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January 27, 2007

Unverifiable Health Figures

On Wednesday, January 24th, Finance Minister Carole Taylor took the unusual step of releasing the health budget, four weeks less a day before her 2007-2008 budget is tabled in the Legislature. Health Minister George Abbott was quoted in the news release justifying its early release on the ground that it gave health authorities more time to develop ideas that could be funded through a new $100 million Health Innovation Fund. It is hard to believe that the February budget had to be pre-empted for any reason since the authorities are used to handling much more confidential information and could have been trusted with a confidential pre-budget briefing. It is far more likely that the announcement was made to coincide with the firing of Vancouver Coastal Health Authority chair Trevor Johnstone and to further the government's message about the unsustainability of health-care funding.

Johnstone's firing came after conflict between the Campbell government and the Vancouver Coastal Health Authority over a projected budget over-run for the fiscal year ending March 31, 2007 of between $40 million and $62 million. News that they planned to close operating rooms so as to balance the budget was made public on January 16th by NDP Leader Carole James. Abbott was on vacation so Colin Hansen, former Health Minister and now Economic Development Minister, stepped in to calm the political storm but instead made a mess of it. He announced that the Authority could run a $40 million deficit, only to face the media following a cabinet meeting and announce that he was wrong. Johnstone was made the fall-guy and what the government claims is an additional $885 million in health funding was announced on the day he was axed.

It is useful to verify as much as possible of the information that is contained in government news releases. The health funding announcement claimed that: "Funding for the Ministry of Health, including the new Health Innovation Fund, will increase to $13.1 billion in 2007/08 from $12.2 billion this fiscal year, an increase of 7.3 per cent." Whether or not the increase is 7.3 per cent depends on whether spending this year is $12.2 billion. The Second Quarter Financial Report 2006-2007 forecast spending for the Ministry of Health in 2006-2007 as $11.910 billion, up just 4.3% from $11.414 billion in 2005-2006. That's hardly the kind of "unsustainable" increase that the Campbell government would have the public believe is regularly occurring in health care. It suggests that part of the 2007 increase is catch-up for previous inadequacies. It is not clear from the Financial Report whether the $11.414 billion in 2005-2006 included the one time "negotiating framework incentive payments" which would distort year-to-year comparisons. It is clear that there is a $310 million difference between the spending forecast for the Ministry of Health that is included in the Second Quarter Report and the $12.2 billion figure that is used in the January 24th news release.

In December the Ministry of Finance held a news conference in which they furthered their story about spending pressures originating with the health authorities. A document provided to the media asserted that the authorities wanted a 28.7% increase over three years, between 2006-07 and 2009-10. That document showed "base funding" for the health authorities INCLUDING MSP/Pharmacare payments as $7.658 billion for 2006-07. Unfortunately it is impossible to verify that figure from the health authority websites. Consistent with their general approach of not sharing information with the public, none of the websites for the health authorities contain their 2006-07 budgets. They show their 2005-06 budgets and, for some authorities, what they hoped to get for budgets in 2006-07. The premature health budget release said that the 2007-08 budget for the health authorities would be $7.534 billion EXCLUDING MSP/Pharmacare payment, and it said that is a 6.7% increase over their budgets for 2006-07. A footnote added that the MSP/Pharmacare payments to the authorities is estimated to be $650 million in 2006-07. Dividing $7.534 billion by 1.067 and adding the $650 million yields a 2006-07 budget of $7.711 billion which is $53 million more than the base provided in the December document.

It appears that the Campbell government maintains so much control over access to information on health spending that it is impossible to verify what it says about its budget. It will be July 2008 before the Public Accounts are available for fiscal year 2007-2008 providing audited figures that can be used to check the claim that the health budget is increased by 7.3% effective April 1, 2007. Even then details can't be checked because the Public Accounts present data at such a highly aggregated level that checking figures in the documents cited here is impossible.

The Campbell government expects British Columbians to participate in its Conversation on Health guided by incomplete, unverifiable financial information. It concluded its January 24th news release with the statement that: "Over the next year, the Ministry of Finance will continue to work with the health authorities and the Ministry of Health to accommodate any changes that may flow from the Conversation on Health prior to finalizing the funding commitments for 2008/09 and beyond." Only Campbell knows what changes will flow from his Conversation on Health. Giving early notice on those intentions to the health authorities and the general public would be far more useful than the kind of news release issued on the day the Vancouver Coastal Health Authority chair was fired.


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