To the editor:
Re: “Kitsilano youth fear losing Pine Free clinic,” April 23.
The recent backlash towards funding cuts to community health centres in Vancouver is a reminder that our provincial health care system will be faced with many challenges when setting priorities and allocating funds over the next few years.
The B.C. government spends a large portion of its budget on health care (42 per cent) and has decided that this percentage needs to be contained. Over the next three fiscal years, the government has restricted health spending to an annual increase of 3.2 per cent versus the 7 percent increase seen in previous years. Thus, decision makers will be charged with the daunting dilemma regarding what to fund and what not to fund.
In the past, resource allocation decisions have been based on historical trends — allocation based on previous years, and political factors — the “squeaky wheel gets the grease.” This should be of concern to British Columbians as it suggests that our health care tax dollars are not being allocated effectively.
More specifically, in a recent study, 62 key decision makers in various Canadian health regions (all senior executives and medical directors) admitted that they did not have clear guidelines for setting priorities during resource allocation. The majority claimed to rely on historical trends or political pressures. Not surprisingly, only 22 per cent of these individuals believed their process was effective.
There is a simple solution to this issue; the B.C. government should require publicly funded areas of our health care system to demonstrate the use of a systematic and explicit process for setting priorities and allocating funds.
There are many frameworks to assist decision makers in priority setting and resource allocation (e.g., program budgeting and marginal analysis). These frameworks use specific criteria for judging what should be funded, incorporate evidence wherever possible, and create advisory panels to draw on expertise. Furthermore, they promote transparency and accountability of the allocation process so that resulting decisions are clear and fair.
Step by step guidelines for carrying out these processes leave no excuses for key decision makers to maximize tax dollars and improve the health of British Columbians.
Sarah Boorman,
Vancouver
