Report on Resources
Resource Summary Table 2005/06
| Estimated | Other Authorizations | Total Estimated | Actual | Variance | |
|---|---|---|---|---|---|
| Operating Expenses ($000) | |||||
| Services Delivered by Partners | |||||
| Regional Health Sector Funding | 7,239,659 | 7,239,659 | 7,250,617 | 10,958 | |
| Medical Services Plan | 2,627,065 | 2,627,065 | 2,631,857 | 4,792 | |
| PharmaCare | 889,547 | 889,547 | 867,032 | (22,515) | |
| Debt Service Costs | 169,500 | 169,500 | 133,884 | (35,616) | |
| Amortization of Prepaid Capital | 152,908 | 152,908 | 151,002 | (1,906) | |
| Health Benefits Operations | 28,213 | 28,213 | 29,231 | 1,018 | |
| Sub-Total | 11,106,892 | 0 | 11,106,892 | 11,063,623 | (43,269) |
| Services Delivered by Ministry | |||||
| Emergency Health Services | 253,523 | 253,523 | 256,854 | 3,331 | |
| Vital Statistics | 6,786 | 6,786 | 6,013 | (773) | |
| Sub-Total | 260,309 | 0 | 260,309 | 262,867 | 2,558 |
| Executive and Support Services | |||||
| Minister's Office | 567 | 567 | 554 | (13) | |
| Stewardship and Corporate Management | 102,730 | 102,730 | 103,616 | 886 | |
| Sub-Total | 103,297 | 0 | 103,297 | 104,170 | 873 |
| Recoveries — Health Special Account | (147,250) | (147,250) | (147,250) | 0 | |
| Total Vote 34 — Ministry of Health | 11,323,248 | 0 | 11,323,248 | 11,283,410 | (39,838) |
| Health Special Account | 147,250 | 147,250 | 147,250 | 0 | |
| Sub-total — Operating Expenses | 11,470,498 | 0 | 11,470,498 | 11,430,660 | (39,838) |
| Reversal of Prior Year Over Accruals1 | (13,257) | (13,257) | |||
| Total — Ministry of Health | 11,470,498 | 0 | 11,470,498 | 11,417,403 | (53,095) |
| 1 | Reversal of prior year over accruals is the total amount written off for prior years' accruals that are no longer valid. The credit was not available for spending. |
The Ministry of Health 2005/06 budget was $11.470 billion. The actual operating expenditures for the fiscal year ending March 31, 2006 are $11.430 billion, resulting in an operating variance of $40 million. Additionally, the Ministry reversed $13 million of prior years' accruals, resulting in a total surplus position of $53 million; however, the reversed amounts were not available for spending.
Summary of Resources
Operating Expense Variance Explanations
Regional Health Sector Funding: The deficit was primarily due to increased investments across the continuum of care by health authorities. Investments included increasing access and reducing waiting times for surgeries, enhancing home and community care, implementing the nursing strategy and providing life support programs.
Medical Services Plan: The deficit is primarily due to increases in fee-for-service billings by physicians.
PharmaCare: The surplus in PharmaCare is primarily related to lower than anticipated Fair PharmaCare utilization increases.
Debt Service Costs: The debt servicing surplus at year-end is due to lower debt balances, lower than anticipated interest rates and higher sinking fund recoveries.
Emergency Health Services: The deficit is due to additional costs for staffing, air ambulance services, provincial operations, and building occupancy.
| Estimated | Other Authorizations | Total Estimated | Actual | Variance | |
|---|---|---|---|---|---|
| Full-time Equivalents (Direct FTEs) | |||||
| Health — Ministry Operations | |||||
| Emergency Health Services | 1,999 | 1,999 | 1,964 | (35) | |
| Stewardship and Corporate Management | 680 | 680 | 651 | (29) | |
| Minister's Office | 6 | 6 | 6 | 0 | |
| Vital Statistics | 85 | 85 | 78 | (7) | |
| Total Ministry of Health | 2,770 | 0 | 2,770 | 2,699 | (71) |
The FTE budget was 2,770 in 2005/06. Utilization was 2,699 resulting in a surplus of 71 FTE's due to lower than anticipated utilization in emergency health services and recruitment lag elsewhere in the Ministry.
| Estimated | Other Authorizations | Total Estimated | Actual | Variance | |
|---|---|---|---|---|---|
| Ministry Capital Expenditures (Consolidated Revenue Fund) ($000) | |||||
| Health — Ministry Operations | |||||
| Stewardship and Corporate Management | 44,510 | 44,510 | 14,040 | (30,470) | |
| Emergency Health Services | 15,490 | 15,490 | 10,128 | (5,362) | |
| Vital Statistics | 550 | 550 | 269 | (281) | |
| Total Ministry of Health | 60,550 | 0 | 60,550 | 24,437 | (36,113) |
The Consolidated Revenue Fund Capital budget was $60.550 million in 2005/06. The surplus is mainly due to deferred information systems projects.
| Estimated | Other Authorizations | Total Estimated | Actual | Variance | |
|---|---|---|---|---|---|
| Consolidated Capital Plan ($000) | |||||
| Prepaid Capital Advances | 280,000 | 31,088 | 311,088 | 311,088 | 0 |
| Total Ministry of Health | 280,000 | 31,088 | 311,088 | 311,088 | 0 |
The budget for prepaid capital advances was $280 million. During the year, the budget was increased by $31.088 million to implement a 2005 agreement for replacement funding for the Greater Vancouver Regional Hospital District.
| Estimated | Other Authorizations | Total Estimated | Actual | Variance | |
|---|---|---|---|---|---|
| Other Financing Transactions ($000) | |||||
| Health Innovative Incentive Program | |||||
| Receipts | 769 | 769 | 769 | 0 | |
| Disbursements | 0 | 0 | 0 | 0 | |
| Net Cash Source/Requirements | 769 | 769 | 769 | 0 | |
The financing transaction recovery totaling $0.769 million was received in 2005/06 from the Vancouver Island Health Authority as the third in a series of repayments for the reimbursement of funds provided to the authority in a prior year for its Picture Archiving and Communication System.
Health Authorities Included in the Provincial Reporting Entity
As required under the Budget Transparency and Accountability Act, British Columbia's six health authorities are included in the government reporting entity. The health authorities have been primary service delivery organizations for the public health sector for several years and many of the performance measures and targets included in the Ministry's service plan are related to services delivered by the health authorities. The majority of the health authorities' revenues and a substantial portion of the funding for capital acquisitions are provided by the Province in the form of grants from Ministry budgets.
| Health Sector | 2005/06 Budget | 2005/06 Actual | Variance |
|---|---|---|---|
| 2005/06 Combined Income Statement ($000) | |||
| Total Revenue1 | 8,618,000 | 9,087,411 | 469,441 |
| Total Expense2 | 8,618,000 | 9,085,274 | 467,274 |
| Operating Results | 0 | 2,167 | 2,167 |
| NOTES: This combined income statement is based on audited financial statements from six health authorities and 10 hospital societies. Numbers do not include the eliminating entries required to consolidate these agencies with the government reporting entity. | |
| 1 | Revenue: Includes provincial revenue from the Ministry of Health, plus revenues from the federal government, co payments (which are client contributions for accommodation in care facilities) and fees and licences. |
| 2 | Expenses: Provides for a range of health care services, including acute care and tertiary services, residential care, mental health services, home care, home support, and public health programs. |
Capital Investment
The province's six health authorities and the Ministry collaborate on financial and infrastructure planning to ensure capital investments in the health system are strategic and cost-effective. Recognizing the significant cost and long lifespan of most capital investments — both in acquisition and use — the Ministry and health authorities are moving toward a comprehensive ten-year capital planning process that is aligned with other health sector planning. This change in the planning horizon will enable the Ministry to better anticipate future demand for health services, resulting from a growing and aging population and medical and technological innovations, and to plan and prioritize long-term capital investments accordingly.
In 2005/06, health sector projects included expanding hospital and community services, expanding BC's medical school, purchasing high tech medical equipment, and investing in information management technology to support B.C.'s eHealth strategy.
Major Capital Projects
A major capital project is defined as any capital commitment or anticipated commitment that exceeds $50 million. In 2005/06, the Ministry's commitments that exceeded $50 million were:
Vancouver General Hospital Redevelopment (VGH) — Vancouver Coastal Health Authority
Objective: The hospital redevelopment is to consolidate patient services and clinical expertise to assist in meeting patient care needs over the next 20 years or more.
Benefits: Anticipated benefits are new patient areas and consolidation of hospital services within the Centennial Pavilion and the Jim Pattison Pavilion to create a modern and efficient hospital environment for enhanced patient care and accessibility.
Cost and Timeline: The total capital cost is $156 million, and the project is expected to be completed in 2007.
Academic Ambulatory Care Centre (AACC) — Vancouver Coastal Health Authority
Objective: The AACC is a state-of-the-art, 11-storey, 365,000-square-foot facility planned for the Vancouver General Hospital (VGH) site. The project will be completed through an agreement with Access Health Vancouver (AHV), a team of companies selected through an open competitive process.
Benefits: The AACC will provide single-site access to a range of outpatient (ambulatory) services along with undergraduate and post-graduate medical education facilities, teaching physician/specialist practice offices, and related commercial/retail activities. The facility is expected to support several hundred medical students, approximately 580 medical and health professionals, and an estimated 600,000 patient visits annually.
Cost and Timeline: The capital cost for the project is estimated at $95 million. Construction commenced in October 2004 and is scheduled for completion in 2006.
For more information on the Academic Ambulatory Care Centre project, please see the Ministry's website at http://www.healthservices.gov.bc.ca/cpa/publications/index.html.
Abbotsford Regional Hospital and Cancer Centre — Fraser Health Authority and Provincial Health Services Authority
Objective: The Abbotsford Regional Hospital and Cancer Centre (ARHCC) will be a new 300 bed facility that replaces the current 202-bed Matsqui-Sumas-Abbotsford (MSA) hospital, which is aging, physically obsolete, and not suitable for expansion.
Benefits: The new hospital and cancer centre will provide enhanced programs and services to meet the needs of Fraser Valley residents, and will also help to recruit and retain health professionals. ARHCC includes integration of a new cancer treatment centre that will be part of the provincial network operated by the BC Cancer Agency.
Cost and Timeline: The capital cost of the project is estimated to be $355 million. The Fraser Valley Regional Hospital District is contributing $71.3 million towards the project. Construction, which commenced in December 2004, is expected to end in spring 2008, with the facility opening for patients in Summer 2008.
For more information on the Abbotsford Regional Hospital and Cancer Centre project, please see the Ministry's website at: http://www.abbotsfordhospitalandcancercentre.ca. To see Partnerships British Columbia's value for money report on the project, go to: http://www.healthservices.gov.bc.ca/cpa/publications/PBCAbbotsford.pdf.
Investments Across the Province
In addition to the major capital projects listed above, significant capital investments to improve B.C.'s health system have been made by the Ministry, health authorities, regional hospital districts, foundations and other funding partners. The following are some examples of those investments.
Fraser Health Authority
- Investments to help address congestion in the Emergency Department at Surrey Memorial Hospital, including a minor treatment unit adjacent to the emergency room, which opened in December 2005 ($4.8 million).
- A new 10-bed critical care unit, completed in November 2005, at Royal Columbian Hospital ($1.1 million).
- Expanding and redesigning the Delta Hospital Emergency Department and Surgical Day Care. The $6 million project is scheduled for completion in 2006.
Interior Health Authority
- Redeveloping the Royal Inland Hospital in Kamloops. The $27.5 million project doubles and modernizes the ER and medical imaging departments and includes renovations to numerous outpatient areas such as pharmacy, vascular, and orthopaedic clinics, pathology and the nuclear medicine department. The Regional Hospital District and Hospital Foundation are major funding partners for this project, which is scheduled for completion in 2006.
- Expanding the East Kootenay Regional Hospital in Cranbrook to enhance its Regional Health Care Centre role. The addition will expand and upgrade the Emergency, Ambulatory Care and Diagnostic Imaging departments. The $32 million project is scheduled for completion in 2007.
- Building a $17 million, 44-bed tertiary mental health facility located on the grounds of the Royal Inland Hospital in Kamloops that opened in early 2006. It contains three separate programs, including: a 10-bed psychiatric intensive care unit, a 10-bed secure care unit, and a 24-bed geriatric psychiatric unit.
Northern Health Authority
- Renovating and building an addition to the Prince George Regional Hospital to accommodate a special care nursery, a combined labour delivery and maternity unit and improvements to pediatric and pediatric ambulatory care. The project has a budget of $12.5 million and is scheduled for completion in 2006.
- Upgrading emergency and intensive care services at the Mills Memorial Hospital in Terrace. The $1.9 million project, with funding from government and the Regional Hospital District, was completed in early 2006.
- Relocating the Intensive Care Unit at the Prince Rupert Regional Hospital to improve workflow and work processes. The $2.4 million project is scheduled for completion in 2006.
Vancouver Coastal Health Authority
- Redesigning the Vancouver General Hospital Emergency Room to improve treatment efficiency and patient care. The $3.3 million project is scheduled for completion in 2006.
- Improving Richmond Hospital's management of severe respiratory illness through a $2.2 million project to provide upgraded isolation capability. The 2003 SARS outbreak emphasized the need to safely manage potential infectious disease cases. The project is scheduled for completion in 2006.
- Expanding the mental health program by 15 beds at St. Paul's Hospital in Vancouver through a $4.2 million project.
Vancouver Island Health Authority
- Aberdeen Primary Health Care Centre is a $14.4 million, 12-bed 'respite hotel' and a seniors' primary care centre. It is an innovative project that combines assisted living accommodation that is owned and operated by Victoria Cool Aid Society.
- Island Medical School projects are under construction at Royal Jubilee and Victoria General Hospitals. The $7 million projects are to be completed in September, 2006 to accept the medical students that are part of the medical school expansion established in 2004 at the University of Victoria.
- Redeveloping Nanaimo Regional General Hospital which includes a $23 million surgical expansion completed in April 2005 and the new $12 million perinatal services component to be completed in 2007.
Provincial Health Services Authority
- The Child, Adolescent and Women's Mental Health Centre will open in 2006, and will provide a full range of mental health assessment and treatment services including a child and adolescent psychiatric emergency unit, outreach services, specialty clinics and an eating disorders program. The total project cost is $19 million.
- Enhancing disease control through a $4.6 million project to consolidate lab functions at the BC Centre for Disease Control to a single site.
- Expanding the Radiation Therapy Annex at the Vancouver Cancer Centre. The $7.8 million project includes construction of four underground linear accelerator treatment vaults with associated patient waiting and change areas, plus an exam room.
