Ministry Operating Context

The Ministry of Health Services operates within the broader societal and environmental influences on the population's health status. Enjoying good health and a high quality of life depends on many factors, including access to quality education, meaningful employment and stable family environments. Making healthy lifestyle choices is also important in optimizing the chance of good health.

Another influence on health status is access to high quality health services. British Columbians are supported in maintaining their health by a publicly funded health system, directed by the Ministry of Health Services and delivered primarily by B.C.'s health authorities and health care professionals. In the past 35 years, the scope of the public health system has expanded beyond traditional hospital and physician services to include comprehensive public health programs, a broad team of service providers, prescription drugs, home and community care and more.

Overall, British Columbians have a quality health system they can rely on and have some of the best health outcomes in the country. This is reflected in British Columbia's report on nationally comparable performance indicators entitled Healthy British Columbia released in November 2004. The report gives a broad snapshot of the health system and the health of the population in B.C. using 2003 data from the Canadian Community Health Survey. The report indicates British Columbians are mostly satisfied with their health care system, have good access to heath care, live healthier longer than other Canadians, are less likely to smoke than other Canadians and more likely than other Canadians to lead an active lifestyle. (The report can be found at http://www.healthservices.gov.bc.ca/cpa/publications/pirc_2004.pdf)

Challenges and Risks

The ministry must monitor broader societal indicators and trends to assess and plan for potential impacts on the health of the public and the health care system. For instance, while British Columbians currently enjoy the best health status in Canada, there are worrying trends that are already creating unprecedented demands for health services:

• 42 per cent of adult British Columbians are overweight or obese according to self-reported data, and only 58 per cent are physically active or moderately active.
• Injuries continue to be the leading cause of death for British Columbians age one to 44, with injuries killing more children and young adults than all diseases combined.
• Tobacco use remains the risk factor that most contributes to the burden of diseases in British Columbia, but problematic substance use is also a concern. 19 per cent of youth who attend school and have tried alcohol reported binge drinking three or more times in the past month.
• An aging population with a rising burden of illness is resulting in the continuing rise in demand for increasingly complex and expensive health services.
• The health care workforce is aging, and maintaining an adequate supply and mix of health professionals and workers will be challenging.

As noted, population growth and demographic shifts put pressure on the health system as different health services tend to be used at higher rates in older age groups. The following demographic trends help to illustrate the scope of the future challenge to the health system:

• British Columbia's population is growing; in 2004 the population increased by 44,094 persons and is expected to increase by 41,670 persons in 2005, 44,472 in 2006 and 46,467 in 2007. In 2001 B.C.'s population was 4,078,447. By 2007 it is forecast to be 4,317,613, an increase of 5.9 per cent.
• The share of British Columbia's population over the age of 65 is expanding; relative to 2005, there will be 35 per cent more people over 65 by 2015, 20.5 per cent more over 75, and 45 per cent more over 85. The median age in British Columbia is 39.6 years, and is expected to reach 41.9 years by 2015. Expenditures on health increase with age.
• Life expectancy is increasing. In 2005, the median age at death was 79 years and by 2015, the median age at death will be 80.6 years.

In addition, the health system is also challenged by:

• A need to update or expand health care facilities, technology and equipment.
• The development of new treatments for patients with conditions that were previously untreatable.
• The emergence of new diseases, which result in new tests, drugs and treatments.
• Public health emergencies such as SARS, Avian flu, and West Nile Virus.

Capacity to Manage Risks

Government has annually increased funding for health services; however, funding increases alone will not meet the increasing and changing demands placed on the health system. As shown in this annual report, and the ministry's 2005/06 – 2007/08 service plan, the ministry has undertaken many strategies to ensure the health system is able to adapt and respond to changing demands.

A key to realizing these reforms and building a system that will remain sustainable in the face of the many challenges has been to strengthen the ministry's relationship with its health system partners. Our capacity to respond to change has been greatly increased through the development of an accountable, efficient and responsive health sector that welcomes the challenge of improving services for the citizens of British Columbia. The new model for health care is driven by one principle — people must come first. Where success had previously been measured by the amount of money spent, the number of beds available or the number of health professionals working in the system, success in meeting our challenges is now measured in terms of accessibility, health outcomes and overall health status.