A leaked memo from Dr. Brendan Carr, Island Health鈥檚 CEO, is the latest evidence of dangerous pressures building within our health-care system. In his memo to staff, Carr warned the health authority was headed for a $10-million to $12-million deficit in the current fiscal year.
Since deficits are not permitted, immediate economies had to be made. Moreover, staff were given a very short time to find these savings, because the fiscal year ends March 31.
The timing could hardly be worse. Island Health is already coping with an epidemic of drug-overdose deaths and a nasty strain of flu. Emergency departments are struggling to keep up, and residents have been asked to visit other facilities first, such as walk-in clinics. Unfortunately, these, too, are under pressure.
Carr makes clear that patient-care services are not to be touched. The savings must be found in administrative measures, such as a freeze on consulting, cutbacks on overtime and less committee work.
As far as it goes, this is the best option. And it appears to have succeeded. Staff confirm the necessary savings have been found.
But Island Health鈥檚 budget projections show that further economies will be needed next year, as well.
This is the eighth year running in which health authorities across the province have had to tighten their belts. Government funding throughout this period has scarcely kept up with the needs of a growing and aging population.
At a time when wage rates have stagnated in parts of the economy, we have a right to expect frugality in public agencies. That said, there is an underlying reality that must also be acknowledged.
Engineers talk about metal fatigue 鈥� the idea that structures such as bridges can be worn down by the repeated application of pressure. The same thing happens to organizations.
And one cause of fatigue is repeatedly going back to the same well when savings are required. Yet that鈥檚 what we鈥檝e been seeing across the sa国际传媒 health system: Staffing freezes, travel freezes, purchasing freezes, overtime freezes and the like.
For a year or two, perhaps, these measures make sense. But when they become an annual necessity, the basic infrastructure of the organization is whittled away.
And why are we seeing this self-destructive behaviour? Because after years of budget restraint, the more productive options have been exhausted.
Hospitals are vastly more efficient than they were 30 years ago. Bed counts are down, more surgeries are conducted in outpatient clinics, support services have been privatized. Hospitals in our province have the lowest overhead costs in sa国际传媒.
But eventually the limits of such measures are reached. And Island Health shows every sign of having arrived at that point. With most of the fat gone, managers are hacking away at the bedrock. What other choice do they have?
There is a ray of hope. Finance Minister Mike de Jong is projecting a $2.42-billion surplus this year. With revenue estimates finally trending up, it鈥檚 a reasonable assumption that surpluses will continue.
The worst thing de Jong could do with this long-awaited windfall is go looking for new programs to roll out or, as Premier Christy Clark has hinted, taxes to cut.
Those, of course, would be popular, and this is an election year.
But the first duty of government is to ensure decent quality in those services that are essential to the community鈥檚 well-being. If what鈥檚 happening at Island Health is anything to go by, the province is failing in this duty.
With money in hand, de Jong should cut the health sector some slack. Organizational burnout is more difficult to identify than metal fatigue, but the results can be just as disastrous.
