Strategic Context
Planning Context and Key Strategic Issues
The Ministry of Health operates within the broader economic, social and environmental influences that affect the population's health status. Enjoying good health and a high quality of life depends on many factors, including access to quality education, meaningful employment, stable family and community environments, and making healthy lifestyle choices.
Access to high quality health services also has a positive influence on health status. In British Columbia, citizens are supported in maintaining their health by a publicly funded health system, directed by the Ministry of Health and delivered primarily by B.C.'s health authorities and health care professionals. In the past 35 years, the scope of the public health system has expanded beyond traditional hospital and physician services to include comprehensive public health programs, a broad team of service providers, prescription drugs, home and community care and more.
Overall, British Columbians have a quality health system they can rely on and have some of the best health outcomes in the country. This was recently reflected in Healthy Provinces, Healthy Canadians: A Provincial Benchmarking Report released by the Conference Board of Canada in February 2006. The report compared and evaluated the performance of provincial health care systems in Canada based on 70 comparable health indicators, and found British Columbia to have the top ranked health system in the country. The full report is available at http://www.e-Library.ca.
Challenges and Risks
The Ministry must monitor broader societal indicators and trends to assess and plan for potential impacts on the health of the public and the health system. For instance, while British Columbians currently enjoy the best health status in Canada, there are worrying trends that are already creating unprecedented demands for health services:
- An aging population with a rising burden of illness is resulting in the continuing rise in demand for increasingly complex and expensive health services.
- 42 per cent of adult British Columbians are overweight or obese according to self-reported data, and only 58 per cent are physically active or moderately active.
- Tobacco use remains the primary risk factor that contributes most to the burden of diseases in British Columbia.
- Advances in technology are enabling and improving services, but also creating increased demand.
- As the population ages, so too does the health care workforce. The combination of looming retirements in the health workforce and increased demand for services from an aging population will make maintaining an adequate supply and mix of health professionals and workers challenging.
British Columbia's population growth and demographic shifts are also putting pressure on the health system, as health services tend to be used at higher rates in older age groups. The following demographic trends help to illustrate the scope of the future challenges to the health system:
- British Columbia's population is growing; in 2005 the population increased by 42,700 persons and is expected to increase by 45,000 persons in 2006, 47,600 in 2007, and 48,600 in 2008. By 2010, the population is forecast to be 4,485,000, an increase of 5.8 per cent from 2005.
- The share of British Columbia's population over the age of 65 is expanding. Relative to 2005, by 2015 the share of the population 65 and over will grow by 21.8 per cent, from 13.9 per cent to 16.9 per cent. Moreover, the median age in British Columbia is expected to reach 42.0 years by 2015 from 39.6 years in 2005.
- Life expectancy is increasing. In 2005, the median age at death was 79 years and by 2015 it is expected to be 81 years.
Furthermore, maintaining a high quality health system is also challenged by a number of other factors in a rapidly changing environment. Those factors include:
- The development of new treatments for patients with conditions that were previously untreatable.
- The emergence of new diseases, which result in new tests, drugs and treatments.
- Significant new public health risks such as avian flu, SARS, and West Nile virus, as well as accidental or natural emergencies.
- The continuous need to update or expand health facilities, technology and equipment.
Capacity to Manage Risks
Government has annually increased funding for health services; however, funding increases alone will not meet the increasing and changing demands placed on the health system. Accordingly, the Ministry has and will continue to undertake several strategies to ensure the health system is able to adapt and respond to changing demands.
The Ministry is engaging in longer-term planning and employing more integrated approaches to anticipating and meeting longer-term needs. The Ministry has significantly strengthened its data collection and analysis capability, and developed a long-term planning framework that provides structured guidance to ensure health system planning activities are evidence-based and focused on population and patient needs. The improved data and the framework guide the Ministry's planning in key service delivery and infrastructure areas, such as health human resource planning, information technology (including eHealth) planning, and capital investment planning for facilities and equipment. Longer term coordinated approaches based on evidence derived from sound data and analysis strengthens the Ministry's ability to make the right strategic investments to address the challenges facing the system, and deliver a quality health system now and in the future.
Further, our capacity to manage change has been greatly increased through the development of an accountable, efficient and responsive health sector that welcomes the challenge of improving services for the citizens of British Columbia. One of our strengths is the streamlined structure of five geographic health authorities responsible for the delivery of health services within their regions, and one additional authority responsible for highly specialized services, such as cancer and cardiac care, province-wide. This structure is well designed to manage the complexity of the health system, take advantage of the ability to adapt to change, foster innovation and make strategic investments across the continuum of care. The British Columbia structure is responsive to the changing needs of the population and well prepared to meet the challenges of an increasingly diverse, growing and aging population.
The Ministry is also working with other government and non-government organizations in support of British Columbians' health. ActNow BC is a health and wellness initiative that promotes healthy living choices to reduce chronic disease and improve the quality of life and health among the province's citizens. Coordinated across all provincial government ministries, it is a multi-year, multidisciplinary effort to create policies, programs and services that motivate British Columbians to eat a healthier diet, become more physically active, maintain healthy weight, reduce, quit or avoid tobacco use, and make healthy choices in pregnancy. What makes ActNow BC unique among health promotion initiatives is that the program broadens the focus of responsibility for the promotion of health and fitness beyond the health care system. Not solely the responsibility of the Ministry of Health, ActNow BC engages all provincial ministries as well as external partners. The BC Healthy Living Alliance (BCHLA) is a major partner, with the capacity to mobilize more than 40,000 volunteers, 4,300 health and recreation professionals and 184 local governments across B.C. BCHLA member organizations include: the Heart and Stroke Foundation, Canadian Cancer Society, Canadian Diabetes Association, B.C. Lung Association, B.C. Recreation and Parks Association, Dietitians of Canada, Public Health Association of B.C., Union of B.C. Municipalities, and the B.C. Pediatric Society. These partnerships greatly expand the Ministry's capacity to promote good health for British Columbians.
Ministry Linkage to the Five Great Goals
Government has set out five overarching goals to guide the work of ministries in achieving the full potential of British Columbia. The Five Great Goals for a Golden Decade focus on literacy and education, healthy living and physical fitness, supports for the most vulnerable members of society, environmental stewardship and job creation.
The work of the Ministry of Health is guided by the government's Five Great Goals. While the Ministry's primary contribution to achieving the five goals can be found in the goals focused on health and wellness (Goal 2) and providing supports to the most vulnerable members of society (Goal 3), the work of the Ministry ultimately contributes to the achievement of all the government's goals. Following is an overview of the key initiatives for B.C.'s health system that support the attainment of the Five Great Goals for a Golden Decade.
Great Goal 1: Make British Columbia the best-educated, most literate jurisdiction on the continent.
The Ministry of Health is:
- Providing health promotion and disease prevention programs that will help people stay healthy so they can learn. For instance, the Ministry is contributing to healthy childhood development by providing hearing screening, sight testing and dental checks for children before the age of six.
Great Goal 2: Lead the way in North America in healthy living and physical fitness.
The Ministry of Health is:
- Leading government's ActNow BC initiative through which all ministries and all sectors are supporting British Columbians to make healthy lifestyle choices in their schools, workplaces and communities. The ActNow BC initiative promotes physical activity, healthy eating, living tobacco free, and making healthy choices during pregnancy.
- Strengthening health protection and emergency management programs to promote health and safety and prepare for and respond to major public health risks such as SARS, West Nile virus, influenza, meningitis, and natural or accidental disasters.
- Continuing to deliver expanded immunization programs for children and seniors.
- Working to continue to reduce inequalities in health status among British Columbians, with a particular focus on improving Aboriginal health and wellness.
- Expanding the BC HealthGuide and BC NurseLine program to provide citizens with health information and advice 24 hours a day, 7 days a week, with translation services in over 130 languages. Providing the right information to the right person at the right time supports British Columbians to make the right health decisions for themselves and their families.
Great Goal 3: Build the best system of support in Canada for persons with disabilities, those with special needs, children at risk, and seniors.
The Ministry of Health is:
- Expanding home and residential care options for seniors and persons with disabilities, including building 5,000 new residential care, assisted living and supportive housing with care beds in partnership with BC Housing and community affiliates by December 2008.
- Strengthening and modernizing health services for seniors.
- Continuing to enhance mental health and addiction services across the Province, and participating with other ministries, health authorities, BC Housing, municipalities and community organizations to develop and implement strategies to address mental health, addictions and homelessness.
- Working with the Ministry of Children and Family Development and the Ministry of Education to better integrate services for children and youth with special needs.
Great Goal 4: Lead the world in sustainable environmental management, with the best air and water quality, and the best fisheries management, bar none.
The Ministry of Health is:
- Working with ministries across government on the ongoing implementation of the Drinking Water Protection Act to ensure safe, quality drinking water for British Columbians.
- Working with ministries across government to protect and enhance the Province's air quality by moving ahead on the recommendations of the Provincial Health Officer's Report on Air Quality in British Columbia.
Great Goal 5: Create more jobs per capita than anywhere else in Canada.
The Ministry of Health is:
- Continuing to foster innovation in the expanding health sector while creating safe, healthy and rewarding workplaces that will attract skilled workers and professionals to British Columbia.
- Working with the Ministry of Advanced Education, post-secondary institutions, the federal government and other provinces and territories to address the long-term need for a stable supply of health workers.
- Encouraging health research and innovation by investing $100 million in the Michael Smith Foundation for Health Research.
