Reorganizing Vancouver Coastal Health Authority
VCHA is organized into three operating divisions: North Shore/Coast Garibaldi, Vancouver, and Richmond. It’s a big enterprise, with an operating budget of $2.0 billion.
VCHA has been coy about publishing its financial results for the North Shore, making it difficult to compare where we are today with where we have been, or with where we are going tomorrow. Suffice to say, total operating revenues and expenditures are probably significantly greater than the $1/4 billion or so within which our beloved but phased-out North Shore Health Region operated, both because the new region is larger – extending all the way up to Bella Coola! – and because its service portfolio has changed significantly. However, after three years in which issues of “fairness” of resource allocation within VCHA keep bubbling to the surface, it may be time to start asking tougher fiscal questions. Published service plans are devoid of North Shore fiscal information, and even the aggregate VCHA offers skimpy detail -- except for the fact that budgets are highly constrained. It is probably premature to pass judgment on how North Shore’s loss of the autonomy it previously enjoyed under the North Shore Health Authority, has affected local excellence and resources.
In July, we received notification of a 3-year reorganization plan, described as follows:
VANCOUVER, BC - Over the next three years, Vancouver Coastal Health (VCH) will aim to improve patient access to key services and care through the establishment of three specific care networks.
The Acute, Primary Care and Community Care networks are outlined in an update to VCH's Health Redesign Plan, released today. The plan, which covers the period 2004/05 to 2006/07, provides insight into the main priorities and objectives for VCH over the next three years and is part of the authority's ongoing public reporting process.
VCH established the three care networks to link programs and services more cohesively and provide patients, clients and residents with a more seamless approach to health service delivery. Within these programs, a number of initiatives will be implemented including:
- A commitment to increase same-day surgical cases and reduce the number of surgical cancellations;
- Improving patient flow through the acute care system;
- Planning for at least two residential campuses of care by 2007;
- Improving care options and needs for seniors, such as 1,250 more assisted living units, increased home support hours, and over 30 new hospice beds over the next three years;
- Establishing five new primary care network access centres;
- Developing a comprehensive regional strategic plan for mental health and addictions; and
- The creation of over 200 specialized mental health beds.
For example:
- VCH completed over 85,200 surgeries in 2003/04 - an increase of around 8,300 procedures from the previous year;
- There was a reduction in the time people waited for placement in a residential care bed from acute and community settings to 15 days and 32 days respectively - well below the provincial target of 90 days;
- Wait times for residential detox decreased from six weeks to two days through the implementation of a central coordinating service for all detox centres (Access 1);
- 14 new Primary Health Care projects were funded across VCH;
- Emergency Room visits increased by 4.3%, with the number of admitted patients through ER up by 3% compared to 2002/03. Overall, VCH met the care needs of 3-4% more patients than the previous year.
- VCH reduced cost pressures by $147 million in 2003/04, while achieving its financial targets for the fiscal year ended March 31, 2004.
External Communications Officer
Vancouver Coastal Health
Tel: 604 730 7662. Cell: 604 329 4351. Fax: 604 874 9182 melissa.kane@vch.ca www.vch.ca
Vancouver Coastal Health
North Shore/Coast Garibaldi, Vancouver and Richmond
Promoting wellness. Ensuring care.
Ralph’s Comment:
MLA offices are a sounding board for medical system distresses and successes. It seems to me – based on case evidence flowing through my office plus our own West Vancouver-Capilano polling – that the vast majority of constituents in this part of British Columbia are satisfied that the health system is providing good service.
For this, our leaders Ida Goodreau, Ellen Pekeles, and their medical staffs, plus the physician and nursing professions, deserve a pat on the back.
What isn’t working so well?
- Waiting lists for replacement hip and knee surgery are long – in some cases too long.
- Detox and substance abuse services on the North Shore are seriously inadequate.
- Continued strategies to concentrate lab and other specialized services “downtown” must be greeted with some cautious skepticism, due to conflicting motives of the players and the complexity of issues.
- Family practice on the North Shore is seriously under-funded and possibly even shrinking, forcing patients into the poorer care walk-in clinic and hospital emergency ward modes.
- Lions Gate emergency facilities are overloaded with inappropriate applicants for service.
- The Ambulance Service is frequently called out inappropriately.
Did Prime Minister Paul Martin’s recent televised premiers’ conference, a riveting spectacle watched by a mass audience equaling 0.1% of Canadians, help? Well, thanks to good work by Premier Gordon Campbell, Minister Hansen, and others, it did result in a tiny, marginal, upward creep in the federal fiscal contribution but fell far short of the Romanow Commission recommendations.
Fundamental reform of the demand side of the system has been put off for another day. Was it Kim Campbell who said a political campaign is no place for a serious policy discussion?
But let’s put all of this into context: I believe that based on outcomes – the acid test of performance - we have a superbly performing system, and virtually every Canadian I talk to nowadays says “Thank heavens we are not saddled with the American system!” Compared to attitudes (including my own) a decade ago, that’s progress.
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