A plan for timely, effective health care

Issue: BCMJ, vol. 42 , No. 5 , June 2000 , Pages 253-254 Clinical Articles

The BC Liberal health critic on the BC medical system.

An episode of the popular British sit-com Yes Minister showed the minister of health visiting a brand new hospital that has 350 administrative staff, but cannot begin accepting patients because it has run out of money. When the minister tries to shut it down, he is told he cannot because, after all, it is such an efficient hospital and, besides, it has been nominated for the Florence Nightingale Award for most hygienic hospital in the British Isles.

Unfortunately, that’s not far from what’s happening in our province. We have a situation in which the only way BC hospitals can meet their budgets is to turn away patients at the door—not just because there is a shortage of beds, but because funds have not been allocated to allow existing beds to be used. Funds have been diverted from where they are needed most: patient care.

The reality is, the NDP have had 9 years to develop a strategy to prevent this crisis, and failed to do so. In fact, they have made a bad situation worse.

Where is the long-term strategy? At present, health authorities are not even told what their annual budget is until several months after the start of the fiscal year. The NDP are fond of boasting about how much money they spend. What counts are health outcomes—not a government’s ability to aimlessly spend money. To achieve long-term objectives, you need a long-term plan.

Without a clear strategy for how they should be spent, funds are wasted and mismanaged. As the Health Association of BC pointed out in its submission to the health minister last October, the ministry has supposedly decentralized decision-making to health authorities, yet continues to micro-manage from Victoria. The result? Duplication and inefficiency.

The attention to the capital spending needs for health care has been woefully inadequate. Last year’s data showed the NDP underspent their 98/99 capital budget for health by $72 million, at the same time they overspent BC Ferries’ capital budget by $75 million. For the past fiscal year, capital spending was $129 million under what was budgeted while other NDP mega-projects get funded. The result is buildings that continue to deteriorate and new life-saving equipment that is not being purchased. So much for the government’s claim that health care is its top priority.

In every case, the government is spending money with no plan, no long-term objectives, and no focus on outcomes. It’s small wonder our health care is in crisis. The way to establish a thriving health-care system is not by simply spending more money, but by having a clear plan to make sure those funds are spent effectively and efficiently.

A BC Liberal government will protect health funding. We will allow decisions to be made locally—not by micro-management from Victoria. We will consult with all health-care stakeholders to establish priorities and identify where duplication and mismanagement of funds is occurring. And we will develop a long-term strategic plan to ensure money is redirected to patient care.

One strain on our system is a shortage of long-term community care beds. Patients who could be staying in community care facilities are being forced to occupy far more costly acute care beds, creating shortages there. This spill-over, in turn, carries on into emergency rooms.

Not only has the government refused to deal with the shortage of community care beds, it has exacerbated the problem by moving to expropriate, without compensation, the assets of existing not-for-profit facilities like Glacier View Lodge in Comox. A first step to restoring the willingness of volunteer organizations to develop new community care facilities is to revoke the government’s power of expropriation.

We are facing critical shortages in trained health-care professionals. Our medical school at UBC must be expanded to allow our students to train to become doctors rather than relying on doctors trained in other jurisdictions. Likewise, the government has done nothing to deal with the growing shortage of nurses. It promised to hire 1000 new nurses over 3 years to deal with the problem, yet BC nursing training programs are not even producing enough graduates to maintain current staffing levels. Far from closing the gap, the government has allowed it to grow larger, and recent announcements are 3 years too late.

Finally, we need to develop a workable model of regionalization, eliminating the duplication that currently exists, and restoring local input. Those who serve on regional health authorities must truly represent and be accountable to the communities they serve. Our goal is a health system that provides timely, effective care for everyone who needs it—one where the government provides the long-term direction and resources, and holds the regional management teams accountable for the effective delivery of acute and community health-care programs.

Mr Hansen, the MLA for Vancouver-Quilchena, is the BC Liberal health critic.

Colin Hansen, MLA. A plan for timely, effective health care. BCMJ, Vol. 42, No. 5, June, 2000, Page(s) 253-254 - Clinical Articles.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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