BC Continues to Improve Measured Health System Performance

April 27, 2009

The Canadian Institute for Health Information (CIHI), a federally funded clearing house of health data, has just released its 2009 Wait Times Table by province. The report looks at five surgical areas along with MRI and CT wait times, and evaluates them by province against benchmarks established at the 2004 Health Ministers conference.

Since 2005, BC has shown measurable improvements in all five categories: radiation cancer treatment, coronary artery bypass surgery, hip replacement, knee replacement and cataract surgery. The target agreed to at the Health Ministers Conference is that 75% of the procedures should meet the benchmark. In 2008, BC achieved this in four of the five categories, and only marginally missed the targets in knee replacements.

Here is a sample of the data:

Procedure: Cancer Treatment – Radiation
Benchmark: Treatment within 4 weeks of being ready to treat
% achieving benchmark: 95%

Procedure: Coronary Artery Bypass Surgery
Benchmark: Surgery within 26 weeks
% achieving benchmark: 91%

Procedure: Hip Replacement
Benchmark: Surgery within 26 weeks
% achieving benchmark: 78%

Procedure: Knee Replacement
Benchmark: Surgery within 26 weeks
% achieving benchmark: 71%

Procedure: Cataract Surgery
Benchmark: Surgery within 16 weeks
% achieving benchmark: 78%

The full report may be found at http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=PG_2010_E&cw_topic=2010&cw_rel=AR_1909_E

In fact, only one province, Ontario, betters BC in the number of categories that meet the established benchmarks. It should be noted that BC and Ontario have different reporting and measurement systems.

BC has strategically managed its healthcare resources by placing priorities on commonly performed procedures. The challenge however, is in balancing these scarce resources with the increasing demand on the system. The aging population will continue to increase demand for these procedures. The BC government has pledged an additional $4.8billion in funding for the public healthcare system between now and 2012 in an effort to meet this, and other, growing demands and wait lists.

It is clear that the best way to meet a limited supply (of funded and resourced surgical time), is to reduce demand. With a growing population and aging populace this going to prove a greater challenge in the years to come. We need to continue to look at alternatives to traditional funding and delivery systems for healthcare; increasing our health literacy rates to improve the health of the population; and reassess what the public healthcare system “basket of services” will look like in the future.

BC has excelled in its management of wait times for these nationwide benchmarks, and succeeded through its diligence. The Province needs to stay on track to manage both supply and demand for this generation and those that follow.

BC Politics - Who's offering what in healthcare

As we approach the provincial election on May 12th, we need to look at the issues and platforms relating to healthcare. While the economy and public safety are polling at the top of the list, healthcare remains in the top three in terms of "most important issue facing BC" according to a recent Angus Reid Strategies survey.

The NDP platform on healthcare is spelled out on its website (www.bcndp.ca) , although detail is sparse:

• More nurses and health professionals
• Improved seniors care with 3000 new long-term care beds and independent seniors advocate
• Shorter waitlists and plan to clear backlogged emergency rooms

There is no discussion of how this will be done; nor is there any discussion on how much this will cost, or what percentage of the provincial budget would be allocated to healthcare.

The Liberal platform is laid out in far greater detail, supported by video "platforms" on specific issues in healthcare separated into two categories: innovation and investment. Health Minister Abbott is seen on the Liberal website identifying the issues and addressing the challenges with solutions (see http://www.bcliberals.com/platform/premiers_message/#vidPlatform). In all, the Liberals will commit an additional $4.8 billion to healthcare by the end of 2012.

What stands out in these two platforms is the strategy by which both parties intend to address healthcare - the largest and fastest growing government expenditure. The NDP plan appears to demonstrate a "through more money at the problem" approach. The Liberal plan is more strategic, looking for innovative ways to address the issues. They've already demonstrated some of this in their management of emergency room overcrowding - which included expanding capacity for inpatients in order to be able to admit patients requiring further care; expanded capacity for short stay in several ERs in the Lower Mainland; and an innovative approach in providing department funding based upon the ER staff's ability to provide time-measured, appropriate care for patients.

Frankly, the Liberal and NDP platforms are not even comparable in their promise. There is nothing to the NDP platform on healthcare. The Liberals have created a strategy and long term plan that is fact based and already proven.