Service Delivery and Core Business Areas
Service Delivery
The Ministry of Health provides leadership, direction and support to its service delivery partners, such as health authorities, physicians and other health professionals, who directly deliver the majority of health services in British Columbia. The Province's six health authorities are the main organizations responsible for local health service delivery (see Appendix 1 — Map of Health Authorities). Five regional health authorities are responsible for delivering a full continuum of health services to meet the needs of the population within their respective regions. A sixth health authority, the Provincial Health Services Authority, is responsible for ensuring British Columbians have access to a coordinated network of high quality specialized health services, such as cancer care, specialized cardiac services and transplant operations. Performance agreements between the Ministry and each health authority are used to detail health authority responsibilities and the Ministry's expectations for service delivery.
The Ministry also leads and manages other health programs outside the scope of services delivered by the health authorities. The two largest of these are the Medical Services Plan and PharmaCare programs, which, respectively, provide physician services and prescription drug coverage for B.C. residents.
The delivery of health services and the health of the population are continuously monitored and evaluated by the Ministry. These activities inform the Ministry's strategic and policy direction, and lead to interventions and course corrections when required, to ensure the delivery of health services continues to meet the needs of British Columbians.
Core Business Areas — Overview
The health system is complex and multi-faceted with many different organizations, agencies and providers delivering services to meet the population's health needs. The Ministry's core business areas are organized to reflect the major partnerships and roles that combine to form a high quality, coordinated health system for British Columbians.
Core Business Area: Services Delivered By Partners
Our partners deliver the vast majority of health services to the public. These services span the continuum of health services, from population health programs to end-of-life care. Accordingly, this core business accounts for the vast majority of health expenditures, and is the primary focus of the system redesign efforts detailed in this service plan. The major areas included in this core business are:
Regional Health Sector
2005/06 expenditure: $7.251 billion
B.C.'s six health authorities are the Ministry's key organizational partners in delivering services to British Columbians. More than 90 per cent of the Regional Health Sector funding is provided to the six health authorities for the provision of most local health services, including health promotion and protection services, primary care, hospital services, home and community care, mental health and addiction services, and end-of-life care.
The remaining funding is provided to other health agencies for related health services, including: the provision of blood services, out of province hospital services, post-graduate medical education, health care risk management, and some palliative care services.
Medical Services Plan
2005/06 expenditure: $2.669 billion
The Medical Services Plan funds medically necessary services provided by general practitioners, specialists, midwives and other practitioners, including diagnostic services. Services are funded in a variety of ways: through fee-for-service, contracts (including contracts with health authorities), and salaried positions. Medical Services Plan funding also provides supplementary benefits to low-income British Columbians for a range of services, including physical therapy, naturopathy and chiropractic.
PharmaCare
2005/06 expenditure: $867 million
PharmaCare is B.C.'s prescription drug insurance program and includes several benefit plans. The main plan is Fair PharmaCare, which provides insurance to B.C. families for prescription drug costs. Several other plans exist to address the health needs of individuals, including seniors in long term care facilities, severely disabled children who are cared for at home, enzyme treatment for people with cystic fibrosis, and clients on provincial income assistance.
Health Benefit Operations
2005/06 expenditure: $29.2 million
Health Benefit Operations provides administrative services for B.C.'s PharmaCare Program and Medical Services Plan. These services do not involve direct health care delivery, but include registering beneficiaries, processing medical and pharmaceutical claims from health professionals, and responding to inquiries from the public. Since April 1, 2005 these administrative services have been delivered by Health Insurance BC through an operating agreement. Funding in this area represents the Ministry's purchase of these administrative services.
Health Infrastructure Investment (Debt Service Costs and Amortization of Prepaid Capital Advances)
2005/06 expenditure: $285 million
Government also provides debt-financed funding to health authorities for specific capital purposes including the capital cost of new buildings and renovations and improvements to health facilities, as well as diagnostic and medical equipment and information technology. Debt service costs and amortization related to infrastructure investment are captured in this area.
Core Business: Services Delivered By Ministry.
This core business encompasses two important public services: the B.C. Ambulance Service, which is delivered through the Emergency Health Services Commission, and the Vital Statistics Agency.
Emergency Health Services (B.C. Ambulance Service)
2005/06 expenditure: $257 million
The B.C. Ambulance Service (BCAS) is responsible for providing effective, efficient and equitable emergency health services for the Province. Approximately 1,300 full-time and 1,900 part-time paramedics and dispatchers provide emergency and medical transport services. BCAS is a provincial service with 190 stations and 460 ambulances across the Province, providing more than 460,000 ground calls and 7,000 air evacuations annually.
British Columbia Vital Statistics Agency
2005/06 expenditure: $6 million
The Vital Statistics Agency is responsible for documenting important events for B.C. citizens such as births, marriages, and deaths. There are two primary outputs of the Agency's vital event registration activities: the production of accurate, timely and relevant health statistics and information, and the issuance of certified documents pertaining to individual vital events (e.g., birth certificates). The Agency also has a key responsibility to secure and protect personal identity records by taking appropriate measures to prevent identity theft and related frauds as they may relate to British Columbia vital event records and documents.
Core Business: Stewardship and Corporate Management
2005/06 expenditure: $104 million
As stewards of the system, the Ministry provides leadership and support to its health system partners, including health authorities, physicians and other care providers. While this business area accounts for less than 1 per cent of health system expenditures, it is crucial to the effective functioning of the health system.
The Ministry sets the overall strategic direction for the health system, provides the appropriate legislative and regulatory frameworks to allow it to function smoothly, and plans for the future supply and use of health professionals, technology and facilities. The Ministry also monitors the health of the population and plans for and coordinates responses to major public health risks and emergencies. Lastly, the Ministry evaluates health system performance against clearly articulated expectations, and takes corrective action where necessary to ensure the population's health needs are being met.
This core business area includes the Office of the Provincial Health Officer. Under the Health Act, the Provincial Health Officer is the senior medical health officer for British Columbia and provides independent advice to the Minister of Health, the Ministry and the public on public health issues and population health. Each year, the Provincial Health Officer must report publicly, through the Minister of Health, to the legislature, on the health of the population.
