Corporate costs are rising faster than any other part of Fraser Health's budget even though area hospitals remain heavily congested.
Corporate costs – spending that doesn't directly relate to patient care – are budgeted to soar 20 per cent, from $211 million in 2010/11 to more than $253 million in this fiscal year, according to the health authority's 2011/12 service plan.
The document was finally released after being withheld for months by health ministry officials in Victoria.
It shows corporate costs are now the third largest component in Fraser Health's budget, for the first time surpassing expenditures on community care, which accounts for $237 million and was held to a 2.9 per cent increase.
"It's a dramatic increase," NDP leader Adrian Dix said of the corporate budget, adding the plan reflects misplaced priorities and a lack of a coherent strategy.
Fraser Health's overall budget rises to $2.75 billion this year, with the largest amounts going to acute care (up 3.8 per cent to $1.55 billion) and residential care (up 5.1 per cent to $480 million.)
The plan show Fraser's base funding from the province climbed 6.3 per cent this year to $2.3 billion.
Fraser Health spokesperson Roy Thorpe-Dorward said the $42 million increase in corporate costs is mainly due to larger provisions for the depreciation of assets (an extra $13 million), interest expenses for the newly opened outpatient hospital in Surrey ($12 million), a higher contingency provision ($10 million) to cover unexpected costs or overruns, and a $4.2 million rise in information management (IT) expenses.
The corporate budget category does not include all administration expenses, he said, adding they are actually split up across each of the other budget components.
Administrative costs aren't shown in the service plan, but Thorpe-Dorward said they have remained steady at about nine per cent of Fraser Health's budget, or close to $250 million.
"That compares favourably to most large organizations," he said.
Corporate costs include areas like human resources, legal services, finance, telecommunications, plant services and research.
Performance measures in the plan show Fraser has made little progress so far in reducing hospital congestion and hallway medicine.
It shows 57 per cent of patients admitted through emergency in 2009/10 got a hospital bed within 10 hours.
That rate has barely budged since 2005, when it stood at 55 per cent and the goal then was 80 per cent.
The bed wait indicator had been stripped from previous incarnations of the plan in the past couple of years – drawing criticism that the province was trying to whitewash poor performance – but has now been re-introduced.
It sets a 2011/12 target of 67 per cent of ER admissions getting a bed within 10 hours, climbing to 90 per cent by 2014.
But the latest numbers for 2011 have actually worsened, with 52 per cent admitted by the benchmark time as of early December.
"There are some pockets of good progress," Thorpe-Dorward said, adding the rates at Burnaby and Royal Columbian hospitals are nearing 70 per cent.
He noted emergency department visits are up 6.3 per cent this year.
Fraser Health said is taking steps to manage hospital occupancy to ensure patients get admitted through emergency as quickly and efficiently as possible, Thorpe-Dorward said.
He cited the use of quick response case managers in the busiest ERs, ongoing efforts to get elderly patients out of hospitals and into home support or residential care, and an increasing emphasis on chronic disease prevention to reduce hospital use.
But Dix said the plan is short on detail on how further gains will be made.
"They're just sticking numbers in here without any relationship to their plan, their ideas or anything else," Dix said. "There's no plan to get to 90 per cent. And they're going to have more problems because they're not meeting their targets to create acute care beds."
The service plan warns Fraser will need 1,100 more hospital beds than it has by 2020.
Dix noted a similar warning was issued in 2007 that nearly 750 more beds were needed by 2010 and most of them did not materialize.
New facilities have opened in recent years, including the Abbotsford Regional Hospital and the Jim Pattison outpatient hospital in Surrey, which helps take day surgery and diagnostic pressure off nearby Surrey Memorial Hospital.
A new ER and critical care tower is also under construction at SMH to expand emergency space and add 150 more beds.
But Dix criticized delays in expanding Royal Columbian Hospital, which is still in a pre-planning stage despite years of controversy about overcrowding.
"The plans to redevelop that hospital have been before the government for the entire decade the BC Liberals have been in power and they've done absolutely nothing to deal with that," he said.
The plan shows the average wait for high-demand non-emergency surgeries is 17 weeks and it aims to cut that to 15 weeks by 2012.
Fraser is the fastest growing health authority in B.C., nearly doubling in population since 1986, and it's expected to grow by another 21 per cent by 2020.
Because of the growth rate, Fraser has tended to get a bigger budget increase than other health authorities.
But the province will be under growing pressure to rein in those increases because of reforms to the way Ottawa calculates federal health transfer payments to the provinces.
The federal government has also warned its annual six per cent increases in per-capita health transfers will be reduced to the combined rate of growth of the economy and inflation starting in 2016.