Premier David Eby's government in British Columbia is taking decisive steps to address the dual challenges of health-care worker shortages and bloated administrative costs. In a recent mandate letter, Premier Eby tasked new Health Minister Josie Osborne with ensuring every British Columbian has access to primary care. This move comes as the province grapples with an overwhelming $1.8 billion spent on health-care administration in 2022, as reported by the Canadian Institute for Health Information.
The alarming figures have sparked a debate about the efficiency of B.C.'s health-care administration. A gynecologist recently told CBC News that the number of administrators at health authorities was unsustainable, underscoring the need for reform. The province operates seven regional health-care authorities, including the First Nations Health Authority and the Provincial Health Services Authority, responsible for improving care for First Nations people and coordinating care across the province. Yet, B.C. has over 70 vice-presidents in its health-care administration compared to Alberta's seven, highlighting a significant discrepancy.
Health Minister Josie Osborne emphasized the importance of this task, saying:
"We made the commitment to review health authorities."
"And so we will be… working with health authorities to look to those ways to cut administration."
Osborne also acknowledged the essential role that regional health authorities play in understanding local community needs:
"Regional health authorities have a really important role in understanding the context of the communities that they serve and the delivery of those services."
In an effort to streamline operations and enhance efficiency, the NDP government has committed to reducing administrative costs to focus resources on frontline care. This plan includes a thorough review of the province's seven health-care authorities. However, Osborne has not yet committed to a full reform of the health-care authority model, indicating that the review process remains in its early stages.
The province's approach to solving the primary care shortage includes innovative measures such as the longitudinal doctor payment model introduced in 2023. This model has been met with approval from Dr. Darren Joneson, president-elect of the B.C. Family Doctors group, who noted its success:
"[It] has actually seen, you know, a net increase of 250,000 British Columbians being attached to a family doctor, being able to access that primary care."
Despite these strides, challenges remain. The province continues to face a shortage of family doctors, leaving hundreds of thousands of British Columbians without access to primary care. The government prioritizes setting up team-based primary care models to reduce administrative time for doctors.
Additionally, B.C. has been hiring private agency nurses, particularly in rural areas where emergency room closures have necessitated "travel nurses." Adriane Gear, president of the B.C. Nurses' Union, welcomed the government's commitment to implementing minimum nurse-to-patient ratios but expressed concerns:
"We still need to recruit thousands of nurses to this province in order for us to be successful at implementing minimum nurse-patient ratios."
"Where I'm really challenged is these for-profit companies that really are exploiting a situation, and have been charging exorbitant amounts to supply nurses in situations where, frankly, we're quite desperate."
The Greens party also weighed in on health-care administration inefficiencies:
"There are far too many [vice-presidents], managers and executives with amorphous job descriptions."
"The health-care authority model needs to be examined for its effectiveness and streamlined to cut out wasted time and resources."
Peter Milobar further criticized the expanding bureaucracy:
"There's a massive growth that we're seeing in administration and bureaucracy, not just in health care but across government over the last seven years."
"And so it's good to hear the premier recognizing that, but why they've refused to recognize that over the last six years, to get us in the fiscal mess that we're in right now, is a concern."
The province's spending on health-care administration also stands out when compared nationally. B.C. spends $100,000 less per capita than Quebec, highlighting discrepancies in administrative costs.
