July 28, 2005

Vancouver Island Health Reorg

Roughly 22 cents out of every dollar you pay in provincial taxes, all taxes including sales tax, and your imputed share of resource revenue, go to pay for the provincial health authorities. Their budget of more than $7 billion is 22% of total provincial spending of $32.45 billion. The health authorities are not like a private company since they are spending your money and their actions could affect your life and well-being; they should be open and accountable to you. Those are a few of the reasons to be concerned when you read the report dated July 5, 2005 on the Vancouver Island Health Authority's website. Their "Health Services Plan 2005/06 - 2007/08" carries the subtitle "Final - revised for public release -". What did the original document look like and what was removed from public scrutiny? Fortunately what appears to be a version of the original document is still available on the VHA website. A difference between the original plan and the revised plan is that the original contains a 111 page appendix with detailed plans for various service areas.

The Vancouver Island Health Authority (VIH) is nearing the final stages of another reorganization. 17 new directors of clinical departments have been appointed and they are in the process of hiring administrative assistants and medical personnel for the new departments. The "revised for public consumption" service plan states:

The revised service plan is dated July 5, 2005; on July 4, 2005, an email was sent to a wide distribution list announcing the names of 17 directors for the new departments. The original plan (appendix page 86) called for VIHA-wide co-management of five major portfolios, consisting of an executive medical director and an executive director, with additional directors to be appointed as required. The July 4th email made the announcement on behalf of the Executive Directors and Executive medical Directors and said that: "The major part of the organizational renewal recruitment process is nearly complete. As the leadership team evaluates program functions and individuals get established in their roles over the coming months, some additional posting, appointments, realignments or secondments may occur as a result." It is no wonder that the email concluded by saying: "This has been an intense and, at times, unsettling process for many employees across the organization. We understand that a period of change such as this can bring with it additional stress and uncertainty. All the pieces, so to speak, are nearly in place, and we will soon begin realizing the benefits of the renewal process." Renewal was supposed to occur in 2001 when the previous health authorities were reduced in number to five regional and one provincial authority. VIH decided that a second major shakeup would produce benefits. Of course there are also costs to reorganization, but don't expect our less-than-open government to report those figures. A rough guess would put the total cost of 17 directors, 5 executive directors, admin assistants, 5 executive medical directors and numerous medical co-leaders and support staff at well over $6 million per year plus the costs of transition such as severance for previous managers.

Given the scope of the reorganization and the likely costs, one might expect to find some disclosure on VIH's website regarding the change. Apart from the leaked email and one small paragraph in the revised plan, there appears to be nothing on the website regarding the new structure. The last section of the revised plan is titled "communications". It states that: "The primary communication vehicle will be the website as the plan, in its entirety, can be accessed by anyone with Internet service." The authority could start to use that vehicle by posting information on its new organization model including detailed budgets for each of the 17 clinical departments and information on the full cost of the reorganization.