The walk from the parking lot to the front door of your hospital is not a long trek.

It might take about two minutes, or maybe a couple hundred strides by an adult walking with purpose B次元官网网址� more for those feeling the weight of age, illness or worry.

ItB次元官网网址檚 the latter some say shouldnB次元官网网址檛 have to feel the additional burden of fretting about feeding the parking meter.

Complaints about overcrowding and aggressive ticketing in the hospital parking lot are not uncommon in Nanaimo, and underlying those complaints is a basic philosophical question faced by all public health facilities: why should people have to pay at all?

The issue has surfaced with a vengeance recently in the Campbell River area, where free hospital parking is poised to become a thing of the past when the communityB次元官网网址檚 new $274.5 million, 95-bed hospital opens in late 2017.

Brenda Leigh is the elected Strathcona Regional District director for Oyster Bay/Buttle Lake, a rural area southwest of the city. Her board is unanimously opposed to pay parking at not only the new Campbell River facility, but its $331.7 million, 153-bed sister hospital, simultaneously being built in the Comox Valley.

She said her concerns apply throughout the Island Health region.

Distance is a factor for residents of many smaller communities, particularly the offshore islands. Poverty makes the ability to pay a problem. Vancouver IslandB次元官网网址檚 abundance of seniors is another issue. And Leigh thinks there is something fundamentally wrong with residents having to pay to use parking stalls their tax dollars have already paid to build.

B次元官网网址淚 think it does create a barrier,B次元官网网址� Leigh said. B次元官网网址淚tB次元官网网址檚 not a healthy idea (for) people already under a lot of stress to face the issue of paying for parking.B次元官网网址�

Health officials arenB次元官网网址檛 fond of people calling parking fees a cash cow, not when revenues total just under $7.5 million in an organization that operates with a $2.2 billion budget. Fees B次元官网网址� typically between $2.25 and $2.75 for the first two hours, and $1.25 for each additional hour B次元官网网址� have not increased since 2010.

The lots at Royal Jubilee and Victoria General in Victoria are the biggest revenue generators, with the Aberdeen, Gorge Road, Saanich Peninsula, Nanaimo and Priory facilities also charging fees.

James Hanson, the Island Health corporate director of logistics and operations, points to Nanaimo Regional General Hospital as a good example of how that revenue is put to use. The parking lot at NRGH collects a little over $1.1 million in fee revenue a year, which has helped create between 120 and 140 new stalls.

According to Hanson, the fees are necessary in order to provide parking services since Island Health will always pick health care over parking when it comes to setting budget priorities.

B次元官网网址淚f we didnB次元官网网址檛 have parking fees, we would have to take it out of patient care money,B次元官网网址� he said. B次元官网网址淚tB次元官网网址檚 that simple.B次元官网网址�

According to Island Health, the revenue collected from parking fees also pays for all parking lot maintenance, including cleaning catch basins, oil interceptors, potholes/infrastructure repairs, lighting, line painting, snow removal, de-icing and security.

Hanson said in some ways Island Health is paying the price for its own success in reaching more patients. Hospital parking lots are starting to resemble those at the malls in terms of the amount of people coming and going.

B次元官网网址淪urgeries that used to take three, four or five hours now take 45 minutes,B次元官网网址� he said. B次元官网网址淭he more vehicles, the more maintenance and servicing you have to do.B次元官网网址�

Major Island hospitals currently without parking fees include Duncan, Port Alberni and Campbell River, however users should expect that to change as aging facilities are replaced.

B次元官网网址淧arking fees will be implemented at new hospital builds moving forward,B次元官网网址� Island Health communications officer Valerie Wilson said.

Leigh is skeptical of Island HealthB次元官网网址檚 position that parking fees help subsidize health care, citing a 2013 which revealed that is not necessarily the case in some parts of Canada.

According to Hanson however, your parking fees are not being used to line corporate pockets. A contractor (currently Robbins) is paid a flat fee to operate and maintain the lots.

B次元官网网址淭he health authority retains parking revenue,B次元官网网址� he said.

Public opinion is varied on the issue.

Linda Thomas works at Nanaimo hospital as an educator. NRGH employees pay between $114 and $466 annually for parking. That doesnB次元官网网址檛 bother her at all.

B次元官网网址淚n Vancouver it was $120 a month,B次元官网网址� she said. B次元官网网址淐oming from Vancouver that was just bonus.B次元官网网址�

While she thinks low-income users should be subsidized, she feels parking fees are a reality others need to accept.

B次元官网网址淚tB次元官网网址檚 sort of changing for Nanaimo. ItB次元官网网址檚 a growing community. I donB次元官网网址檛 have a problem. To me, itB次元官网网址檚 a nominal amount.B次元官网网址�

As a nursing student doing her practicum at Nanaimo hospital, Ashley Lambie also has to pay a staff fee to park on site. ItB次元官网网址檚 a fee she now avoids by parking off site and walking the rest of the way.

B次元官网网址淚 canB次元官网网址檛 afford the parking, but even if I could, I canB次元官网网址檛 find a parking spot,B次元官网网址� she said.

Cars belonging to patients and visitors speckle the streets around NRGH, a situation Comox Valley officials are concerned will be repeated in the lots surrounding their new hospital.

That raises the question of off-site enforcement and municipalities having to pay for it.

But 12 years of parking at NRGH on a regular basis have given Brian Evans a different perspective.

As an Anglican minister who gets free volunteer parking for his pastoral care work, Evans said he has seen great improvement in Nanaimo, including new lots and designated patient and visitor parking areas.

B次元官网网址淧arking is so expensive to provide,B次元官网网址� he said. B次元官网网址淧eople have to realize there is a cost for this service.B次元官网网址�

B次元官网网址淚 remember living in small-town Saskatchewan. When we had to pay for parking we thought it was the end of the world. It wasnB次元官网网址檛 long before we forgot.B次元官网网址�

Evans said for every person complaining about a ticket for going ten minutes over the limit, there is someone else who got away with an extra half-hour.

B次元官网网址淚f going in you figure itB次元官网网址檚 two hours, you better plan for four. ThatB次元官网网址檚 the reality of going to the hospital.B次元官网网址�

Several sources who declined to be interviewed on the record for this story termed NanaimoB次元官网网址檚 enforcement officials B次元官网网址減arking Nazis.B次元官网网址� Lambie didn't use those words, but she has learned the lesson first-hand.

B次元官网网址淭hey are very efficient. IB次元官网网址檝e gotten several tickets,B次元官网网址� Lambie said. B次元官网网址淚 understand that itB次元官网网址檚 their job, but there is no leeway at all.B次元官网网址�

According to Wilson, Island Health receives few complaints about overcrowding or aggressive ticketing at the Nanaimo site.

But for Andy Webster, those issues take a back seat to affordability.

Even if long-term parking fees may only amount to $10 or $15 a day (weekly permits are available for $26.75), Webster says for some people thatB次元官网网址檚 $10 or $15 they donB次元官网网址檛 have, especially when hospital visits become extended.

B次元官网网址淚t does (matter) if you have a relative in intensive or long-term care,B次元官网网址� he said. B次元官网网址淚t is only through the charity of family that they can get by.B次元官网网址�

A resident of Victoria, Webster was at NRGH visiting a relative from Ahousat.

B次元官网网址淎housat is already marginalized. ItB次元官网网址檚 not just Ahousat. IB次元官网网址檓 sure there are people in Nanaimo who are marginalized.B次元官网网址�

Several people pointed to subsidies as a means of addressing that issue. They may be surprised to discover some are already in place.

Renal patients requiring life-sustaining dialysis are issued a permit and provided parking areas. Family members and caregivers of residents in long-term care facilities are not charged either.

B次元官网网址淲e also have hardship provisions to waive or reduce parking fees where they will pose a genuine challenge to families B次元官网网址� and we can substantially reduce rates for patients facing an extended stay through purchase of a weekly parking rate permit that is valid 24/7,B次元官网网址� Wilson said.

Hanson said that anyone who thinks they need a subsidy should ask on-site.

For others however, such subsidies arenB次元官网网址檛 enough. They point to the Canadian health philosophy of free and equal access for all.

People with this point of view have some support from the medical profession.

The Canadian Medical Association Journal ran an editorial in 2011 calling parking charges a user fee in disguise, and an impediment to good care.

Author Dr. Rajendra Kale told the Charlottetown Guardian the fees distracted patients, and interfered with the examination process. He said health authorities in Wales and Scotland eliminated the fees in 2008 and suggested they run counter to the Canada Health Act.

While he understands the philosophy behind that point of view, Hanson said it fails to pass the test in a pragmatic world, where, even with fees, Island Health struggles to keep up with parking demand.

B次元官网网址淚f I wasnB次元官网网址檛 in the business and knowing what it would cost, I would feel the same way,B次元官网网址� he said. B次元官网网址�(But) if we didnB次元官网网址檛 have paid parking, we wouldnB次元官网网址檛 have parking spaces.

B次元官网网址淲hen we donB次元官网网址檛 have enough stalls, it impacts the patient experience.B次元官网网址�

The last word on the issue belongs to B.C. Health Minister Terry Lake. Where he stands was spelled out in a recent letter to the Strathcona Regional District board:

B次元官网网址淏ecause Campbell River Hospital has been a non-paying site to date, maintenance and other costs associated with the parking facilities have been born out of general health authority funding which can now be better directed toward patient care,B次元官网网址� he wrote.

Still, Leigh and her supporters are not giving up the fight.

B次元官网网址淲eB次元官网网址檙e not accepting that,B次元官网网址� she said. B次元官网网址淚n 15 months there will be an election, so we will see.B次元官网网址�