Healthy lives strategy

Healthy lives strategy

Government has one job that is more important than anything else: promoting the health and well-being of the people it serves. Healthy lives begin before we are born and continue for our entire lives. Subsequently, effective healthcare requires investing in the health of British Columbians at every stage of life.

While B.C. has a strong public healthcare system, the province’s approach to healthcare has been largely reactive, rather than proactive. It is widely accepted that primary prevention is better and more cost-effective than attempting to cure a health issue after it has already taken hold. Therefore, the B.C. Green Party is proposing an approach that will, in the long-term, mean less reliance on acute care, taking the strain off our healthcare system and improving quality of life province-wide.

The B.C. Green Party believes in an integrated, fiscally sound approach to health and wellness care that focuses on the following six goals:

  • Promoting wellness

  • Prioritizing prevention and primary care

  • Providing effective and efficient acute care

  • Addressing mental health and addictions

  • Supporting seniors and providing quality end-of-life care

  • Protecting children

Promoting Wellness

Promoting wellness means supporting people to take active, lifelong measures to stay as healthy as possible. Helping to promote awareness and the accessibility of healthy choices will improve the long-term health and well-being of all British Columbians.

Targeted results:

  • Healthy consumption choices that result in better health outcomes, including a reduction in obesity and substance abuse and addiction.
  • Improved mental health outcomes.
  • Improved quality of life, including physical fitness.
  • Reduced costs for the healthcare system.

Budget implications: funding will be drawn from current funding for healthy lifestyles in other Ministries.

  • Between 2008-2010, B.C. had a Ministry of Healthy Living and Sport, and a program called ActNow B.C. with a mandate consistent with the approach taken in platform pieces 1-3.
  • The Ministry was disbanded in October 2010 and responsibilities were transferred to other ministries.
  • Budgets for many responsibilities were cut or eliminated. Funds were reprioritized to acute care. ActNow B.C. transitioned into Healthy Families B.C.
  • In 2011, the UN member states acknowledged that non-communicable diseases are a major threat to development and to the global economy. They also recognized the primary role and responsibility of Governments in responding to the challenge of noncommunicable diseases and the essential need for the efforts and engagement of all sectors of society to generate effective responses for prevention.
  • This initiative will help prevent noncommunicable diseases caused by the consumption of harmful substances.
  • Research shows many children are not eating the balanced, nutrient-rich diet required for optimum cognitive function.
  • Children who suffer from poor nutrition during the brain’s most formative years score much lower on tests of vocabulary, reading comprehension, arithmetic and general knowledge. For example, studies show that students with the lowest amount of protein in their diets showed the lowest achievement in test scores.
  • Students who participate in daily physical education exhibit better attendance, a more positive attitude towards school and superior academic performance.
  • This investment will enable all B.C. children to have the healthiest start possible so that they are best positioned to learn the knowledge and skills they need to succeed in the emerging economy.

Prioritizing prevention and primary care

It is widely accepted that we need to increase the emphasis of health care spending on prevention. The challenge is how to make the transition, for the benefits of prevention are enjoyed in the future, while people needing treatment, whether it be for chronic conditions, heart surgery or hip replacements, need it now. Making the shift requires political will and a plan to make the transition.

Targeted results:

  • Enhanced access to GPs
  • Availability of excellent integrated community care
  • Shorter waitlists

Budget implications:

  • $100 million over four years through reallocation of resources.
  • Specific initiatives that require funding may be identified during the review .
  • We will consult with physicians and other stakeholders to improve efficiency, reduce administration, and incentivize becoming a General Practitioner.
  • There is agreement among political parties that we need to increase the emphasis of healthcare spending on prevention. The challenge is how to make the transition.
  • Access to primary care is a key part of preventing small health issues from becoming full blown crises. Whether it is preventing an unattended sprained ankle from becoming chronic arthritis or a small lump from metastasizing into a larger cancer, early intervention improves health outcomes and is far more cost-effective.
  • Despite the importance of primary care, many British Columbians do not have a family doctor. Others can’t afford costly prescription medications or services like physiotherapists. A B.C. Green government would remove barriers to care so that British Columbians can get the services they need to stay healthy.
  • Effective interprofessional teamwork is an essential component for the delivery of high-quality care in an increasingly complex health care system
  • This initiative to enhance and support interprofessional health care will enable patients to benefit from the full scope of knowledge and expertise of qualified health practitioners, reduce the burden on medical practitioners and in some cases avert wait times for treatment.
  • The goal is to optimise the system to ensure that early intervention at the right level avoids more costly treatment at a later stage, thus reducing the need for more invasive treatment.
  • BC Greens will work with all stakeholders to make this happen, including doctors, nurses and hospital workers, health authorities and other health care professionals.
  • The cost of prescription drugs prevents too many British Columbians from addressing treatable conditions. As conditions go untreated, it becomes much costlier to deal with the consequences down the road.
  • Although many political parties have acknowledged this fact, it requires a solid plan and political will to act.
  • This initiative will provide an evidence-based, integrated roadmap that will ensure British Columbians can get the essential pharmaceutical drugs they require in order to treat their health conditions.

Providing effective and efficient acute care

Integrated healthcare delivery, where there is a closer relationship between acute and post-acute care providers, can improve the efficiency and effectiveness of healthcare resource use. By coordinating care across settings, investing in integrated information technology systems, addressing unwarranted variations in the utilization of healthcare services, and leveraging non-physician healthcare professionals, the pressure on acute care beds can be reduced.

Targeted results:

  • Shorter waitlists
  • Ability to concentrate acute care resources on those who need it

Budget implications: $40 million capital expenditure for long term care beds.

  • The availability of hospital beds is the choke point, determining surgery waitlists, which are one of the top-of-mind issues in health care.
  • The costs of an acute care bed can range from $800 to $2000 per day according to a 2015 report by the BC Care Providers Association (BCCPA).
  • According to the BCCPA, approximately 13% of acute care beds are occupied by someone who is waiting for a long-term care bed, which cost about $200 per day.
  • The bulk of health care spending is allocated to acute care hospitals.
  • The shift from inpatient to ambulatory and community care has been shown to decrease health care costs and better address the range of health care needs of the population.
  • There have been a myriad of changing models of care during the last decade in an effort to move toward integrated care, including regionalization of the B.C. health care system. However, regionalization has not fully addressed fragmented care or acute-care spending.
  • Extra cash for elective surgeries is not the only solution to address surgical wait times.
  • Hospital bed shortages frequently result in cancellations of elective surgeries and, ultimately, increased wait times.
  • More residential care beds and home health care are required to support frail seniors and others who occupy hospital beds because community alternatives are not available.
  • Eighteen per cent of operating rooms in public hospitals are not regularly staffed, primarily because of inadequate funding, and none have extended hours.
  • Wait times vary widely across surgeons and specialty areas. Centralized management of these waitlists and referral of patients to the first available surgeon could expedite care.
  • Modernizing and integrating information systems to support data-driven waitlist management strategies and quality improvement innovations is required.

Addressing mental health and addictions

“Mental health and substance use problems and illnesses affect people from all walks of life – our parents, siblings, children, friends, co-workers, neighbours and often, ourselves. The costs of inadequate planning and inconsistent access to mental health and substance use services are high – both personal and financial. People with mental health and substance use problems and illnesses face stigma and discrimination. They contend with obstacles to completing edu cation, pursuing employment opportunities and obtaining adequate housing.”

Carol Bellringer, Auditor General, Access to Adult Tertiary Mental Health and Substance Use Services, May 2016)

Targeted results:

  • Better outcomes for children and youth
  • Easier transition between youth and adult services
  • Greater integration and coordination of services
  • Early intervention and effective on-going support for those with mental health issues
  • End to fentanyl deaths

Budget implications:

  • $80 million over three years for new and enhanced programming
  • Redirection of funding to address fentanyl response
  • More than 6.7 million Canadians are living with a mental health challenge.
  • 75% of mental health challenges occur before the age of 25, while 50% develop before age 14.
  • According to the Ministry of Children and Family Development, 15% of B.C. children and youth will experience a mental health challenge yet less than 30% will access care, thus extending the likelihood of the challenges carrying on into adulthood.
  • People with a mental illness are twice as likely to have a substance use problem compared to the general population.
  • A major concern outlined in the B.C. Auditor General’s report on Mental
  • Health and Addictions was the lack of a proactive approach to Improving
  • Health services for individuals with severe addictions and mental illness
  • A major recommendation of that report was to establish a process for long-term, comprehensive planning
  • A growing body of evidence demonstrates that promotion, prevention, and early intervention initiatives show positive returns on investment.
  • Supervised injection sites are one strategy that has a direct impact. For example, fatal overdoses within 500 metres of Insite (the Vancouver safe injection site) decreased by 35 per cent after the facility opened compared to a decrease of nine per cent in the rest of Vancouver.
  • A clean, safe, non-judgmental injection site can serve to connect people to other services. For example, last year Insite staff made more than 5,000 referrals to other social and health agencies.
  • At least 20% of people with a mental illness have a co-occurring substance use problem. For people with schizophrenia, the number may be as high as 50%.
  • Similarly, people with substance use problems are up to 3 times more likely to have a mental illness.
  • A community based strategy with coordinated resources is needed to effectively address the combination of mental illness and addictions.
  • Patients and families continually report difficulty navigating mental health services, inconsistencies between service systems, lack of age-appropriate services and a need for additional supports.
  • 50% of child and youth mental health practitioners have indicated that ineligibility was the greatest barrier for young people moving into the adult system, and 64% agreed that eligibility requirements hindered transition planning.
  • A coordinated, comprehensive mental health plan that includes performance measures, targets and outcomes, and regular reporting to the public, decision-makers and service providers is needed to coordinate the care process.
  • Drugs contaminated with unknown quantities of fentanyl are killing people. Providing a clean alternative will save lives.
  • Addressing the current overdose crises in B.C. requires an investment in treatment on demand, drug substitution, an early-warning monitoring system and a coordinated response.
  • Currently, it takes eight days to access an addiction treatment bed in B.C., so people who wish to address their addiction seldom make it into treatment.
  • Substitution drugs can be therapeutically administered and monitored in supportive housing units, pharmacies, overdose response centres and clinics.

Supporting seniors and providing quality end-of-life care

As the number of seniors in BC rises, so the pressures on the health care and long-term care systems increase. In BC, seniors are generally healthy and independent as they age. According to the 2nd Annual Report of the Office of the Senior’s Advocate, only 10% of seniors (88,900) are frail and require residential care, palliative care, or supports for daily living. However, while those with age-related, health concerns account for less than 2% of the provincial population, they consume 35% of all services.

Targeted results:

  • To ensure the safety, and quality of life of seniors through adequate staffing levels;
  • To promote and support the independence of the population in their senior years;
  • To remove uncertainty regarding assisted dying.

Budget implications: $235 million over 4 years.

  • Age-related health concerns may either require residential care or substantial community based health care and support.
  • Since 2012, the number of seniors aged 85 and older has increased 21%.
  • In 2015/16, 8,549 seniors were admitted to residential care facilities This represents a decrease of 6% since 2014/15.
  • Average and median wait times for residential care grew longer in three of the five B.C. regional health authorities.
  • In 2015/16, on a provincial level, the average home support hours delivered per year per client decreased by approximately 2% from the previous year, while the number of clients increased by 2%.
  • The government will collaborate with Health Authorities and the BC Care Providers Association to ensure that clear, measurable and enforceable staffing standards for residential care facilities are implemented. Standards will be supported by monitoring and enforcement to ensure they are being met.
  • 91% of care homes failed to meet the Ministry of Health’s staffing guideline of 3.36 hours of care per senior every day.
  • People in publicly operated facilities receive 40-per-cent more physical-therapy hours and almost double the occupational-therapy hours than those in privately operated facilities.
  • 16% of residential care facilities had no reported inspection in the last year
  • Legislation governing Medical Assistance in Dying (MAiD) was passed by the Federal Parliament on June 17, 2016.
  • Not all doctors and nurses are willing or able to provide medical assistance in dying.
  • Providing respectful and compassionate access to MAID requires specialized training of physicians and nurses to adequately assess eligibility, ensure safeguards are in place to protect vulnerable patients and support informed decision-making.

Protecting children

British Columbia’s child welfare system plays an important role in ensuring the safety and protection of children in our province. However, our current system is often unable to adequately perform its duties, leaving children and families struggling in vulnerable situations without resources or support. Our goal is to provide preventative support, education, and family preservation work so that families can provide primary care for their children while ensuring that our system of protecting children is able to intervene when necessary.

Targeted results:

  • To improve child welfare, and support families so that they can support their children
  • To have a sensitive and effective system of intervention when a child is vulnerable or in danger.
  • Improved outcomes for disadvantaged children.

Budget implications: $100 million over four years for additional staff.

  • Budget 2017 announced additional funding of $109 million in 2017/18, $89 million in 2018/19 and $89 million in 2019/20. The B.C. Green commitment of $100 million over four years is in addition to Budget 2017 commitments.
  • The report by the B.C. Representative for Children and Youth has identified numerous child protection issues in B.C., including underfunding, chronic understaffing, standards routinely not met, and urgent child safety concerns not dealt with in a timely manner.
  • The annual budget of the Ministry of Children and Family (MCFD) has been reduced by nearly $100 million in real dollars between 2008/09 and 2013/14 when inflation is taken into account
  • Child protection interventions in B.C. are extended to children aged 0-19, which is an older eligibility threshold than any other province or territory in Canada.
  • Child protection services in British Columbia are provided through 429 ministry offices in five regions and 22 delegated Aboriginal agencies
  • Of the total 30 Aboriginal child welfare agencies, 23 are First Nations agencies, four are Métis agencies, and three are urban Aboriginal agencies
  • B.C. is the only province in Canada without a province-wide poverty plan
  • “Poverty can have a crushing effect on a child’s growth and development and on his or her future prospects” (B.C. Representative for Children and Youth).
  • BC’s child poverty rate is higher than the Canadian average of 18.5%, and represents 163,260 children.
  • BC’s child poverty rate of 19.8% is higher than the overall (all ages) poverty rate of 16%.
  • Children under 6 have an even higher poverty rate of 20.1%.
  • There is a 50.3% poverty rate of children living in lone-parent families, the vast majority of which are single-mother families. Nearly half (49.4%) of BC’s poor children live in lone-parent families.
  • The range of services provided to children and families under the Child, Family and Community Service Act include: investigation, provision of family services, and placement in out-of-home care.
  • A child is removed from their home only as a last resort, and most children in British Columbia never come into contact with child welfare services.
  • Responding to the recommendations of the Representative for Children and Youth and the Select Standing Committee on Children and Youth and working with that office to better support vulnerable children and families is a crucial first step in addressing the failures of the current system.
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