Fraser Health shortchanged in funding formula

In January 2013, the auditor general of B. C. released a report providing details of budgets for the six provincial health authorities. These six authorities include the five geographic regions, being Northern, Interior, Fraser, Vancouver-Coastal and Vancouver Island, together with the Provincial Health Authority, which covers provincewide specialty health services such as Children’s Hospital and the various cancer clinics.

Turning to the five regions, the auditor general’s report provides a comparative analysis of operating budgets on a per- capita basis. This analysis is most revealing, indicating a great disparity in funding, with Fraser Health Authority ( FHA) having 1.77 million people or 39 per cent of the provincial total, receiving only 28 per cent of the funding. Contrast this with Vancouver Coastal, ( VCHA) where about one million people live ( 22 per cent of the province) but who receive 29 per cent of the funding.

In absolute dollars, FHA received an average of $ 1,585 per person compared to $ 3,008 for VCHA and $ 2,554 for Vancouver Island. That’s about 90 per cent more funding for folk who happen to live in West or North Vancouver, as compared to Surrey or Langley.

It’s quite likely that many of the people living in Burnaby, New Westminster, Coquitlam or even Surrey, although domiciled in the Fraser Health region, are actually using the services of hospitals in VCHA and this would distort the figures.

In fact, the writer, who lives in the central Fraser Valley, chose to have major surgery at Vancouver General Hospital, even though the procedure was readily available in my hometown and would have been much more convenient. I made that decision based on the advice of medically knowledgeable acquaintances who suggested there were significant disparities in the service levels at that time. Service levels that translated into lower ratios of nurses to patients, better waiting times, lower crowding situations, and higher levels of supporting technology.

Having received service in both Fraser Health hospitals and Vancouver Coastal, it is my experience that notwithstanding that FHA and VCHA both have dedicated, highly professional caring nurses and doctors, there was a noticeable difference in the level of service they were able to provide. I suggest these differences are a function of funding.

And where else does this disparity in funding show up? Well, VCHA spends about 3.4 times more per capita on mental health and addictions. While there is no doubt the challenges of the Downtown Eastside require more resources, mental health, addictions, homelessness and all of the other symptoms of this serious social issue are just as prevalent throughout Metro Vancouver and the Fraser Valley. And if VCHA has a legitimate reason for over three times more funding, how about Vancouver Island, which can apparently afford to spend more than double on mental health and addictions, as compared to FHA?

In a recent article in The Vancouver Sun, where my concerns were quoted, a spokesperson for the Ministry of Health attempted to rationalize the differences by explaining that VCHA is “providing specialized services such as organ transplants, bone marrow transplants, cochlear implants and adult metabolic services for rare diseases.” He goes on to state that VCHA is “providing significant services to people who live in the Fraser Valley region but regularly commute to Vancouver” and is “serving people in the Downtown Eastside, who tend to be more vulnerable and have higher health care costs.”

Well, I don’t really know how much more these specialized services cost, but since Vancouver Coastal receives about $ 1,400 more per capita, with a population of one million, that translates into a top- up of $ 1.4 billion. All things being equal, are we to believe these valuable services really cost an extra $ 1.4 billion?

Another well- used argument is that VCHA must operate “tertiary hospitals,” being Vancouver General and St. Paul’s. However, FHA has its own tertiary hospitals, being Royal Columbian, Surrey Memorial and Abbotsford Regional and while the latter two are not as highly specialized as VGH and St. Paul’s, they are projected to expand in an effort to meet rapidly growing populations.

I am not suggesting Vancouver Coastal wastes taxpayers money; in fact I’m sure they are prudent managers and I can personally testify they provide excellent service. I am suggesting that by any fair comparison, Fraser Health is being grossly underfunded, which limits its ability to provide much- needed services.

The auditor general makes no comment on the huge disparity. The figures speak for themselves, loud and clear. It’s hard not to conclude that Fraser Health Authority, the fastest growing and largest region in the province, is being underfunded, particularly when compared to Vancouver Coastal and Vancouver Island.

In my opinion, it’s long overdue that the funding formulas for all health regions be reviewed by an external, independent agency. Perhaps the auditor general would take on that task?