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B.C. government can't show value for billions spent on health care: report

B.C. Minister of Health Terry Lake

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VICTORIA - British Columbia's auditor general says the Liberal government lacks oversight over a key portion of the largest-ticket item in their annual budget — health-care spending.

A report released Thursday by auditor general Russ Jones said the province can't demonstrate that it's getting good value for the billions of dollars it pays doctors every year.

"We found government is not ensuring that physician services are achieving value for money," said the 46-page report.

"Government is unable to demonstrate that physician services are high-quality and cannot demonstrate that compensation for physician services is offering the best value.

"Furthermore, there are systemic barriers that are hampering government’s ability to achieve value for money with physician services."

The Opposition New Democrats called the report a damning indictment of the management of health care in B.C. but Health Minister Terry Lake said British Columbians can be assured they receive high-quality care for the money paid to doctors.

"I think some of the recommendations there are just not based on reality," said Lake. "However, in an ideal world, perhaps, that's where we would get."

Lake said there is always room to improve and modernize the current fee-for-service model used to pay physicians in B.C., but to undertake a complete rebuild of the system is a mammoth undertaking that would take years to accomplish.

"Similar systems exist across the western world and when you look at what we pay for our physician services versus other jurisdictions we do very well," he said. "We get very good value."

Jones's report said that in 2011-2012, physician costs of $3.6 billion consumed nine per cent of the province's total budget, but the government can't demonstrate the physician services are high quality or offer the best value for the money.

Among his six recommendations was a call for the Health Ministry and other health-care bodies, including the B.C. Medical Association and the College of Physicians and Surgeons, to clarify their roles. He also called for accountability for ensuring the health-care system supports quality and cost-effective physician services.

He also recommended the Health Ministry work with the medical association and other health bodies to rebuild the physician-compensation model to align with high-quality, cost-effective physician services.

"Physicians' performance is not evaluated consistently, so we don't know if British Columbians receive high-quality care," Jones said in a conference call with reporters. "There is no consistent and regular oversight of physicians' service."

Judy Darcy, heath critic for the Opposition NDP, said the Liberals are raising medical services premiums but can't prove they are delivering high-quality medical care.

"Payment to doctors takes up nine per cent of the annual provincial budget, but the Liberals have no idea if that money is being spent wisely," she said.

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