Liberals hit by health-care turmoil

VICTORIA - Those people who argue the government has been underfunding health care have just got some pretty strong support from the best of sources.
Within 48 hours the heads of the regional health authorities serving almost half B.C.'s population were gone from their jobs; one fired, the other resigning.
And in both cases, the central issue was the lack of money to provide the care people needed - the operations, emergency-room care, seniors' homes.
The revolution from within capped what had been a bad week on the health-care file for the Campbell government.
The first to go was Vancouver Coastal Health Authority chairman Trevor Johnstone, fired by Health Minister George Abbott. Johnstone, said Abbott, was being axed because the health authority wasn't managing its spending pressures properly.
The authority and the government had been arguing over $40-million.
The authority said it was short that much and couldn't meet health-care needs in the region for the rest of this year.
It warned the government of the problem well in advance. When there was no solution, the health authority cancelled surgeries and closed acute-care beds to avoid a deficit.
The government, after some confused waffling, ordered the decision reversed and told the authority to find $40 million in other savings - all to be realized in the next two months.
That's pretty much impossible. The authority would have to find an immediate way to cut spending by nine per cent for the rest of the fiscal year.
That can't be done without service cuts, no matter what the health minister decrees from his Victoria office.
Maybe the health region management had done a poor job and Johnstone deserved to go.
But the government looked nervous. On the same day Johnstone was axed Finance Minister Carole Taylor made an extraordinary announcement. She didn't only pre-empt the coming budget by announcing next year's funding for the health authorities. She made the announcement months ahead of any other year. The authorities would get an average 6.3 per cent increase, she said.
The announcement was an attempt to counter the criticism likely to follow the budget-related firing of Johnstone.
It didn't work out too well. Only 48 hours after Abbot fired Johnstone, another health authority chairman said he was quitting. Partly, because of the way the government had treated his colleague.
But more significantly, Fraser Health chair Keith Purchase said Taylor's funding plan would leave the authority unable to provide the region with the needed care.
Purchase is not some well-meaning amateur. He has an extensive background in the forest industry and was CEO of TimberWest. The Liberals named him chair of the Vancouver Coastal authority in 2001 when it overhauled the health system.
The Campbell government then appointed him chair of Fraser Health in late 2005, when the region faced mounting problems.
Health Minister George Abbott said Purchase should have been content with the increase promised by Taylor. Fraser Health is slated to get a 7.1-per-cent budget increase next year, more than any other authority.
But a big one-year increase can't make up for several years of inadequate funding.
Even with the promised jump, the health authorities will have received funding increases averaging 3.5 per cent a year since they began delivering services in 2002.
That's not enough to keep up with population growth and increases in the cost of living.
It's certainly not enough to allow them to deal with the cost pressures Premier Gordon Campbell keeps citing - an aging population, rising drug costs, increased expectations.
The government hoped that the new structure would allow health authorities to cut costs - to deliver more with less, as the big bosses like to say.
But the departures of Johnstone and Purchase suggest that despite their best efforts, the authorities simply don't have the money needed.
The government is now going to have make the tough argument that British Columbians can't or won't pay more to fund their local health authority.
Footnote: Taylor added another problem to the list facing health regions. She warned that they will only receive one-year funding increase in the budget because of possible changes resulting from the Conversation on Health. It makes efficient planning and management of the system much more difficult for the regional authorities.