LANGFORD B.C. – B.C. Green Party leader Sonia Furstenau today called on the BC NDP to reform healthcare leadership in B.C. amid a healthcare crisis that is seeing chronic staff shortages and an increase in preventable patient deaths. Surrey Memorial Hospital is the latest hospital to reach a crisis-level as the emergency department struggles to admit new patients.
“A year ago, the former premier said that our healthcare system was teetering. Since then, things have gotten worse, and doctors, nurses, and patients are repeatedly sounding the alarm,” said leader Sonia Furstenau. “This government responds with announcements, but ignores the underlying issues that are contributing to these outcomes. We need an overhaul of how healthcare decisions are made in this province.”
B.C. Greens are calling for a suite of reforms to healthcare bureaucracy, including standardized processes for healthcare programs, measurable patient outcomes tied to every plan, comprehensive support for healthcare workers, and a re-evaluation of how money is spent by health authorities.
Camille Currie, B.C. Green candidate for Langford-Juan de Fuca and founder and President of B.C. Health Care Matters, has long campaigned for health authorities to listen to healthcare professionals, and to focus on patient outcomes first and foremost. “The care of incoming patients should be oriented around preventive medicine and measurable health outcomes, not risk management that results in mountains of needless paperwork and wastes valuable time,” Currie said. “Healthcare professionals’ concerns aren’t money or equipment, but working conditions and quality of care. They’re trying their hardest to provide care in a system that is working against them. This is why we need reform. If the people who see the worst of the crises every day are ringing the alarm bells and the decision-makers aren’t listening, we’ll never see improvements.”
“The B.C. NDP is focused on announcing impressive statistics: how many MRI machines they have, how many beds they’re providing, and how much money they’re pouring into the healthcare system,” said Dr. Sanjiv Gandhi, deputy leader for the party. “More than a third of the provincial budget is spent on healthcare, and we only have crisis after crisis to show for it. The reality is, healthcare is about people and people care about transparent metrics that measure accessibility, timeliness, and clinical results.
“A system that is supposed to protect and heal has been hijacked by red tape and inefficiencies. Doctors, nurses, and other medical practitioners undergo years of rigorous education and training, driven by a genuine desire to save lives and alleviate suffering. Yet, these individuals increasingly find themselves buried under a mountain of bureaucratic obstacles that impede their ability to provide the best care possible.”
“Robust, preventative care through community health centres is the best way to ensure British Columbians stay healthy in the first place,” Furstenau added. “We need a well-functioning acute care system in BC, but ultimately, we want fewer people needing support from that system because they never got sick in the first place, or ailments were identified at an early stage. Systems and processes need to be simplified, working conditions need to be regularly reviewed, and patient care needs to be the top priority.
“Bureaucracy has gotten in the way of quality healthcare in BC. By reforming it, we can retain more healthcare workers, spend money more efficiently, and ultimately deliver the health outcomes people expect a universal healthcare system to deliver.”
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Attached: B.C. Green reforms for healthcare bureaucracy (below)
Healthcare leadership and bureaucracy
Reprioritize BC’s vision for healthcare
Make disease prevention the central pillar of BC healthcare.
- A lack of access to primary care has meant more people do not get care for their ailments at early stages. This puts more pressure on acute care, and ultimately costs the system significantly more money.
- Robust primary care through community health centres is the best way to ensure British Columbians stay healthy in the first place. Healthy patients make for the best medicine and best economics.
Orient plans around measurable health outcomes - not money spent, equipment purchased or people hired.
- When healthcare workers come forward with concerns about the healthcare system, they don’t point to lack of funding. They point to working conditions, and standards of care.
- While investments in facilities, equipment and people are necessary to support good healthcare delivery, they are the means for achieving good healthcare delivery, not the outcome. To measure the success of any initiative, our healthcare leaders need to be explicit about the goal and how we will evaluate its success. 10 new MRIs is not a success. 500 fewer people with late-stage cancer is a success.
Be transparent about the system’s challenges and the data that is being used to evaluate it.
- BC is notorious for not sharing key information, or making it hard to find. Data and decisions need to be communicated in detail so that British Columbians understand how decisions were made.
- Create an easily accessible dashboard of key performance indicators, such as the number of people attached to a primary care provider, so that British Columbians, researchers and media can easily understand the challenges facing our healthcare system and the progress we are making to overcome them.
- Offer reliable, monthly press briefings on progress implementing programs and solutions.
Re-evaluate health authority structures and spending
Critically examine the merits of the health authority model.
- Health authorities are overly bureaucratic, with a hyper-focus on systems and processes that get in the way of healthcare delivery. We need to take an honest look at how this model can be improved or replaced.
- Primary care providers have shared how the Ministry of Health and health authorities have actively worked against the creation of community health centres (CHCs), despite the fact that CHCs could alleviate many of the pressures on the system itself. Our healthcare structures should be flexible and adaptable enough to support new ideas and solutions brought forward by communities and frontline workers.
Reassess health-authority and Health-Ministry expenditures.
- There are entire wings of hospital beds that are not staffed, and many unused diagnostic imaging (like MRI) spots. We don't need to spend millions of dollars on new MRI machines - the problem is not having the right people to do these tests.
- There are 64 vice presidents and 6 presidents for 6 health authorities, plus hundreds of managers and supervisors with amorphous job descriptions. Based on publicly-available data, the average salary for an executive was $396,773/year in 2022. This figure does not include the 36 executive roles whose salaries are not publicly disclosed.
- By contrast, Alberta has one health authority and 7 executives total.
Build a new internal culture
Create permanent, accessible means for frontline workers to communicate their insights and concerns directly with health authority management and the Ministry of Health. Mandate healthcare management with an ongoing responsibility to seek out frontline workers’ perspectives on new and existing programs.
- Frontline workers are frequently the first to know if there’s an issue in healthcare delivery, and often have solutions based on their experience as healthcare professionals. Yet there is no connection between frontline workers and those with leadership positions at health authorities and the Ministry of Health to routinely communicate how the system is functioning and how systems can be improved. Healthcare leadership cannot continue to make decisions in a vacuum without the real-world information that only frontline workers possess.
Make employee health and wellbeing a core aspect of the delivery of healthcare itself.
- Burnout leads to poorer healthcare delivery and outcomes, while the system itself loses healthcare providers in droves, often only one to three years into their careers.
- Healthcare leadership needs to make frontline workers feel like they are the heroes they are. Celebrating their successes and addressing their challenges is critical to making employees feel acknowledged and appreciated in their work environment.
- New ideas need to be embraced to make careers attractive and fulfilling. Healthcare leadership should work with employees to create the support structures they need: work-life balance, reasonable hours, mental healthcare, jobs in their own communities, etc.
- By supporting healthcare workers’ wellbeing, we can improve retention and make BC a desirable place to work, while delivering better health outcomes for patients.
Create safe working environments, including a new approach to management and real whistleblower protection.
- Authoritarianism, bullying, and coercion from healthcare leadership are common experiences for healthcare workers. This is utterly unacceptable. If health authority leadership cannot adapt to a more empathetic, caring approach, we need new leadership.
- Remove all requirements for healthcare workers to discuss public communications with health authority communications departments. Healthcare workers should be permitted to freely and directly express their concerns regarding systematic issues that are so prevalent today and are resulting in a decreased quality of care for the British Columbians. We must start listening to those that provide care. Listen to what works, what does not, and allow our doctors and nurses to speak to their expertise and experiences.
Simplify and standardize processes, and improve internal communications
Shift from a legal risk-management approach to care-oriented approach in process creation.
- Nurses spend an average of 45 minutes per patient on paperwork - costing the system critical time that could be spent on patient care.
- Health authorities have prioritized risk management over timely and supportive patient care. Hospital admission can sometimes require up to 70 pages of forms simply to protect the hospital from fear of legal action. The information that is recorded goes far beyond what is necessary to ensure patients’ identities are confirmed, critical medical information is recorded, and healthcare professionals have the information they need to provide a high quality of care.
Standardize forms across departments, facilities and health authorities
- Departments in the same hospital have different forms for overlapping data that have to be completed every time a patient moves. The same is true between hospitals and health authorities.
- These redundant processes also cost the healthcare system critical time that skilled professionals should be using to advance patient care.
Build a new unified computer system for BC healthcare
- Not only do computer systems between health authorities not communicate with one another, but systems within the same hospital often do not. Healthcare professionals frequently have to access 3-4 different systems just to get all the pertinent information on one patient.
- Current hospital systems are deliberately designed by a US for-profit company for individual departments without a native way to communicate and share information. The only way to bridge that gap is to hire the US developer to facilitate the communication on an on-going basis.
- We need software that can be built and managed by BC so that it works for our needs and reduces redundant processes.