Accord reached on laboratory, rehab and breast cancer screening services

The Report: October 1998 vol.19 num.3

In 1996, HSA launched a major campaign calling on the provincialgovernment to enhance the role of public providers in the delivery of laboratory services.

Finally, it seems the government is ready to act.

On September 4, 1998, HSAs Director of Labour Relations RickLampshire signed a Public Sector Accord on Strengthening BCs Public Health CareServices. The other signatories are the governments chief public sector accordnegotiator Tony Penikett and HEU business manager Chris Allnutt.

The accord focuses on enhancing the role of public providers in threeareas of the health care system: laboratory services, breast cancer screening, andrehabilitation services and programs for clients of the Workers Compensation Boardand the Insurance Corporation of British Columbia.

-Were pleased that the provincial government has opened thedoor for discussion," says HSA President Cindy Stewart. -Of course, whatsmore important is whether this process leads to any substantial change in delivery ofservices. And that will depend on whether the political will exists to implement realchange."

As a first step, HSA has been invited to participate on a jointunion/Ministry of Health policy committee that will advise government on issues identifiedin the accord. The committee will meet no less than four times annually. Every six monthsthe chair will alternate between the ministry and the unions, with Cindy Stewart assumingthe first chair.

Any substantive changes to the delivery of lab services or breastcancer screening will require Cabinet approval.

As a basis for discussion, the accord recommends that governmentseriously examine the introduction of a new block-funding system with the followingelements:

  • Health authorities would be provided with the funding for all laboratory services in their geographic area.
  • Health authorities would be given the authority to determine the number and location of outpatient and inpatient laboratory facilities including collection stations.
  • Health authorities could be expected to rationalize the provision of laboratory services and capture the savings potential from technological change.

As a condition of the new funding, health authorities would be requiredto plan and manage diagnostic services in a manner consistent with Section 3 of the HealthAuthorities Act. The accord says -specifically, this means giving preference tothe provision of services through the public sector and ensuring optimal utilization ofexisting and future public investment in laboratory services." This principle wouldalso apply to any future changes to breast cancer screening.

The other part of the health care system covered by this accord isrehabilitation services for WCB and ICBC clients. Currently, a high percentage of rehabservices for ICBC and WCB clients is delivered by private providers. This is largely dueto the significant downsizing of rehab services in acute-care hospitals. As part of theaccord process, ICBC has indicated a willingness to explore partnerships with HSA,regional health boards and community health councils to provide a variety of rehabservices to their clients. Similarly, the WCB has expressed interest in partnering withpublic health care facilities to provide rehab services to injured workers.

-For years, HSA has lobbied the government to seriously examinethe waste and duplication that exists in health care," says Stewart. -Ourmembers know that significant changes are necessary to keep our public health care systemsustainable for the future."

Stewart says she strongly supports the recommendations put forward bythe accord negotiators and looks forward to participating on the joint committee to ensurethese recommendations are put into action.