B.C. Health Minister Margaret MacDiarmid says the health care budget is divided up between health regions based on many differing factors, not just each region's share of population.

Health cash flow not unfair to Fraser region: Minister

MacDiarmid addresses complaints on low per capita funding

Health Minister Margaret MacDiarmid says B.C.’s health funding formula doesn’t short change Fraser Health, even though the health authority receives the lowest amount of funding of any region on a per capita basis.

She spoke out after critics seized on a recent report of B.C.’s Auditor General that shows Fraser Health’s $2.8-billion budget for 2011/12 works out to average spending of $1,585 per resident, much less than other regions.

It’s almost twice as high at $3,000 per person in the Vancouver Coastal region, while per capita spending ranges from $2,370 to $2,550 in the Interior, Northern and Vancouver Island health regions.

MacDiarmid said in an interview the allocations fairly reflect the differing needs of each region.

“The funding formula does make sense, but it’s not a sound bite,” she said.

“When you think about the complexity of some of our populations, like the Downtown Eastside, it’s not a matter of one size fits all.”

Surrey Coun. Mary Martin, who chairs Surrey’s health advisory committee, argues the numbers suggest unfair treatment.

“I just don’t get it,” she said, noting Surrey is the fastest-growing city in the province.

“We are tremendously underfunded,” Martin said. “I find it a little bit astonishing and hard to believe that we are one of the lowest in per capita expenses.”

Martin was careful to acknowledge the province’s decisions to expand Surrey Memorial Hospital and build the Jim Pattison outpatient hospital nearby.

But she suggested the planned rebuild of B.C. Children’s Hospital should happen in Surrey, to better serve the younger population profile in Fraser, not at the current site in Vancouver.

“The ministry understands we are the fastest-growing region. But we’re always somehow behind.”

Abbotsford politicians also recently held up the per capita funding gap as proof of inequity.

MacDiarmid said Fraser’s growth has been recognized and it gets bigger annual funding increases – more than seven per cent on average over the past six years compared to less than five per cent elsewhere.

In terms of per capita spending, MacDiarmid said comparisons to rural regions aren’t valid.

“If you look at a health authority like Vancouver Island or Interior or Northern Health Authority, there are some communities that are incredibly remote and they do require more funding,” she said. “It’s just very difficult to serve them as efficiently as in an urban riding.”

Demographics are also factored in – Vancouver Island has a larger share of aging seniors who are more likely to need medical care than relatively young Fraser.

Fraser Health serves by far the most people – 1.77 million compared to a population of about one million in Vancouver Coastal.

But Vancouver’s hospitals get more money – acute care spending there was $1.73 billion in 2011/12 compared to $1.63 billion in Fraser, according to the Auditor General’s report.

Vancouver Coastal also got much higher allocations for mental health and addictions as well as population health and wellness, while Fraser got more for residential care and home and community care.

MacDiarmid said one reason Vancouver Coastal gets more for acute care is its hospitals are the only ones where some specialized procedures are done, including all organ transplants, bone marrow transplants and cochlear implants.

She also noted some money spent through Vancouver Coastal actually serves Fraser residents, who often show up in Vancouver hospitals.

“It may be a preference thing,” MacDiarmid said. “They may opt for treatment in Vancouver for various reasons or perhaps work there during the day anyway. And in some cases it’s that Vancouver Coastal is the only place some services are provided.

The health ministry has twice hired external consultants to assess the fairness of the funding allocations.

“Each time it has been found to be reasonable and it hasn’t been changed.”

While she maintains the formula is fair, MacDiarmid also supports increased use of patient-focused funding to encourage innovation by hospital staff, and improved primary care to help prevent chronic disease in the decades ahead.

Demands for more cash in Fraser have also been made repeatedly over the years by Fraser Health’s senior executives, who point to a trend of rising hospital visits and the large and fast-growing population.

Auditor General report

Health Funding Explained – a report of B.C.’s Auditor General by Jeff Nagel

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