B.C. launches efficiency review of health authorities, looks to rein in 'unnecessary administrative spending'

The British Columbia government says it is reviewing health authority spending in an effort to  "minimize unnecessary administrative spending" in health care and focus money on front-line patient care.

Premier David Eby instructed Health Minister Josie Osborne to review health authorities in his mandate letter to her earlier this year.

Health services in B.C. are delivered through five regional health authorities — Northern, Interior, Fraser, Vancouver Coastal and Island — as well as the First Nations Health Authority and the Provincial Health Services Authority, which provides additional shared services.

Each authority has its own administrative staff, board of governors and CEO.

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B.C. health-care professionals welcome review of administrative system costs

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Critics have said B.C.'s health administration is too bloated, with the province spending $347.5 million on health-care administration in the 2022-23 fiscal year, according to the Canadian Institute for Health Information.

That's nearly 50 per cent more than the province of Alberta, which has around four million residents to B.C.'s five million, and spent $181.2 million that same fiscal year.

B.C. Conservative Party finance critic Peter Milobar has pointed out that there are more than 70 presidents and vice-presidents in B.C.'s health-care administration, while Alberta — which has around four million residents compared to B.C.'s five million — has fewer than 10.

"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," he told CBC News in January. 

The B.C. Greens, who signed a co-operation agreement with the NDP after the election, had previously pushed for a review of health-care authority expenditures.

"There are far too many [vice-presidents], managers and executives with amorphous job descriptions," say the Greens on their website.

During an unrelated news conference on Monday, Eby said he expects health authorities to be "lean."

"We expect them to be operating in a way that delivers and focuses resources on those front-line services."

He said part of the review will include making sure front-line staff have the opportunity to speak up about efficiencies and anxiety from a practical point of view. 

"We're going to try to eliminate as much of the layer between government and the front-line health workers as we can so that we can deliver a health-care system that works for everybody."

The review comes as emergency room closures that have long plagued parts of rural and northern B.C. have crept into the Lower Mainland.

Health Minister Josie Osborne says the government wants to ensure that all authorities are best positioned to tackle the "complex challenges" facing the health-care system.

Osborne says every health authority in the province will be reviewed and that the government is committed to ensuring the authorities are functioning as effectively and efficiently as possible.

"That's why we're reviewing each health authority to confirm patients, their families and health-care providers are benefiting from the most possible and the best use of resources directed to front-line patient care," she said in a news release.

The ministry said in a news release that the Provincial Health Services Authority (PHSA) will be the first to undergo the review because of its provincewide role across the health system.

That includes services through B.C. Cancer, B.C. Children's Hospital, B.C. Women's Hospital and Health Centre, B.C. Emergency Health Services, B.C. Mental Health and the B.C. Centre for Disease Control.

The release said PHSA president and CEO David Byres last week accepted a secondment reporting to Osborne to work on eliminating anti-Indigenous racism in health care.

It said Dr. Penny Ballem has stepped out of her role as board chair at Vancouver Coastal Health to serve as PHSA's interim president and CEO, and will lead the review.

The release says Ballem will "make recommendations and associated changes as needed to reposition, streamline and optimize resources at the PHSA."