Paddy Rodney’s blog on the Transformation of Health Care in Canada (Jan. 16, 2012) and news from the Council of the Federation meetings in Victoria have generated considerable interest during the past few weeks.
For anyone wishing to do more background reading on health system funding as it pertains to British Columbia, I suggest two documents that have captured my interest, and that of the ARNBC Board —both highly relevant at this time of renewed attention to health system transformation in Canada. I encourage all registered nurses to stay informed about this type of issue which will impact all of us as we strive to provide safe, competent patient care.
Beyond the Hospital Walls: Activity Based Funding Versus Integrated Health Care Reform was released this month by the BC Office of the Canadian Centre for Policy Alternatives. It offers a thoughtful examination of options for cost-effective health funding. The authors point out the challenges associated with inappropriate use of hospitals and the need for improvement in integrating care across the continuum. They draw upon examples of health system reform in other countries and within B.C., cautioning against the trend towards engaging in activity-based funding with a narrow focus on wait times, to a broader look at large-scale system improvements. I encourage nurses to read and reflect on the ideas in this report since it offers a progressive economic analysis on health care spending in the context of its impact.
A second document worth reviewing on the same theme is BCNU’s July 2011 Position Statement on “Patient Focused Funding” (this is the umbrella term used by the BC Government to encompass activity-based funding and other performance incentives). The BCNU position statement provides background on the introduction of Patient-Focused Funding currently being piloted in selected B.C. hospitals and presents the view that this funding model “has no place in B.C.’s healthcare system” (BCNU 2011, p. 1). It complements the first report, providing a nursing perspective along with recent references on these proposed funding models.
The BCNU statement highlights concerns about the potential impact of financial incentives on the quality of patient care.It serves as an example of the profession’s role in informing the public about new policies by offering a nursing analysisas we monitor impact in all the settings where nurses practice. Nurses have a unique capacity to envision the longer-term repercussions of changes across the care continuum—we should use this knowledge to speak out about the unintended consequences of policies.
Nora Whyte is ARNBC’s Project Manager. She is an independent nursing consultant with experience in community health nursing, project management, nursing education and health policy work. She has managed primary health care initiatives and has worked with professional associations, civil society organizations and First Nations health organizations. She has a longstanding interest in nursing leadership development at local, provincial, national and international levels.