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B.C. Health Minister Margaret MacDiarmid, middle, acknowledges that waiting lists for care are longer than she would like.DARRYL DYCK/The Canadian Press

British Columbia's health care system could do better, according to Health Minister Margaret MacDiarmid.

Responding to a report by the province's auditor-general providing a detailed breakdown of last year's $15.5-billion health budget, Ms. MacDiarmid acknowledged that waiting lists are still too long for her liking.

Although significant progress has been made in areas such as cancer and cardiac procedures, the minister said she was troubled by patient waits for less common surgery.

"A whole lot of them have come to my attention as health minister, unfortunately," she said on Thursday in an interview. "You hear of some very difficult waits that people have. They wait too long, and I am aware of that.

"I was aware of that as a family doctor, and I'm aware of that as a minister," Ms. MacDiarmid observed. "I want us to do better, and I believe that we can."

But it's not simply a matter of expanding the health care budget, which already consumes nearly 40 per cent of the provincial budget, she said. "Our resources are finite."

Innovation and creativity can resolve bottlenecks, Ms. MacDiarmid said. She pointed to breast cancer procedures for which local anesthetic and day surgery are increasingly used. "It's not only economically better, it's fantastic health care, and we can learn from that.

"It's not always about putting more money in," she said. "Alberta has a far younger population than B.C., they spend more per capita on health care than we do, and we have better outcomes."

Although the auditor-general's report did not question details of B.C.'s large health care budget, it did point out that spending on health promotion and prevention measures, touted by the government in recent throne speeches, accounts for less than 5 per cent of all health care dollars.

Assistant auditor-general Morris Sydor said such spending had even declined in some regional health authorities.

"There may be reasons for that, but what we are saying to legislators is: Here's something you may want to have a closer look at," Mr. Sydor said. "Because, after all, the government has identified the prevention side of health care as a priority area, with the idea being that, if we prevent people from getting ill, there will be savings down the road."

Over the past four years, spending by the Interior Health Authority on "population health and wellness" has declined to $52-million from $57.6-million.

Spokeswoman Darshan Lindsay said the IHA decided to put more money into community care to help people manage their health care and chronic conditions. And she noted population health and wellness spending is back up to $56-million in the authority's current budget.

Although increases have stalled in recent years, Ms. MacDiarmid said that overall spending on promotion and prevention is up 150 per cent since 2000. The government is also pumping much more into primary care, another important factor in heading off illness, she said.

The auditor-general's report found that physicians and other health care professionals receive 25 per cent of all health care funds, PharmaCare accounted for 7 per cent, and acute care costs gobbled up nearly 50 per cent of the $15.5-billion budget.

The report also revealed that providing chiropractor services to low-income British Columbians cost the government $7.9-million last year, and acupunture treatment cost $6.4-million. Medicare does not cover either service for those with combined family incomes higher than $28,000.

Asked why only the poor are covered if the services are considered valuable enough to pay for, Ms. MacDiarmid said it boils down to affordability. "We're not expanding in very many areas these days."

She defended paying for acupuncture. "It doesn't work for everyone, but I think for patients with chronic conditions, migraines, it can assist them and help them avoid medication, which is also helpful."