Lower Mainland hospitals collect $14 million a year in parking fees that critics say amount to an unfair user fee that can even harm patient care.
The Canadian Medical Association Journal on Monday called for hospital parking fees to be at least waived for all patients, if not abolished entirely.
"Parking fees are a barrier to health care and add avoidable stress to patients who have enough to deal with," Dr. Rajendra Kale, the journal's interim editor-in-chief, wrote in an editorial.
"They can and sometimes do interfere with a clinical consultation, reducing the quality of interaction and therefore of care."
Patients who wait weeks for a consultation at a hospital may abruptly end it when they realize they must soon pay for more parking time, Kale said.
"This is parking-centred health care, which is not compatible with patient-centred health care."
Fraser Health spokesman Roy Thorpe said there are no plans to end pay parking.
About a third of the money that comes in from parking covers the cost of maintaining and running the lots, while the rest – nearly $10 million a year – goes into general revenue for the Lower Mainland health authorities.
"If we didn't get those fees it would have to come out of other health care revenues," Thorpe said.
The money involved is just two-tenths of one per cent of the combined $5 billion spent annually by the Fraser and Vancouver Coastal health authorities, and by the Provincial Health Services Association and Providence Health Care on services in the region.
Most of the parking revenue is generated by Fraser Health, which gets $8.4 million a year.
Patients who come to hospital repeatedly for services like hemodialysis or chemotherapy are offered greatly reduced rates or in some cases vouchers to waive parking fees, Thorpe said.
"We have a very flexible, compassionate approach to our parking system," he said.
Health authorities don't get the fines that are paid when hospital visitors stay too long and are ticketed, he said. That money goes to parking lot contractors.
But nobody should halt a consultation or other care prematurely over parking, he said, adding any fine resulting from that can be voided.
"When there are exceptional circumstances, appointments go long and someone gets a fine, call Parking Services – they will waive the violation ticket," Thorpe said, adding Fraser gets about 30 requests a day.
(Phone 604-875-4832 in Vancouver Coastal or 604-930-5440 in Fraser Health to request a special waiver of parking fees; Phone 604-909-3933 to dispute parking tickets at Fraser Health facilities.)
Thorpe said rates are based on the local parking market, with the highest rate of $7.50 an hour charged at Vancouver General Hospital and rates as low as $1 charged at Chilliwack General.
Most Fraser Health hospitals charge $3 to $4 for the first hour of parking, and lower rates after that. B.C. Children's Hospital charges $3.75 an hour.
The rates include a 21 per cent parking tax that goes to TransLink plus 12 per cent HST.
While public visitors pay full rate, staff at hospitals get pay parking discounts of 40 to 45 per cent.
"If we had free parking, I think we'd have a real difficult time with ensuring turnover of parking spaces and limiting the time people stay," Thorpe said.
But patients and visitors do get free parking at both Delta and Mission hospitals, where municipal bylaws prohibit pay parking for hospitals.
Delta Mayor Lois Jackson said Fraser Health is "not happy" about Delta's bylaw but predicts her council won't bend to pressure to scrap it.
"They've spoken to us about it," she said. "They say it's all about money and they need the money. Well I have a difficult time with that."
Jackson said pay parking at hospitals offends many people and said she thinks back to when her own infant daughter was once in Surrey Memorial Hospital for three months.
"Had I not been able to go there two or three times a day I don't know what I would have done."
Frequent visits by grandchildren and other loved ones can be critical encouragement for the elderly in hospital to try harder to get better, she added.
"I think it's just another money grab from people who can ill afford it."
The CMA Journal argued pay parking is a "surrogate user fee" contrary to the Canada Health Act and could be challenged in court.