We’re sorry to hear that you felt your knowledge of the budget is limited. We hope that through future forums and other communication we can make you more aware of the finances of VCH and help you to feel more comfortable in asking questions. To answer your question:

Yes, there are different organizations across Canada that represent segments of the health care community on everything from funding levels to policy development and standards of care. In B.C., however, health authorities no longer have a representative organization to speak for us (the BC Health Association folded when the health authorities were established in 2001), but we work closely with government through meetings of Board Chairs, CEOs and other groups to raise concerns and seek solutions to system-wide issues.

Car allowances are part of the Senior Executive Team’s (excluded) employment contract, whereas premiums and allowances for unionized staff are based on terms of their negotiated collective agreements. Employment contracts of excluded/management staff differ from collective agreements for unionized staff in other ways, too, and most notably in terms of salary increases. For example, unionized staff negotiated salary increases in the last round of bargaining, whereas all excluded/management staff still fall under the salary freeze implemented by government last September.

Like VCH executives, some management/excluded staff and some unionized staff require reliable and efficient transportation to perform their jobs. That is why we’ve just begun looking into the cost/benefit of Vancouver Community teams using shared VCH vehicles instead of individuals using their personal vehicles for work transport. We believe it may make sense for some teams to use, for example, the highly fuel-efficient smart car. We see the potential for economic and environmental benefits, but first we need to do our homework.

We continually review our programs and services, and adjust them to meet clients’ needs, as well as to ensure that we’re making the best use of our resources. The decision to disinvest from these programs came about from a wider review of mental health services. We need to focus our resources towards mental health programs where there is growing demand and greatest need. To this end, disinvesting from the Art Studio (now funded by a private donor, this program will remain open until at least March 31, 2014), ACE and the Mood Disorders Association enables us to reinvest in our ACT Teams and crisis interventions for mental health clients. Additionally, a portion of the disinvestment dollars will help us balance our budget and fund organizational priorities such as CST. None of the “savings” will be applied to either acute or residential care. Guiding all our future decisions is the need for VCH to continue providing the widest range of necessary health care services to the most people who require them — all within a finite healthcare funding envelope.

You’re absolutely right in suggesting that there are potential benefits to a national health care information system. Achieving this has been a huge challenge given the number of different electronic systems currently in place across Canada, the costs involved, and the differing needs and expectations of the various health organizations, governments and other stakeholders. By working in partnership with Providence and the Provincial Health Services Authority, we hope that our CST project will pave the way for even broader implementation down the road and will take us closer toward the scenario you suggest.

As with all programs, Public Health is continuing to review its programs and services within the context of our budget challenge. At this point it’s important to let everyone know that disinvesting from a program isn’t a reflection on staff’s dedication or the quality of care/service provided. Rather, it is one of the many hard choices we must make in order to operate within our limited budget.

Regarding the change in newborn services on stat holidays — which is being implemented across Vancouver, Coastal and Richmond — we have advised our hospital partners of the change for discharge-planning purposes. We will follow up on any concerns that arise. And, where two stat holidays fall together or closely together – for instance, Christmas/Boxing Day and Good Friday/Easter Monday — we will continue to provide service on one of the stat holidays.

In addition, should a new mom need to talk to a nurse on a stat holiday when PHNs aren’t available, they can call HealthLink BC at 8-1-1 to speak with a nurse at any time of the day or night, seven days a week.

Sustainability is one of our True North goals and this includes financial sustainability. Through the reduction of service on 10 single days throughout the year we can reduce costs with, we believe, minimal impact on clients. We intend to monitor any unintended impacts closely as part of our ongoing quality review process and adjust as required.

Within the context of growing demand and finite resources, our budget-balancing efforts across VCH will continue next year and for the foreseeable future.