2002/03 Annual Service Plan Report Ministry of Health Services

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 increase in chronic diseases have put new demands on our health system. We are now focused on creating a flexible, adaptable health system to meet the diverse and changing needs of British Columbians.

The Ministries of Health Services and Health Planning 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 Services and Health Planning 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

The Ministry of Health Services provides funding, direction and leadership to regional health authorities to support the delivery of quality health services throughout the province. In turn, the health authorities run the health system's day-to-day operations. The ministry also provides operational support to the Ministry of Health Planning. In addition, the ministry oversees and operates PharmaCare, the province's drug insurance program, and the Medical Services Plan to ensure British Columbians get the physician services and pharmaceuticals they need.

In 2002/03, the BC government increased funding for health care 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 yearly and will comprise 13.8 per cent of the population in 2005.
• There will be a decrease in the number of residents under 19 as part of BC's total population.
• 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;
• Fostering cooperative working relations with health system partners and among various ministry areas;
• Building relationships with other provincial 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 the province's health care goals and objectives. These reports are available at http://www.gov.bc.ca/healthservices or http://www.gov.bc.ca/healthplanning.

Update on New Era Commitments

In June 2001, the Premier of British Columbia gave the Minister of Health Services the responsibility of implementing 23 of government's New Era commitments. Please refer to Appendix 3 for a status on each of these New Era commitments.

Core Business Areas

At the beginning of 2002/03, the Ministry of Health Services had four core business areas: Performance Management and Improvement Division; Emergency Health Services; Medical and Pharmaceutical Services; and Corporate Services and Financial Accountability.

These represented the four divisions of the ministry. During the year, these functions were integrated into three new core business areas:

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

These core businesses better reflect the functions of BC's health care system as a whole, as well as the different roles of the ministries and their health care partners.

Services Delivered by Partners

BC's regional health authorities, agencies, doctors and other care providers are our key partners who deliver the majority of health services to the public. They are responsible for identifying patients' needs, planning and allocating health resources, and managing the delivery of health services throughout the province. Health services managed and delivered by our health system partners include the following:

• Prevention, protection and promotion including public health programs, health information campaigns, inspections and licenses; and
• Primary or episodic care — often the first point of contact — such as doctors' visits, acute care, specialist care, rehabilitation services, and ongoing chronic or palliative care.

Health authorities are responsible for the delivery of the majority of these services, including running public health programs and providing acute care services at hospitals. They also manage the delivery of home and community care and mental health services to address patients' needs. Doctors and pharmacists are other key system partners in delivering these services.

Services Delivered by Ministry

Health Benefit Operations

As part of the Ministry of Health Services, Health Benefit Operations administers BC's PharmaCare and Medical Services Plan. PharmaCare is the province's drug insurance program, which assists British Columbians with paying for eligible prescription drugs and medical supplies. The Medical Services Plan (MSP) insures medically required services provided by physicians and supplementary health care practitioners, as well as laboratory and diagnostic services.

Emergency Health Services

The ministry also funds Emergency Health Services delivered by the British Columbia Ambulance Service.

Stewardship and Corporate Management

In their stewardship role, both ministries provide leadership and support to health authorities and other partners in delivering quality health services to the public. The Ministries of Health establish funding, performance agreements for health authorities, and performance measures for BC's health system. Their role includes monitoring and evaluating health system performance and service delivery in order to facilitate improvements. In addition, the ministries support the health system and their partners through negotiations with care providers, as well as decision support systems.

Corporate management includes managing ministry budgets, human resources and information needs. The Ministry of Health Services provides support and funding for these shared management functions across both ministries. Both Ministries of Health also provide support to the Ministers' Offices.

Strategic Initiatives and Corporate Services

Strategic Initiatives and Corporate Services oversees priority initiatives of the ministry, such as the implementation of Fair PharmaCare. The division also provides corporate support services for both health ministries, including information management, human resources and finance. Working with the Performance Management and Improvement Division, it also establishes financial performance standards and monitoring systems for BC's health authorities. Finally, the division provides financing for capital health projects.

Performance Management and Improvement Division

The Performance Management and Improvement Division is the main link between the province and the regional health authorities, which are responsible for the direct delivery of many health services in BC. These services include acute care, residential and community care, mental health and public health services. The division works with health authorities, service providers and other partners to implement performance agreements, accountability standards and monitoring systems. The ministry provides three-year funding allocations to health authorities for health service delivery in their local communities.

Medical and Pharmaceutical Services

The Medical and Pharmaceutical Services Division is responsible for the management of medical services through policy development, systems improvements and effective issues resolution. The division also manages physician relations through strategic planning, policy development, negotiated agreements, and the development of patient strategies and policies. In addition, Medical and Pharmaceutical Services manages BC PharmaCare — the province's public drug insurance program that subsidizes eligible prescription drugs and medical supplies, protecting British Columbians from high drug costs.