Ministry Overview

This service plan continues the redesign and reform of the health system started in 2001. The overriding goal is to build a sustainable, publicly funded health system that will meet the needs of today's and future generations. To do this, the system is being redesigned to address the needs of the population in more innovative, appropriate and efficient ways.

Planning and implementing fundamental changes to large, inter-related and inter-dependent systems takes time. However, we have made significant progress in setting the organizational and directional foundation for an integrated, accountable health services system that responds to patient needs within a fiscally sustainable framework.

In 2001, government created six new health authorities. By delegating responsibility for local health services, such as home and hospital care, to five regional health authorities and responsibility for provincial and specialized health services, such as cancer care, to a single provincial health authority, government made a significant shift from the piecemeal approach of managing health services through 52 diverse regional entities that often had competing or overlapping mandates. These six new health authorities, in conjunction with the Ministry of Health Services, have comprehensive responsibility for managing and delivering most publicly funded health services in British Columbia.

At the same time, the Ministry of Health Services has also focused on a new role in the health system. While the ministry still delivers some services directly to the public, such as the Ambulance Service, Vital Statistics Agency, and Medical Services Plan and PharmaCare registration, it is focusing more on being a steward of the system and less on being a direct service provider. The ministry demonstrates stewardship by setting overall direction for the health system, through legislation, policy and standards, and by monitoring, evaluating and reporting on system performance.

Within these roles, the ministry and the health authorities have established a new business relationship — a partnership to deliver a sustainable public health system in B.C. Performance agreements between the health authorities and the ministry were introduced in the 2002/03 fiscal year and strengthen accountability in the system. These agreements articulate the responsibilities and expectations for performance of the six authorities, and ensure government's direction is reflected in the organization and delivery of services to the public.

This service plan is the health system's key strategic document. It sets the overall strategic direction and is the foundation upon which performance agreements with health authorities are based. The service plan is organized following the structure of responsibility and partnership in the system. The plan identifies three core businesses: Services Delivered by Partners (health authorities and other providers), Services Delivered by Ministry (ambulance, vital statistics, etc.), and Stewardship and Corporate Management. (Details on core businesses can be found on page 16).

The objectives, strategies and performance measures listed in this plan are collectively focused on the ministry's and the six health authorities' commitment to build a patient-centered, sustainable health system. Having a patient-centered health system means patients are able to have their care needs met seamlessly as they move through the system, regardless of who has the administrative or management responsibility for the service being provided. It means a health system that supports people to stay healthy (health promotion and disease prevention), get better (episodic physician and hospital care), live with illness or disability (chronic care), and cope with end of life (hospice/palliative care).

To build a sustainable system that meets the needs of our citizens requires that we recognize there have been many changes over the years, not only in advancing medical technologies and procedures, but also in the way people want to be treated and the way service providers want to practice. In planning the renewal of the system, the ministry has considered that:

• A strong emphasis on prevention of ill health, whether through water quality improvements, infection control or encouraging healthy lifestyle choices makes a measurable impact on the health of the population and the cost of its health care;
• B.C.'s population, while ageing, is staying healthier later in life;
• Seniors and other home and community care clients want options that allow them to stay in their own homes and be independent as long as possible;
• Reliance on hospital inpatient beds has declined over the last 30 years as more care is offered in outpatient or office settings; and
• Care needs to be integrated and coordinated across facilities and in the community to be effective in preventing and managing chronic diseases and helping to avoid unnecessary admissions to hospital.

In last year's service plan, the ministry identified five key system reform objectives to guide and inform ministry and health authority planning and operational activities. These objectives remain the focus of our health system redesign efforts and have been carried forward to this plan. They are:

• Provide care at the appropriate level in the appropriate setting;
• Provide tailored care for key segments of the population to better address their specific health care needs and improve their quality of life;
• Keep people as healthy as possible by preventing disease, illness and disability and slowing the progression of chronic illness;
• Manage within the available budget while meeting the priority needs of the population; and
• Improve the services the ministry delivers directly to the public.

This service plan contains more detailed descriptions of these objectives and the strategies and performance measures the ministry and its partners will be undertaking to achieve them. It also contains additional objectives, strategies and performance measures specific to the ministry's stewardship functions. Explanatory tables linking the core businesses, goals, objectives and performance measures can be found beginning on page 18.