We’ve increased total spending on health care by nearly 70 per cent since 2000/01, from $9.4 billion to $15.7 billion this year.
Over the next three years, 90 per cent of all budgeted new spending will go to health care – increasing health care spending to $17.5 billion by 2011/12.
We enshrined the principle of sustainability in law in with the Medicare Protection Act.
We created ActNow BC , a nationally-recognized leader in promoting healthy living and chronic-disease prevention.
We’re increasing the number of diagnostic tests at birth to screen for 19 disorders (up from six), and we’re providing $21 million annually for hearing, vision and dental screenings that are performed by the time a child enters Kindergarten.
Since 2001 we’ve spent approximately $5 billion on health care capital – such as new hospitals – and we’re anticipating spending a further $2.5 billion over the next three years.
We’ve increased the number of residencies for international medical graduates by 800 per cent since 2001, from two to 18.
We’ve doubled the number of nurse training spaces since 2001, added 24 new nursing programs, and granted a record number of nursing degrees - nearly 13,000.
Median wait times are significantly down since 2001 for hip and knee replacements and cardiac surgery:
Hip replacements – down 41 per cent
Knee replacements – down 33 per cent
Cardiac surgery – down 40 per cent
We’ve committed over $400 million since 2001 to improve and expand more than 30 Emergency Rooms across the province.
We’re ensuring timely, high-quality emergency medical and ambulance services through record levels of investment and innovations in service delivery.
We increased Pharmacare’s budget by more than 60 per cent since 2001, from $645 million to over $1 billion today.
We brought in Fair Pharmacare to focus resources on those most in need first – in particular, low-income seniors and families. As a result, 300,000 more families receive support than in 2001.
We’re banning trans fats in the preparation of food in restaurants and schools by 2010, and we’ve banned junk food in vending machines in schools and hospitals.
We’ve banned smoking in vehicles when children under 16 are present.
Ambulance Service We’re increasing investment in timely and high quality emergency medical services to all British Columbians, and ensuring that fees are fair, regardless of where you live in B.C.
We’ve increased the budget for the BC Ambulance Service by 74 per cent over the past eight years, from $181 million in 2001/02 to $316 million in 2009/10.
Since 2003/04, the number of full and part-time paramedics grew 25 per cent; today there are 3,471 paramedics serving B.C.
Currently there are 511 ambulances and support vehicles on the street, up from 484 in 2003/04.
We implemented a fair fee structure in 2007 to ensure patients pay the same for ambulance transport in B.C., regardless of where they live or how far they must travel to receive care:
Under the new policy a patient transferred from Port Hardy to Victoria General Hospital pays $80, before our changes they paid $214.
Today a patient transferred from Trail to Kelowna General Hospital pays $80, before they paid $188.50.
We cover almost 90 per cent of the cost of an ambulance trip even though ambulance fees are not covered by the Canada Health Act.
We’re no longer billing clients of MSP Assistance for ambulance service, eliminating 68,000 bills a year.
We upgraded 48 ambulance stations in 2005 to provide 24/7 standby coverage thus improving response times by 13.4 per cent (between 2004/05 & 2006/07).
Beginning in 2007, the BC Ambulance Service and Health Authorities partnered to reduce delays in delivering patients into ERs, and today offload delays are reduced by 33 per cent, freeing up over 10,000 ambulance hours.
The majority of full-time paramedics received a 26 per cent pay increase between 2001 and 2008 – an average increase of 3.5 per cent per year.
The average full-time Primary Care Paramedic earned over $60,000 in 2007/08, and the average full-time Advanced Care Paramedic earned over $84,000 in 2007/08.
Other Health Transportation Programs:
In addition to government-subsidized ambulance service, we provide $6 million a year to the Health Connections program, which assists patients with the costs of transportation to and from regional health centres.
We also provide over $6 million to the Travel Assistance Program which primarily subsidizes ferry and car travel for medical appointments.
At the UBCM convention in 2008, we committed to creating a new BC Family Residence Program to help provide accommodation for family members of sick children who need to travel to regional health centres, starting at BC Children’s Hospital in Vancouver.
Travel assistance programs will also be enhanced to support the Residence Program.
Capital Investments We have made record investments in modern, new and expanded hospitals, health care facilities and equipment across B.C. to maintain and improve our world class health care system.
Since 2001 we’ve spent about $5 billion on health care capital, and we’re anticipating spending a further $2.5 billion over the next three years.
In the Lower Mainland:
We built & opened the new 300 bed Abbotsford Regional Hospital & Cancer Centre in August 2008—B.C.’s first new regional hospital in more than three decades. It provides world class surgical, diagnostic and cancer care to Fraser Valley residents.
B.C.’s Auditor General attests that the Abbotsford Hospital public-private partnership (P3) model will save $39 million over the term of this facility’s contract.
We’re building the Surrey Outpatient Hospital , the Fraser Valley’s first outpatient hospital. Construction started September 2008 in Surrey; the facility will provide day surgery, and diagnostic and chronic disease management services to the residents of Surrey and their neighbours
We’re building a new critical care tower at Surrey Memorial Hospital to increase the number of acute care beds by more than 30%, including a new emergency department almost five times the size of the old ER.
Construction should begin in 2010 and be complete in 2014. Total capital value is estimated in the range of $500-$600 million.
We built the new $95-million Gordon and Leslie Diamond Centre Outpatient Hospital at Vancouver General Hospital, serving 600,000 patients each year. This P3 is expected to save $17 million over the life of the contract.
We’ve committed to renovating and expanding BC Children’s Hospital for all of our children across the province.
Our investments outside the Lower Mainland since 2001 include:
Construction started in August 2008 on the new $350-million, 500-bed Royal Jubilee Hospital in Victoria, consolidating and replacing the various inpatient facilities on the grounds of the hospital, providing new, best practice standards around infection control and patient care.
At Prince George Regional Hospital $65 million has been invested in: enhancing and expanding maternity and paediatric care; the emergency room; the Northern Medical School Program; updated ICUs and ambulatory care.
At Vernon Jubilee Hospital , we’re building a larger emergency room; increased operating room space; and added acute care bed capacity; at a total value of approximately $179 million
At Kelowna General Hospital , we’re building a new outpatient hospital; acute care bed capacity; a new emergency room; a medical training school; at a value of approximately $254 million
The Kelowna & Vernon projects have a combined value of about $433 million, with $25.4 million in estimated savings as P3 projects.
We’re investing $27 million for a new cardiac care program for the Southern Interior at Kelowna General Hospital beginning in 2010, eventually providing care to 1,600 residents who currently have to travel to the Lower Mainland for the same services.
We invested $32 million upgrading East Kootenay Regional Hospital in Cranbrook with a new emergency department; new ambulatory care facilities; and expanded diagnostic services.
We invested $28 million in expanding Royal Inland Hospital in Kamloops with new state of the art emergency and medical imaging departments.
We invested $29 million at Nanaimo Regional General Hospital to expand patient care, maternity and surgical services.
Emergency Rooms & Acute Care We believe that timely access to emergency care can be achieved through making record levels of investments in capital and health professionals in our ERs, implementing innovative best practices in delivering that care, and improving options to divert patients away from emergency rooms to more appropriate levels of care. Health Minister George Abbott talks about improving ERs and acute care across B.C.
We’ve committed over $400 million since 2001 to improve and expand more than 30 ERs across the province, including:
Victoria – Royal Jubilee Hospital – completed Spring 2002.
Clearwater – Dr. Helmcken Memorial Hospital – completed Summer 2002.
Vancouver – Children’s Hospital – completed Winter 2002.
Prince George Regional Hospital – completed Fall 2003.
Kamloops - Royal Inland Hospital – completed Winter 2004.
Surrey Memorial Hospital – completed Winter 2005.
Smithers - Bulkley Valley District Hospital – completed Winter 2005.
100 Mile House District Hospital – completed Winter 2005.
Terrace - Mills Memorial Hospital – completed Fall 2006.
Delta Hospital – completed Fall 2006.
Vancouver General Hospital – completed Summer 2007.
Cranbrook – East Kootenay Regional Hospital – completed Fall 2007.
Maple Ridge – Ridge Meadows Hospital – completed Spring 2008.
Abbotsford Regional Hospital & Cancer Centre – completed Summer 2008.
Burnaby Hospital – completed Fall 2008.
Massett Health Centre – completed Fall 2008.
Lytton Health Care Centre –completed Winter 2008.
North Vancouver – Lions Gate Hospital – estimated completion Spring 2009.
Victoria General Hospital – estimated completion Fall 2009.
Chilliwack Regional Hospital – estimated completion Fall 2010.
Vancouver – St. Paul’s Hospital – estimated completion 2011.
Vernon Jubilee Hospital – estimated completion Summer 2011.
Sechelt – St. Mary’s Hospital – estimated completion Summer 2011.
Fort St. John Regional Hospital – estimated completion Fall 2011.
Kelowna General Hospital – estimated completion Summer 2012.
Surrey Memorial Hospital – estimated completion Spring 2013.
Budget 2007 provided a $100-million Health Innovation Fund that provided the following improvements in emergency room care:
Addition of a Streaming Unit at Kelowna General Hospital has helped reduced wait times to just two hours, down from eight hours.
Implementation of the iCare program in Fraser Health hospitals reduced the number of patients who were admitted but stuck in the ER waiting room by 60 per cent.
Another success of iCare saw a reduction in the average stay length at Lions Gate Hospital drop from 9.4 days to 6.3 days, freeing up the equivalent of 30 acute care beds.
The emergency decongestion pay-for-performance pilot in Vancouver Coastal Health is seeing a 24 per cent improvement in the number of admitted patients receiving a bed within 10 hours, and a 22 per cent improvement in the number of lower acuity patients discharged within 2 hours.
We’re now expanding the successful emergency decongestion pay-for-performance pilot to Fraser Health.
By increasing acute care capacity and investing in community based seniors care facilities and mental health and addiction facilities, we are improving the flow through of patients from emergency rooms into acute care beds.
Despite shifts away from acute care through advances in technology and less-invasive procedures, we have more acute care beds in B.C. today than when the Health Authorities were created – 8,005 today compared to 7,743 in 2002 – with hundreds more under development.
We’re creating additional capacity to help reduce the number of patients in hospital waiting for a residential care bed by building over 5,896 net new residential care beds and assisted living units (12,435 including renovations) – thereby freeing up capacity in our hospitals for urgent cases.
We’re decongesting acute care beds by dramatically increasing the number of community-based mental health beds by 57 per cent and community addiction beds by 150 per cent so patients waiting in hospital have greater access to these needed community resources.
Fair Pharmacare We believe in a publicly-funded drug program that is fair and focuses resources on those most in need first – in particular, low-income seniors and families.
We’ve increased the Pharmacare budget by over 60 per cent since 2001, from $654 million to over $1 billion this year.
We provide 100 per cent coverage of psychiatric medications for those in need.
Prior to Fair Pharmacare, a family earning $14,000 paid an $800 annual deductible before receiving benefits. Now under Fair Pharmacare the same family pays no deductible at all.
The deductible for a family with a net income of $30,000 was $1,000 prior to Fair Pharmacare. Today that deductible is $600.
The maximum that same family would pay in one year was $2,000 prior to Fair Pharmacare. Today that family only pays $900.
More than 300,000 British Columbian families receive more support now under Fair Pharmacare than they did in 2001.
We’ve doubled the number of medical school spaces in B.C. from 128 in 2001 to 256 today.
We’ve added new medical programs at UNBC and UVic and we’re building a fourth program at UBC Okanagan – with this expansion we’ll be graduating 288 medical doctors a year in B.C.
Altogether these undergraduate expansions will graduate 288 doctors every year, up from 128 in 2001/02.
We’ve increased the number of residencies for international medical graduates by 800 per cent, from two in 2001 to 18 in 2006.
We’re creating a restricted licence to allow foreign trained physicians to practice in their areas of qualification.
We’re significantly expanding residency positions and implementing a new framework for Canadian citizens trained outside Canada.
We’re working to ensure doctors practicing in other Canadian jurisdictions will be able to work in B.C.
72 new General Practitioners agreed to serve as family physicians in 37 underserved communities under our $10-million Family Physicians for B.C. program.
The Canadian Medical Association (CMA) counts 218 physicians per 100,000 people in B.C. for 2008 (includes GPs & specialists), compared to the Canadian average of 199 per 100,000 – the second highest rating in Canada.
Physician recruitment in B.C. is now outpacing population growth – between 2001/02 and 2006/07, we increased the total number of physicians in BC 11.6 per cent, while total population grew 6.8 per cent.
B.C. saw the highest in-migration of physicians from other provinces between 2002 and 2007 – 429 physicians moved here from other provinces.
Nurses:
We’ve doubled the number of nurse training spaces since 2001, adding 4,000 new training spaces plus 24new nursing programs.
Between 2001 and 2007, there have been nearly 13,000 nursing degrees, diplomas and certificates awarded.
We’ve created the new three-year nursing degree at BCIT, graduating nurses sooner so they enter the workforce faster.
We’ve invested $189 million since 2001 in our B.C. Nursing Strategy to attract & retain nurses and we’ve provided more than $15 million in grants to over 4,300 students.
We started the first program in B.C. to train Nurse Practitioners in 2005.
The number of practicing nurses in B.C. has risen to over 43,000 – with nearly 7,000 more nurses practicing in this province since 2001, an increase of 19 per cent.
We reduced the number of health authorities from 52 to six to reduce bureaucratic overhead costs.
Administration and support staff savings and efficiencies realized from the three-year redesign plan are $126 million.
We established a Health Authority Shared Services Organization that examines more effective ways of delivering non-clinical health care services so all available dollars can be focussed on direct patient care - so far $150 million in potential savings have been identified.
Prevention Prevention remains the best way to avoid illness and increased costs. Through government investment and policies we can support prevention and fitness programs for the public and lead the way in North America in healthy living and physical fitness.
We put in place an entire ministry dedicated to preventative health called Healthy Living & Sport .
We created ActNow BC , recognized nationally as a leader in promoting healthy living and chronic disease prevention by the Health Council of Canada.
We banned smoking in indoor public and work places.
We’re restricting the use of industrially-produced trans-fats in prepared foods all food service establishments throughout the province.
We’ve banned junk food in vending machines in schools and government buildings.
We provide free nutrition information though Dietician Services available by phone and translated in 130 languages through HealthLink BC , just dial 811.
We’re providing the HPV vaccine in 2008/09 to girls in grades 6 & 9 to prevent cervical cancers.
Standard B.C. wait for a mammogram is eight weeks at a location within a one-hour drive.
Our hepatitis framework renews and refocuses efforts to reduce infections, with an emphasis on Hep C. We spend about $200 million annually managing viral hepatitis and preventing new infections.
Investment in public health care has never been higher in B.C. There are more publicly-funded services than ever before and public funding has increased by nearly 70 per cent since 2000/01.
To free up capacity in our public hospitals so they can do more complex surgeries, we’ve contracted out some minor day surgeries.
Our contracts with private facilities are in accordance with the Canada Health Act.
Less than two per cent (8,500) of all surgeries (475,000) are performed in private facilities and paid for with public money through the health authorities.
When a complaint is made that a private clinic may have violated the Canada Health Act or the Medicare Protection Act, we follow up on it and if action needs to be taken, our government will do so.
Sustainability We believe that government’s core responsibility is to ensure our health care system will be there for our children, our grandchildren and their families, and that is achieved through sound investment, planning and innovation in our system.
We believe that the sustainability of our health care system is so important that we enshrined the principle in law under the Medicare Protection Act.
All dollars from sales tax, Medicare premiums, tobacco tax, health-care fees, federal health transfer payments and corporate income tax combined do not cover the costs of health services.
Health expenditures grew at more than twice the rate of growth in GDP over the last 20 years and at nearly quadruple inflation rates this decade.
30 years ago the Ministry of Health represented 26 per cent of the provincial budget. Twenty years ago it was 32 per cent and 10 years ago it was 35 per cent. Today it is 44 per cent of the provincial budget.
In the next 25 years, our province’s senior population will more than double from about 600,000 (2006) to around 1.4 million by 2031, comprising 24 per cent of our total population.
An average person in their fifties uses about $2,100 a year in health care costs - that almost triples to $5,700 in our seventies - and by our nineties it increases to $22,000.
We’ve increased total spending on health care from $9.4 billion to $15.7 billion since 2001, an increase of nearly 70 per cent. Over the next three years 90 per cent of all new budgeted spending goes to health care.
If we are going to address the sustainability of our health care system, we must get a handle on the costly growth of the burden of chronic disease. That is why we have:
Banned smoking in vehicles with children under the age of 16.
Banned smoking in indoor public places.
Are banning the use of trans-fats in the preparation of food in restaurants and schools by 2010.
Banned junk food in vending machines in schools and government buildings.
To ensure more British Columbians get family physicians and are better able to address the issues of chronic disease, we’ve done things like the following:
Doubled the number of medical school training spaces.
Implemented incentive programs to attract physicians to family practice and rural communities.
Creating a restricted licence to allow foreign-trained doctors to practice in their area(s) of qualification(s).
Significantly expanding residency positions and implementing a new framework for Canadians trained outside Canada.
Ensuring doctors practicing in other Canadian jurisdictions will be able to work in B.C.
Waitlists Every patient deserves access to timely care. Through investment and innovation in surgical service delivery we are providing record levels of surgical procedures and service to British Columbians, and seeing significant reductions in wait times.
We created the $100-million Health Innovation Fund in Budget 2007 to encourage and assist health authorities to move forward immediately with new ideas to improve patient care
Following the introduction of the Health Innovation Fund, patient wait times were down 50 per cent in Victoria for Magnetic Resonance Imaging (MRI) tests.
Our $25-million investment established the Centre for Surgical Innovation at UBC Hospital, providing dedicated operating rooms to perform about 1,600 hip and knee replacement procedures each year, using best practices approaches to surgical and post-operative care.
Median wait times reduced since 2001:
Hip replacements waits down 41 per cent from 18.7 weeks to 11 weeks in 2007/08.
Knee replacements waits down 33 per cent from 25.4 weeks to 17 weeks.
Cardiac surgery waits down 40 per cent from 15.1 weeks to 9 weeks.
We’ve increased the number of surgeries since 2000/01:
Total knee replacements – up 118 per cent.
Total hip replacements - up 58 per cent.
Angioplasties – up 55 per cent.
Cataract surgeries - up 42 per cent.
7,437 knee replacements are expected to be performed by the end of 2008/09, up 155 per cent since 2000/01; and 4,917 hip replacements, up 70 per cent.
We increased the number of diagnostics being performed each year since 2001:
Number of MRI machines is up 155 per cent from 9 to 23. The number of MRI scans is expected to be up 163 per cent - 98,000 scans expected in 2008/09.
Number of CT scanners increased 58 per cent from 31 to 49 and the number of CT scans is expected to be up 86 per cent - 448,000 in 08/09.
