2002/03 Annual Service Plan Report Ministry of Health Planning

Ministry Roles and Services

Introduction

Since June 2001, the government has introduced major reforms to improve patient care and modernize BC's health care system. These include innovations and improvements to achieve the following goals for health care:

• To provide high quality, patient-centred care;
• To improve the health and wellness of British Columbians; and
• To create an affordable, sustainable health services system.

BC's health services system was designed for an earlier era with services and care focused on sudden acute care needs. Over the years, an aging population and an increase in chronic diseases have put new demands on our health system. We are now focused on creating a flexible, adaptable system to meet the diverse and changing needs of British Columbians.

The Ministries of Health Planning and Health Services share a common vision, mission, values, goals and objectives. Although both ministries work towards shared goals and objectives, each has unique roles and responsibilities, as expressed by the different service plan strategies each is following to achieve them.

Ministry Vision, Mission and Values

Vision

A health system that ensures high quality public health care services that meet patients' needs, where they live and when they need them.

Mission

To guide and enhance the province's health services to ensure British Columbians are supported in their efforts to maintain and improve their health.

The top priorities are saving and renewing public health care and providing high quality public health care services that meet patients' most essential needs.

Values

Consistent with the principles of the Canada Health Act, our values define our organizational behaviour:

Patient and Consumer Focus which respects the needs and diversity of all British Columbians.

Equity of access and in the quality of services delivered by government.

Access for all to required health services.

Effectiveness of delivery and treatment leading to appropriate outcomes.

Efficiency, providing lowest cost consistent with quality services.

Appropriateness, providing the right service at the right time in the right place.

Safety in the delivery of health services to minimize the risks to the health and safety of British Columbians.

Goals

The Ministries of Health Planning and Health Services share the following goals:

1: High Quality Patient-Centred Care

Patients receive appropriate, effective, quality care at the right time in the right setting and health services are planned, managed and delivered around the needs of the patient.

2: Improved Health and Wellness for British Columbians

Support British Columbians in their pursuit of better health through protection, promotion and prevention activities.

3: A Sustainable, Affordable Public Health System

A planned, efficient, affordable and accountable public health system, with governors, providers and patients taking responsibility for the provision and use of these services.

Ministry Overview

In recognition of the importance of long-term planning and management of the health system, in June 2001 the government created a new Ministry of Health Planning. The role of the ministry is to develop and articulate expectations of health system performance and monitor the health of British Columbians.

In 2002/03, the BC government increased funding for health services by an additional $1.1 billion — to a total of $10.4 billion. This represents 40.6 per cent of total government spending, the highest health budget ever in BC.

Ministry Operating Context

Environmental Scan

BC faces a number of challenges in creating a health system that provides quality, appropriate care that meets the changing and diverse health care needs of British Columbians.

Demographic Trends

• BC's population will increase by 39,000 persons in 2003 and 49,000 in 2005.
• BC residents' median age continues to increase from 35.5 years in 1995 to 39.7 years in 2005.
• The number of BC residents over 65 increases annually and will comprise 13.8 per cent of the population in 2005.
• There will be a decrease in both the number and proportion of BC residents under 19 years of age.
• The health sector's workforce is aging.

Fiscal Challenges

• Annual growth in BC's health care costs puts pressure on health budgets — even with new federal multi-year funding.
• Increasing demand for health care and resources, fuelled by a growing and aging population, higher service expectations and inflation.
• Uncertainty with performance of the provincial economy, public demand and provider supply add to challenges of effective planning.

Key Cost Drivers

• Wage and benefit pressures across the health sector.
• Rapidly rising pharmaceutical costs.
• Emerging illnesses and new treatments increase health care costs.
• Pressure from the public and providers for government to fund new technologies, prescription drugs and clinical interventions.
• Necessary investments in updating and purchasing new facilities or equipment.
• Changing demographics in BC — a growing and aging population.

Challenges and Risks

• Health care planning is impacted by emerging diseases, population growth, changes in demographics, health human resources, clinical practices and new technologies. For example, a flu epidemic or new cases of Severe Acute Respiratory Syndrome (SARS) would change patients' immediate health care needs.
• Attracting and retaining highly qualified health professionals at a time of global shortages of care providers.
• The focus on "patients first" requires a shift in management and provider culture.
• Managing the health care system and the restructuring of the Ministries of Health during a period of fixed health system budgets.

Implications for the Ministries of Health

The goal of health care renewal in BC is to address these very challenges while providing a responsive and well-managed health care system. This renewal process is also designed to ensure sustainability of BC's system in the face of looming cost drivers and increasing demands for services by a growing and aging population.

The restructuring of the health ministries and the health authorities in 2001/02 has been an important first step. It helped to clarify roles and responsibilities of all the health system partners. The Ministries of Health have expertise in health care planning and management and are building stronger relationships with health system partners, who deliver health services. Capitalizing on these two strengths will be critical to delivering quality care and modernizing the health system for the 21st century. In particular, the ministry is:

• Using planning and projection tools to forecast services required to meet the health care needs of all British Columbians, in the short and long term;
• Involving experienced staff and external experts with extensive knowledge of the issues facing BC's health system;
• Introducing innovative planning and management practices;
• Developing and implementing standards of care and accountability to improve the delivery of health services and patient outcomes;
• Leading, monitoring and reporting on system performance and accountability;
• Clarifying and updating the policy and legislative framework for the health sector;
• Fostering cooperative working relations with health system partners and among various ministry areas;
• Building relationships with other ministries in BC and ministries in other provinces and territories to coordinate services; and
• Streamlining the Ministries of Health to focus on core businesses and priority issues.

The 2003/04 – 2005/06 service plans for both ministries present the three-year plan for meeting health care goals and objectives. These reports are available at http://www.gov.bc.ca/healthplanning/ or http://www.gov.bc.ca/healthservices/.

Strategic Shifts and Significant Policy Changes

The year 2002/03 was a significant year for health care in Canada. Over the past few years, all jurisdictions as well as providers and patients have expressed concerns about the future of health care in Canada. In BC, the report of the Select Standing Committee on Health, Patients First 2002: The Path to Reform, December 2002, assessed reform to date in BC and recommended further changes based on the concerns of British Columbians. In early 2003, a series of high profile, public reports on health care culminated in a new federal-provincial Accord that restates and redefines the direction of the Canadian health care system.

The creation of a ministry exclusively focused on health planning was key to British Columbia's ability to focus on the important issues being raised. In turn, this allowed the province to develop complementary structural, policy, and legislative approaches to address the complex issues facing the system.

In 2002/03, the ministry used the tools of policy development, legislation, planning approaches and support for research to shape the environment within which services are provided. This environment is now:

• More manageable within a streamlined health authority structure;
• Able to provide higher quality services. The insistence on evidence-based care, the support for research to determine best evidence and the requirement for quality outcomes are changes that will improve the quality of patient care;
• More accountable and transparent. Through change in policy, legislation and the further refinement of service plans, all aspects of health care are more accountable and transparent; and
• More sustainable. The focus on planning allows us to design services we know we can afford because we have more accurate planning information and reliable delivery systems.

Update on New Era Commitments

In June 2001, the Premier gave the Minister of Health Planning the responsibility of implementing 25 of the government's New Era Commitments. Please refer to Appendix 4 for the status of each of these New Era Commitments.

Core Business Areas

At the beginning of 2002/03, the Ministry of Health Planning had three core business areas: Office of the Provincial Health Officer and Population Health and Wellness; Strategic Change Initiatives; and Planning, Policy and Legislation. These represented the three divisions of the ministry.

During the year, the Ministries of Health redefined their core businesses to better reflect the functions of the provincial health care system as a whole, as well as the different roles of the ministries and their partners within the system. As a result, previous ministry functions were integrated into three new core business areas, which are now shared by both ministries:

• Services Delivered by Partners
• Services Delivered by the Ministry
• Stewardship and Corporate Management

The Ministry of Health Planning has direct responsibility in two of these core businesses "Stewardship and Corporate Management" and "Services Delivered by Ministry" (Vital Statistics Agency). For reporting brevity, the remaining core business "Services Delivered by Partners" is reported only in the Ministry of Health Services Annual Service Plan Report.

Stewardship and Corporate Management

The ministries' primary function is stewardship over the health care system. This includes providing direction and support to our partners, and monitoring and evaluating the impact of services delivered to the public. To be good stewards, the ministry must also provide good corporate management to ensure that its own administration is run as efficiently and effectively as possible. To fulfill its stewardship function, the Ministry of Health Planning is organized under the following areas:

Planning, Policy and Legislation

The Planning, Policy and Legislation division works with the Ministry of Health Services, health authorities and other partners both within and outside government to create policy, legislation, and planned approaches to strengthen the quality and sustainability of health care services at all levels. Strengthening health care services includes developing appropriate and informed policy and legislation, working with the self-regulated professions to ensure patient safety, supporting evidence-based services and the research that will inform such services, and working with other governments on projects designed to improve quality and accountability. Finally, the division works with partners in the area of health human resource planning to ensure an adequate supply of appropriately trained, satisfied health care providers able to provide high quality care.

Strategic Change Initiatives

The Strategic Change Initiatives Division oversees projects designed to improve quality, accessibility or efficiency of the health care system. This division works with provincial ministries, health care providers, administrators and researchers, and provides project management expertise for all areas of the Ministries of Health Planning and Health Services. The division is also responsible for the development of the long-term plan for BC's public health care system, and strategic planning for mental health and addictions and home and community care services.

Office of the Provincial Health Officer (PHO)/Population Health and Wellness

As detailed in the Health Act, the Provincial Health Officer provides independent advice to government on health issues, monitors and reports on the health of British Columbians, identifies the need for legislation or changes in policy or practice, and works with the BC Centre for Disease Control and provincial medical health officers to fulfill their legislated mandates. It also includes the Prevention and Wellness Division, which develops and evaluates provincial strategies to improve the health of British Columbians and reduce future demands for health services.

Services Delivered by Ministry

Vital Statistics Agency

The Vital Statistics Agency provides a system for the registration and certification of vital events for the Province of British Columbia. The agency's mandate is established in a number of pieces of legislation including the Vital Statistics Act, the Marriage Act, and the Name Act. The agency fulfills a direct public service role by providing vital event certificates and documents to the public. The agency also provides vital event data, statistical reports, and health status indicators to support the needs of the ministry, the provincial and federal governments, and regional health care administrators and researchers in managing health-care initiatives.