Health-care professionals are welcoming a commitment from new Health Minister Josie Osborne to review administrative costs in the province. (Mike McArthur/CBC)
Akshay Kulkarni · CBC News · Posted: Jan 19, 2025
Health Minister Josie Osborne’s mandate letter includes commitment ‘to focus resources on the front line’
Health-care workers’ associations in B.C. are welcoming a commitment, laid out in the new health minister’s mandate letter, to reduce the cost of health-care administration in the province.
Coming out of the provincial election, health care has persisted as one of the major priorities for voters, as intermittent emergency room closures continue around the province and hundreds of thousands of British Columbians remain without a family doctor.
In his mandate letter to new Health Minister Josie Osborne, Premier David Eby tasked her with tackling the ongoing health-care worker shortage and ensuring every British Columbian has access to primary care.
The mandate letter also features a commitment to reduce administrative costs “to focus resources on the front line,” including a review of the province’s seven health-care authorities.
Critics have said B.C.’s health administration is too bloated, with a gynecologist telling CBC News in October that the number of administrators at health authorities was not tenable.
The province spent $1.8 billion on health-care administration in 2022, according to the Canadian Institute for Health Information. That is around $100,000 less than Quebec, which has 3.5 million more people.
“We made the commitment to review health authorities,” Osborne told CBC News in an interview. “And so we will be … working with health authorities to look to those ways to cut administration.”
- How the parties are proposing to fix B.C.’s health-care system
- B.C. ministry mandate letters focus on affordability, public safety, economic growth
The health minister says work is just getting underway on her review, and stopped short of committing to a full reform of the health-care authority model, which sees five different authorities responsible for regional care.
“Regional health authorities have a really important role in understanding the context of the communities that they serve and the delivery of those services,” she said.
The two other health authorities in the province, the First Nations Health Authority and Provincial Health Services Authority, are responsible for improving care for First Nations people and co-ordinating provincewide care, respectively.
B.C. Conservative Party finance critic Peter Milobar says B.C.’s health-care administration has more than 70 vice-presidents, while Alberta — which has around four million residents compared to B.C.’s five million — has just seven.
“There’s a massive growth that we’re seeing in administration and bureaucracy, not just in health care but across government over the last seven years,” he told CBC News.
“And so it’s good to hear the premier recognizing that, but why they’ve refused to recognize that over the last six years, to get us in the fiscal mess that we’re in right now, is a concern.”
The B.C. Greens, who signed a co-operation agreement with the NDP after the election, had previously pushed for a review of health-care authority expenditure.
“There are far too many [vice-presidents], managers and executives with amorphous job descriptions,” the Greens say on their website.
“The health-care authority model needs to be examined for its effectiveness and streamlined to cut out wasted time and resources.”
Doctors ask for focus on primary care
Those representing doctors in the province say a review of health-care administrative costs is welcome news, and that the province should turn its attention to primary care.
Dr. Darren Joneson, president-elect of the B.C. Family Doctors group, says the NDP government has been making strides in solving a primary care shortage, particularly with a longitudinal doctor payment model introduced in 2023.
“[It] has actually seen, you know, a net increase of 250,000 British Columbians being attached to a family doctor, being able to access that primary care,” Joneson said of the new payment model.
But the Chilliwack-based family doctor says the government should continue to prioritize setting up team-based primary care models in order to reduce administrative time for doctors.
- B.C. election comes at pivotal moment for health care: workers
- 700 more family physicians in B.C. since payment revamp: doctors
Nurses ask for ratios to be implemented
Adriane Gear, president of the B.C. Nurses’ Union, says she welcomed the commitment in Osborne’s mandate letter to implement minimum nurse-to-patient ratios, but wants more done to make existing nurses feel safer and healthier at work.
“We still need to recruit thousands of nurses to this province in order for us to be successful at implementing minimum nurse-patient ratios,” she told CBC News.
And Gear was critical of the ongoing practice of hiring private agency nurses, especially in rural B.C. where emergency room closures have led to “travel nurses” being brought in on a temporary basis.
“Where I’m really challenged is these for-profit companies that really are exploiting a situation, and have been charging exorbitant amounts to supply nurses in situations where, frankly, we’re quite desperate,” Gear said.
