The Build-Big Agenda in B.C. Should Include Long-Term Care Homes

British Columbia should make long-term care part of its big-project building agenda and commit to a construction timetable for seven deferred public care projects, says a new report from the Centre for Future Work.

The report examines the economic benefits of building public long-term care facilities, and the dangers and costs of relying on for-profit operators. It argues that full accounting of the costs and benefits of long-term care construction needs to include financing charges (which are much lower for public builds), broader economic spin-offs from new construction, and a range of savings resulting from superior health outcomes demonstrated in public facilities.

Projections indicate the province needs 16,000 additional subsidized long-term care beds over the next decade—about 1,600 a year. But over the last six years, B.C. added an average of only about 240 net new beds annually.

Despite that gap, seven public long-term care construction and redevelopment projects were deferred in the province’s 2026 budget. The provincial government continues to list the projects in its long-term capital plan, but without firm timelines for construction.

The report challenges exaggerated stereotypes about the cost of building public long-term care facilities, and called for more transparent and systematic comparisons of cost estimates. Many public projects include services such as child care, hospice spaces and other services, often accessible to the broader community – making simple per-bed comparisons misleading.

Financing is an important cost advantage for public builds. In an illustrative comparison, the higher cost of private borrowing increases cumulative interest costs by 41 per cent, adding $49 million to a $200 million project over 25 years.

Most long-term care in B.C. receives provincial government funding, regardless of whether a facility is publicly owned, non-profit, or for-profit. Those payments help cover building and financing expenses as well as operating costs. Data published by the B.C. Senior’s Advocate indicates that building costs in private facilities (ultimately charged to the public purse) are much higher than non-profit facilities.

Outsourcing new builds to private operators does not make the public cost disappear. Government still pays for those facilities through decades of care funding.

The report calls for a transparent comparison of construction costs across public, non-profit and for-profit facilities. It identifies ways to improve value in future projects, including using public land, sharing sites with other health services, standardizing designs and coordinating procurement.

It recommends that the provincial government quickly complete its review of the deferred projects, and publish a reliable construction timetable by the next provincial budget. It also calls for capital funding and development support for non-profit providers, alongside a longer-term plan to meet projected demand.

Please see the full report, Economic Benefits from Construction of Public Long Term Care Capacity in British Columbia, authored by Jim Stanford, Economist and Director of the Centre for Future Work.