hospitals and add capacity. Key initiatives include the Royal Columbian Hospital redevelopment in , a $1.49 billion multi-phase project initiated in the early , featuring a new 388-bed tower, expanded , and specialized units for high-risk maternity and . Similarly, the Burnaby Hospital redevelopment, valued at $1.4 billion and advancing through milestones by 2021, incorporates seismic upgrades, new operating rooms, and enhanced services to address overcrowding. The Surrey Memorial Hospital expansion added a critical care tower with expanded emergency and maternal care facilities, completed around 2010. Organizational adjustments have periodically supported these expansions, including digital transformations for integrated care systems and recent leadership transitions amid provincial efficiency reviews launched in 2025 to optimize front-line support without merging authorities. These changes emphasize measurable improvements in wait times, diagnostics access, and community-based services, aligning with broader goals of fiscal accountability and patient outcomes.

Response to Major Events

Fraser Health's response to the involved significant workforce expansion and redeployment, including hiring over 600 new staff members, training more than 400 existing physicians and personnel, and deploying over 480 staff to critical areas such as testing, , and surge capacity. The authority managed numerous outbreaks in facilities and s, declaring events such as the January 2022 outbreak at The Residence in Mission affecting two units, and implementing isolation measures, enhanced screening, and in line with provincial health orders. These efforts aligned with broader directives, though outbreaks highlighted ongoing challenges in infection control within congregate settings. In addressing the 2021 atmospheric river floods that disrupted the , Fraser Health activated emergency protocols to sustain services for displaced patients, with the Community Dialysis Unit east of the flood zone assessing needs for all and individuals and reallocating resources to prevent treatment interruptions amid highway closures and evacuations. The floods, which caused widespread infrastructure damage and affected access to healthcare facilities, prompted coordination with to support impacted communities, including crisis lines operational 24/7 at 604-951-8855. This response focused on continuity of essential care while preparing for secondary effects like increased injury and demands from the , which resulted in at least five fatalities province-wide from related landslides and flooding. Fraser Health has maintained ongoing responses to the toxic drug and crisis through initiatives, including widespread distribution and training for overdose reversal, emphasizing immediate 9-1-1 calls, rescue breathing, and administration of the to counter fentanyl-contaminated supplies. Monthly public reports detail unregulated drug deaths, interventions, and supervised consumption site activities, revealing persistent high overdose rates in the region despite provincial pilots. These measures, integrated with peer-led for vulnerable populations, aim to mitigate deaths from synthetic opioids, though data indicate continued escalation aligned with national trends. The authority also adapted to events, such as the June 2021 , by analyzing subsequent spikes in visits and mortality—particularly among vulnerable groups—and issuing targeted guidance for heat preparedness, including support for unhoused individuals through community partnerships. frameworks emphasize 72-hour self-sufficiency planning for facilities during disasters, with annual exercises for events like wildfires and floods to enhance resilience.

Service Area and Population Served

Geographic Scope

Fraser Health's service area spans the southwestern of , covering urban, suburban, and rural communities from and in the west to in the east, and from the in the south to the in the north. This region extends approximately 140 kilometers east-west, encompassing parts of Metro Vancouver and the entire . The authority's boundaries align with three provincially defined Health Service Delivery Areas (HSDAs): Fraser South (including , , Delta, and White Rock), Fraser North (covering Coquitlam, Maple Ridge, , and ), and Fraser East (encompassing Abbotsford, Chilliwack, , and ). These divisions facilitate targeted planning for healthcare access across densely populated urban centers like (population over 600,000 as of 2021) and more dispersed rural areas toward . The overall footprint supports services for over 2 million residents as of recent estimates, reflecting rapid growth in the corridor.

Demographic Profile

Fraser Health serves approximately 1.9 million residents across 20 communities in the eastern and regions of , accounting for roughly one-third of the province's population. This population base supports a wide array of healthcare needs, with services delivered through a network addressing in areas like and more rural settings in Chilliwack and . The region exhibits rapid population growth, fueled by immigration, urban expansion, and internal migration, leading to increased demand on healthcare infrastructure. Projections indicate sustained expansion, with local areas such as Surrey anticipating a 50% increase by 2046 from a 2025 base of 696,175 residents. This growth is accompanied by an aging demographic trend, where over 25% of certain sub-populations are expected to reach 75 years or older in coming decades, exacerbating pressures on long-term care and chronic disease management. Ethnically, the population is highly diverse, with significant concentrations of South Asian residents—particularly —in urban centers like and Abbotsford, reflecting broader immigration patterns from and . Visible minorities comprise a majority in key service areas, alongside , East Asian, and groups; this diversity influences health outcomes, including higher rates of conditions like among South Asian communities, as documented in targeted health reports. The median age remains relatively low due to younger immigrant cohorts, contrasting with provincial averages and contributing to a mix of pediatric and adult care demands.

Organizational Governance and Leadership

Board Structure and Oversight

The Board of Directors of Fraser Health Authority functions as the primary governing body, appointed by the to provide strategic direction, oversight, and vision for the organization's operations. Composed of a and Directors selected for expertise aligned with the Authority's needs, the Board annually recommends criteria and potential candidates in consultation with the President and Chief Executive Officer (CEO), though final appointments rest with the government. This structure ensures alignment with provincial health priorities while delegating routine management to the executive team. The Board's core responsibilities encompass overseeing the Authority's business conduct, supervising management through established performance standards for the CEO, and approving critical elements such as long-term strategic plans, annual budgets, major policies, and medical staff bylaws. It conducts risk assessments, including financial, operational, and compliance risks, and ensures ethical by monitoring adherence to legal requirements and fostering effective communication with stakeholders, including the public and communities. To support these duties, the Board establishes standing and committees—such as those for , , and —with defined mandates to delegate targeted oversight functions while retaining ultimate . Oversight extends to evaluating CEO performance, , and ensuring the Authority's alignment with government directives, including fiscal sustainability and equitable service delivery. The Board reports organizational performance regularly to the , contributes data for program evaluations, and submits an to the government detailing achievements against strategic goals. This accountability framework emphasizes collaboration with the Ministry on priorities like , services, and access, while mandating public posting of key documents such as the 2025 mandate letter by June 2025.

Executive Leadership and Accountability

The executive leadership of Fraser Health is led by the President and (CEO), who holds ultimate responsibility for operational management, strategic execution, and alignment with board directives. Appointed on August 18, 2025, Dermot Kelly serves as the current President and CEO, bringing over 20 years of healthcare leadership experience to oversee one of Canada's largest regional health systems serving approximately 2 million people. The CEO reports directly to the , managing day-to-day operations, presenting annual budgets and progress reports, ensuring compliance with quality and safety standards, and fostering communication with stakeholders, while remaining independent from board membership. The senior executive team supports the CEO and includes vice presidents responsible for specialized portfolios, such as clinical programs, finance, , and initiatives. Key members include Dr. Ralph Belle, Vice President of , who directs medical services and physician engagement; Amanda Laboucane, Interim Vice President of Indigenous Health and Cultural Safety, focusing on culturally appropriate care delivery; and others like Natalie , overseeing mental health, substance use, and community services. This team translates board policies into actionable programs through coordination with frontline management and staff across 12 hospitals and numerous community facilities. Accountability mechanisms emphasize oversight by the , which evaluates executive performance against strategic goals, long-term plans, and community input, while ensuring fiscal responsibility and risk management. Executives are further accountable to the via the Ministry of Health, which sets provincial performance agreements, service standards, and funding targets; Fraser Health submits annual reports on metrics like wait times, outcomes, and resource use to demonstrate compliance. Participation in national accreditation processes by Accreditation Canada provides independent validation of service quality and adherence to evidence-based standards, with results informing board and executive reviews. Compensation for top executives, including the CEO, is disclosed annually in line with provincial taxpayer principles, promoting in public fund management.

Facilities and Healthcare Delivery

Acute Care Hospitals

Fraser Health operates 12 hospitals, ranging from community facilities providing general and inpatient services to three regional referral centers offering tertiary-level care such as , cardiac interventions, , and neonatal intensive care. These hospitals collectively handle high volumes of visits, surgeries, and specialized treatments, with ongoing expansions addressing capacity pressures in the rapidly growing and Metro Vancouver regions. The regional hospitals include Royal Columbian Hospital in New Westminster, which serves as British Columbia's only facility combining trauma designation, cardiac care, neurosurgery, high-risk obstetrics, and acute mental health services; it currently operates approximately 490 inpatient beds following the 2020 addition of a 75-bed mental health and substance use center, with the Jim Pattison Acute Care Tower advancing toward full operations, including support services relocated in July 2025 and robotic surgery capabilities introduced in October 2025. Surrey Memorial Hospital, the largest in the network, delivers primary, secondary, and tertiary services including expanded internal medicine capacity from 30 to 90 beds as of 2023, with plans underway for a new acute care tower to further enhance surgical and emergency capabilities. Abbotsford Regional Hospital and Cancer Centre provides 300 beds focused on comprehensive cancer care alongside general acute services like emergency and surgery. Community hospitals supplement these with localized acute care: Burnaby Hospital (286 beds) offers 24/7 emergency, obstetrics, critical care, and palliative services; Chilliwack General Hospital includes intensive care and general surgery; Delta Hospital emphasizes emergency and medical stabilization; Eagle Ridge Hospital in Port Moody provides emergency, rehabilitation, and select surgical procedures; Fraser Canyon Hospital serves remote areas with basic acute and emergency support; Langley Memorial Hospital, Mission Memorial Hospital, Peace Arch Hospital in White Rock, and Ridge Meadows Hospital deliver emergency, inpatient medical, and maternity care tailored to suburban and rural needs. All sites maintain 24/7 emergency departments, with intensive care units available at select locations including Abbotsford, Burnaby, Chilliwack, Royal Columbian, and Surrey.
HospitalLocationNotable Features
Abbotsford Regional Hospital and Cancer CentreAbbotsfordOncology focus, 300 beds, ICU
Burnaby Hospital286 beds, tertiary , ICU
Chilliwack General HospitalChilliwack, ICU
Delta HospitalEmergency stabilization
Eagle Ridge HospitalRehabilitation, select surgery
Fraser Canyon HospitalRemote acute/emergency
Langley Memorial HospitalMaternity, inpatient medical
Mission Memorial HospitalEmergency, general acute
Peace Arch HospitalWhite RockSuburban emergency/maternity
Ridge Meadows HospitalMaple RidgeInpatient medical/emergency
Royal Columbian HospitalTrauma/cardiac/neurosurgery, ~490 beds, ICU
Surrey Memorial HospitalTertiary services, expanded medicine beds, ICU
These facilities have faced operational strains from , with historical overcapacity noted since at least 2017, prompting provincial investments in bed expansions and technology upgrades.

Community and Specialized Services

Fraser Health provides home and community services designed to support independence and deliver interventions outside settings, including assessments, , and palliative support for eligible residents. These services encompass , which offers on , healthy living, and caregiving, alongside referrals for financial or housing assistance to enhance self-sufficiency. Home health services address nutritional needs through assessments and meal planning, while supports address psychosocial challenges such as or transitions to community living. Specialized community services target vulnerable populations, including a network of seniors clinics that deliver comprehensive geriatric assessments for older adults with multiple comorbidities at risk of institutionalization, incorporating medical evaluations, care planning, and family education. Day programs for older adults provide structured daytime activities emphasizing social engagement, physical exercise, and routine health monitoring to mitigate and functional decline among seniors with conditions. Health services for community living extend rehabilitative, nutritional, and to adults with developmental disabilities residing in non-institutional settings, aiming to sustain their integration and . In and substance use, community-based specialized offerings include outpatient counseling, , and rehabilitative programs that promote skill-building for daily functioning, distinct from acute . initiatives under community services focus on preventive measures such as clinics, campaigns, and communicable , serving diverse demographics across and rural areas. and community programs provide early for developmental delays, , and behavioral health services to prevent escalation to specialized residential needs. These services collectively emphasize outpatient and delivery to reduce reliance, with access coordinated through centralized intake systems.

Ambulatory and Support Facilities

Fraser Health delivers through hospital-based day care units and dedicated outpatient centers, emphasizing procedures that do not necessitate overnight hospitalization. These services include , gastroscopy, , , , , and minor surgeries in fields such as , , ear/nose/throat, and . Access requires a referral and appointment, with patients presenting a valid BC Services Card; walk-ins are not accommodated for these acute day procedures. A prominent ambulatory facility is the Outpatient Care and Surgery Centre in , operational since June 2011, spanning 188,000 square feet at a of $239.1 million. This center handles scheduled outpatient day surgeries, diagnostic imaging (including CT scans from 7:30 a.m. to 8:00 p.m. weekdays and weekends), laboratory testing (open 7:00 a.m. to 5:00 p.m. weekdays with walk-in options until 4:00 p.m.), , , and specialized clinics such as and medical daycare for treatments like blood transfusions, intravenous , iron infusions, and replacements. It operates to from 7:00 a.m. to 8:00 p.m., with reduced hours on weekends and closures on statutory holidays. Hospital-integrated ambulatory units operate at sites including Abbotsford Regional Hospital, Burnaby Hospital, Chilliwack General Hospital, Hope Hospital, Langley Memorial Hospital, Mission Hospital, in , Surrey Memorial Hospital, and facilities. Supporting these are diagnostic and laboratory services across Fraser Health's network, such as , , , MRI, and pulmonary function labs, often co-located for efficient outpatient workflows; laboratory appointments can be booked online or via 1-888-442-5227, with walk-ins accepted though prioritization favors reservations. Outpatient rehabilitation support, integral to ambulatory recovery, includes physiotherapy, , and at locations like Abbotsford Regional Hospital, Burnaby Hospital, and Queen's Park Care Centre in . Additional outpatient support encompasses antibiotic , anticoagulation management, nutrition counseling, home IV programs, and speech-language services, delivered via clinics to reduce hospital admissions.

Operational Performance and Metrics

Access and Wait Time Indicators

Fraser Health tracks access and wait time indicators through quarterly report cards, focusing on performance, surgical procedures, and home health services. In the April to June 2025 period, patients requiring admission achieved treatment within 10 hours in only 18.8% of cases, falling short of the % target, while average wait times for beds reached 333.2 hours against a benchmark of no more than 130 hours. Low-acuity visits to departments stood at 97 per 1,000 , meeting the of 100 or fewer. For elective surgeries, 89% of non-emergency procedures were completed within 26 weeks during the same period, approaching but not attaining the 95% provincial target, with 21.1% of patients waiting longer than 26 weeks compared to a 22.8% maximum . This reflects a slight improvement from 88.8% completion within 26 weeks in 2022/23. Provincial data indicate Fraser Health's surgical wait lists decreased by 23% as reported in 2023, though specific 2024-2025 reductions remain aligned with broader trends emphasizing resource optimization. Home health access met benchmarks, with 52.2% of services provided within designated times against a 50% target and an average wait of 14.7 days for initial Resident Assessment Instrument-Home Care (RAI-HC) evaluations, below the 30-day standard. admissions within 30 days occurred in 58.4% of cases, below the 75% goal, consistent with prior years' performance ranging from 58.5% to 72.1%. Diagnostic imaging efforts include a new mobile MRI and CT scanner deployed in January 2025 to address provincial backlogs, supporting Fraser Health's integration into broader reductions, such as increased MRI operational hours across . wait times have been publicly dashboarded since May 2023, revealing variability by facility, with some sites like Fraser Canyon Hospital averaging three hours in recent analyses.

Quality and Outcome Measures

Fraser Health monitors quality and s through its Health Care Report Cards, which track performance against provincial targets set by the Ministry of Health, focusing on indicators such as infection rates, mortality ratios, and readmissions. These metrics are derived from administrative data and clinical surveillance, with Hospital Standardized Mortality Ratio (HSMR) serving as a key risk-adjusted comparing observed in-hospital deaths to expected deaths based on patient diagnoses, age, and comorbidities. In the 2023/24, Fraser Health's overall readmission rate within 30 days was 9.9 per 100 episodes of care, meeting the internal target of ≤10.0 and showing a favorable trend across six of its sites. For and substance use patients aged 15 and older, the readmission rate was 13.1%, aligning with the target of ≤13.3%. HSMR for April to June 2024 stood at 91, below the target of ≤93, indicating fewer deaths than expected; however, the full 2023/24 annual HSMR was 98.5, exceeding the target. Hospital-acquired infection rates reveal mixed performance. For April 2024 to January 2025, (CDI) incidence was 2.3 cases per 10,000 patient days, meeting the target of ≤3.3, while (MRSA) was 3.9, slightly above ≤3.8. Hand hygiene compliance reached 83.1%, exceeding the ≥80% target. Adverse events like in-hospital (3.9 per 1,000 discharges, target ≤3.8), acquired urinary tract infections (21.3 per 1,000, target ≤10.0), non-aspiration (10.2 per 1,000, target ≤7.3), and (11.2 per 1,000, target ≤7.3) all exceeded targets, attributed in part to seasonal factors and improved screening detection.
MeasurePeriodTargetActualStatus
HSMRApr-Jun 2024≤9391Met
Overall Readmission Rate2023/24≤10.0%9.9%Met
IncidenceApr 2024-Jan 2025≤3.3/10,000 patient days2.3Met
Acquired UTI RateApr-Oct 2024≤10.0/1,000 discharges21.3Not met
Updated data for April to September 2024 in the June 2025 report card confirm HSMR at 92.1 (met target), readmissions at 9.9% overall and 11.1% for /substance use (both met), with persistent elevations in (4.2 per 1,000), (11.7 per 1,000), and urinary tract infections (21.5 per 1,000). These indicators support ongoing quality improvement efforts, though exceedances in adverse events highlight areas for enhanced prevention amid high patient volumes.

Resource Utilization and Efficiency

Fraser Health's resource utilization is characterized by high bed occupancy rates, particularly in facilities, which often exceed 100% capacity and indicate significant strain on available infrastructure. For instance, Abbotsford Regional Hospital operated at 128% of its acute bed capacity during the 2023-24 , accommodating an of 347 across 275 designated beds, leading to hallway overflow and extended waits. Such elevated occupancy, frequently surpassing the 85% threshold deemed unsafe by medical standards due to risks and rapid turnover, reflects bottlenecks in rather than optimal efficiency. Length of stay metrics further highlight inefficiencies, with the 2023/24 ratio of actual length of stay (LOS) to expected LOS (ELOS) reaching 1.07, exceeding the target of ≤0.95 and suggesting suboptimal turnover. Alternate level of care (ALC) days, which represent acute beds occupied by patients awaiting non-acute placements, stood at 14.1% from April to October 2024, slightly above the ≤12.9% target. Long-stay patients totaled 632.7 as of early 2025, surpassing the target of 455, while admitted patients awaiting beds averaged 242.3, far exceeding the ≤130 . Staffing utilization reveals pressures on , with and allied professional overtime at 9.1% from April 2024 to January 2025, double the ≤3.9% target, and sick time at 6.4% against ≤5.8%. These elevated rates contribute to and reduced care quality, exacerbating delays such as only 18.3% of patients admitted within 10 hours against a ≥65% goal.
MetricPeriodActualTargetStatus
LOS/ELOS Ratio2023/241.07≤0.95Not met
ALC Days %Apr-Oct 202414.1%≤12.9%Within 10%
Nursing Overtime %Apr 2024-Jan 20259.1%≤3.9%Not met
Budget Performance RatioApr 2024-Jan 20251.0101.000Within 10% (with $49.5M )
Budgetary efficiency has been inconsistent, with Fraser Health overspending by an average of 13% above planned expenses across the six fiscal years prior to , prompting provincial reviews to curb administrative waste and redirect funds to patient services. The 2024/25 year-to-date budget performance ratio of 1.010 indicates a modest overrun, aligning with a . Efforts to enhance efficiency include streamlining transfers to , which reduced ALC-LTC length of stay by 6.8 days and emergency admission-related LTC stays by 2.3 days in , while cutting closed LTC beds by 89% and boosting weekend transfers by 27%, thereby freeing tens of thousands of acute bed days. These interventions demonstrate targeted improvements in patient flow, though persistent ALC occupancy and high overtime suggest ongoing systemic challenges in matching resources to demand.

Controversies, Criticisms, and Reforms

Management and Leadership Challenges

In February 2025, Fraser Health's president and CEO abruptly departed amid a provincial health-care overhaul, receiving a exceeding $600,000, which drew public criticism for lacking given persistent operational challenges such as extended emergency room wait times and facility access issues for families. The payout, funded by taxpayer dollars, highlighted tensions between and performance metrics, with detractors arguing it incentivized minimal repercussions for during crises including response shortcomings in the Fraser region. Dermot Kelly assumed the role shortly thereafter, inheriting demands for reforms in administrative structures amid reports of disproportionate layoffs affecting frontline staff while sparing higher management layers. Historical precedents underscore recurring leadership instability, as evidenced by the 2005 dismissal of then-CEO Nina Munteanu following documented management failures, including breakdowns in communication and resource allocation that exacerbated service disruptions across the authority's facilities. Similarly, in 2017, former CEO Nigel Murray resigned after an revealed unauthorized expenses totaling tens of thousands during his tenure, later escalating into a investigation in where he had relocated, revealing lapses in oversight of executive spending. These incidents reflect systemic vulnerabilities in governance, where s identified but failed to prevent financial improprieties, contributing to eroded public trust. Recent whistleblower disputes further illustrate challenges in responsiveness, exemplified by Dr. Kaitlin Stockton's 2025 lawsuit alleging retaliation—including threats to her employment—after she publicly warned patients of dangerous ER delays at Fraser Canyon Hospital; Fraser Health sought dismissal of the case, contending her actions breached protocols rather than exposing systemic deficiencies. This pattern aligns with broader critiques of hierarchical cultures prioritizing administrative defense over transparent issue resolution, as seen in 2023 staff concerns at Surrey Memorial Hospital where executives defended care quality despite physician warnings of overcrowding and resource strains. Such dynamics have prompted calls for enhanced board oversight and external audits to address causal factors like misaligned incentives and resistance to in high-pressure environments.

Patient Care and Safety Issues

In emergency departments operated by Fraser Health, such as Eagle Ridge Hospital and , emergency physician . Kaitlin Stockton alleged in a November 2024 lawsuit that conditions have deteriorated since 2022, with and shortages contributing to wait times of 10 to 14 hours and preventable deaths. The suit claims multiple entries in the documenting severe harm, including fatalities, due to these systemic pressures, alongside 4 to 6 daily unfilled emergency physician shifts exacerbating and care delays. Stockton further asserted that Fraser Health failed to address normalized violent incidents, such as a January 2025 machete threat against a nurse at Eagle Ridge Hospital and an April 2025 attack on a , alongside assaults causing injuries like dislocated jaws and concussions. These violence concerns align with broader reports of frequent assaults on healthcare workers in hospitals, where security officers experienced nearly one incident every other day as of August 2025, often involving aggression linked to substance use or crises unmanaged due to resource constraints. The Nurses' Union corroborated such risks, citing additional examples like staff threats with weapons, which compromise safe care delivery and staff retention. Fraser Health has responded to the by seeking dismissal in August 2025, arguing lack of jurisdiction, while maintaining ongoing efforts to enhance security protocols amid these allegations. Fraser Health's June 2025 Health Care Report Card revealed shortfalls in several hospital-acquired condition metrics, including an in-hospital rate of 4.2 per 1,000 discharges—exceeding the target of ≤3.8 and attributed partly to cases—alongside elevated rates of acquired (11.7 per 1,000 discharges vs. target ≤7.3), urinary tract (21.5 per 1,000 vs. ≤10), and non-aspiration (10.2 per 1,000 vs. ≤7.3). While and MRSA infection rates met targets at 2.3 and 3.8 per 10,000 patient days respectively, these exceedances indicate persistent infection control challenges, particularly in high-acuity settings. In , worsened pressure ulcers affected 2.1% of residents, surpassing the ≤1.6% target despite noted improvement efforts. Overcrowding has also driven a provincial spike in patients leaving emergency rooms without being seen, with Fraser Health contributing to British Columbia's total of 64,972 such cases in 2024-2025, an 87% increase from prior years, reflecting delays that heighten risks of untreated conditions. Fraser Health maintains a Care Quality Office for handling complaints and publishes infection control audits, but critics, including over 50 supporting physicians in Stockton's case, argue that systemic under-resourcing undermines proactive safety measures. In June 2025, an emergency room physician at Fraser Health filed a civil lawsuit against the authority, alleging wrongful dismissal after she publicly posted a letter co-signed by multiple doctors highlighting deteriorating working conditions, patient safety risks, and unaddressed violence at facilities including Eagle Ridge Hospital and Royal Columbian Hospital. The suit claims Fraser Health created a toxic work environment, failed to respond to physicians' reports of assaults and threats, and retaliated against whistleblowers by attempting to silence dissent through administrative measures. In its August 2025 response, Fraser Health sought dismissal of the case, arguing that the British Columbia Supreme Court lacks jurisdiction and that the matter should proceed to labor arbitration under collective agreement terms, denying the allegations of retaliation or unsafe conditions. In August 2025, parents of a teenage victim initiated legal action against Fraser Health and the School District, asserting in support and failure to intervene despite prior indicators of distress reported to health services. The alleged that Fraser Health declined private offers and did not adequately address the youth's needs following school referrals, though the authority has not publicly detailed its defense beyond standard protocols for such claims. A March 2025 class complaint filed with the Human Rights Tribunal accused Fraser Health of discriminatory practices by prohibiting use for higher-risk staff during the 2021-2022 period, allegedly forcing vulnerable employees to choose between workplace access and personal safety without . Fraser Health maintained that its policies aligned with provincial guidelines prioritizing universal masking over specialized respirators, but the complaint highlighted potential violations of protections for medical vulnerabilities. In a 2019 British Columbia Supreme Court ruling, A.H. successfully challenged Fraser Health's nearly year-long involuntary under the Mental Health Act, with the court deeming it unlawful, a violation of rights, and not justifiable as an measure due to inadequate justification and procedural failures. The decision underscored lapses in oversight and documentation, leading to damages awarded against the authority. Fraser Health operates a whistleblower and adopted a formal Whistleblower Protection Policy in 2024, supplemented by British Columbia's Public Interest Disclosure Act effective June 2023, which provides protections for reporting wrongdoing in health entities; however, critics have questioned the policy's effectiveness in shielding reporters from reprisal, as evidenced by ongoing litigation.

Achievements, Innovations, and Future Directions

Notable Programs and Improvements

Fraser Health has implemented capital expansion projects to enhance , including new buildings, additional beds, and operating rooms across the region, with over $5 billion invested in ongoing developments as of 2023. These efforts aim to address capacity constraints and improve service delivery in high-demand areas like . In transitions, Fraser Health expanded bed matching and acceptance processes to operate seven days a week, resulting in more timely transfers from beds to residential facilities and thereby increasing availability. The authority's Enabling Aging in Place program supports older adults remaining at home longer by enhancing health outcomes, reducing , building caregiver capacity, and delaying institutional admissions. Virtual care initiatives have connected patients to specialized services both in hospitals and communities, with early implementations noted in to streamline access without physical relocation. The Healthy Schools Program fosters partnerships to promote school environments conducive to physical and mental well-being among students. Additionally, the Whalley Urgent and Centre, operational since , introduced specialized offerings such as a cancer survivorship program and regional pain clinics by 2023. Sustainability efforts include the 2023 Strategy, which integrates environmental considerations into operations to achieve higher standards of and resilience, alongside carbon reduction roadmaps and innovative heating solutions outlined in the 2024 Accountability Report. The Equity, Diversity, and Inclusion Strategy (2023-2028) targets systemic barriers through pillars focused on inclusive environments, , equitable care, and policy integration. The Indigenous Health Program collaborates with , Métis, and Inuit communities to bolster wellness services, including support and cultural liaison roles.

Partnerships and Collaborations

Fraser Health maintains partnerships with municipal governments through its Healthier Communities initiative, launched in 2008 to foster joint efforts in promoting and addressing social determinants of well-being, with 13 such formal collaborations established across its service area. In the realm of Indigenous health, Fraser Health entered the Fraser Partnership Accord in 2020, renewed in 2023, with the First Nations Health Authority, Nation BC, and other regional leaders; this agreement commits to collaborative improvements in health outcomes for and peoples in the Fraser Salish region, emphasizing cultural safety and equitable access to services. For research and innovation, Fraser Health partnered with in July 2025 to establish the SFU-FH , integrating academic expertise with clinical data to advance collaborative on challenges. It also engages partners in through the BC Unit's Fraser Centre, where individuals contribute as equal team members across phases, including priority-setting for projects. In , Fraser Health collaborated with , a Microsoft Gold Certified Partner, to deploy tools like for post-pandemic service enhancements, supporting virtual communication and operational efficiency in clinical settings. Additionally, Fraser Health works with community foundations, such as the Surrey Hospitals Foundation, to secure donor support for hospital infrastructure and programs, ensuring alignment with regional care priorities.

Strategic Initiatives and Projections

Fraser Health has implemented several targeted strategies to address population growth, , and environmental sustainability. The Equity, Diversity, and Inclusion (EDI) Strategy (2023-2028) focuses on four pillars: fostering inclusive environments, building capacity through training and anti-discrimination policies, delivering equitable care by addressing systemic barriers, and integrating EDI into organizational systems such as procurement and leadership. This initiative aims to enhance culturally safe services for equity-seeking groups, including , through commitments to respect, accountability, and . Complementing these efforts, the Wellness Promotion Program Strategy (2024-2029) prioritizes advancing healthy public policies, disseminating evidence-based health messaging, embedding equity and cultural safety, supporting child and wellness environments, and developing a healthy aging framework. It targets building blocks like , , substance use prevention, and , while adapting to demographic shifts such as the projected surpassing of the aged 65+ over those aged 0-19 by 2026. In sustainability, the Planetary Health Strategy (2023-2028) outlines four pillars to mitigate climate impacts: reducing emissions, waste, and pollution from operations; enhancing system resilience to events like wildfires and heatwaves; reinforcing connections through procurement and land use; and cultivating a culture of , incorporating Indigenous knowledge. This five-year plan responds to the health system's contributions to while preparing for increased climate-related health demands. Capital infrastructure initiatives, particularly in high-growth areas like , include short-term expansions such as two additional suites and suites at Surrey Memorial Hospital to localize procedures and reduce travel for and cardiac patients. Medium-term projects encompass adding two MRI units via renovations and constructing a new renal facility with 21 beds (increasing total capacity to 60), slated for operational readiness post-2026 construction completion. These form part of 30 priority actions to transform regional care capacity. Projections indicate significant demand pressures from demographic expansion, with Fraser Health's service population forecasted to grow by 32% over the next 15 years from 2024 levels, driven by regional urbanization and aging. In specifically, the population is estimated at 696,175 in 2025, projected to reach 1,024,428, necessitating enhanced physician coverage, virtual care expansions, and infrastructure to manage rising service needs. Broader regional trends, including a rise in seniors to 23% of the population by 2045, underscore the focus on preventive and resilient systems to sustain care delivery amid these pressures.