BC Health Bureaucracy Clock

How it's calculated

Dollar figures on this page are rounded, except the live counters, which show whole dollars. The calculations behind the counters use the unrounded figures.

B.C. has seven health authorities: five regional authorities, the Provincial Health Services Authority and the First Nations Health Authority. Each has its own CEO, executive team and head office. The clock estimates what B.C. spends on that duplication, called "excess" spending here, by asking what a single health authority would save. It has two parts.

Executive pay. The six provincial authorities paid their CEOs and non-clinical vice presidents about $17 million in 2024–25, according to the salary schedules they publish under the Financial Information Act, and FNHA's non-clinical executives are estimated at about $2 million more. Vice presidents who lead medical, nursing or public-health portfolios are not counted. A single authority would need one CEO and one vice president for each function: finance, human resources, technology, strategy and quality, Indigenous health, communications, and capital and facilities. It would also need one operations vice president. Hospitals and programs would continue to be run by their own site leaders, as they are now. Each is paid the highest salary any authority now pays for that role, for a total of about $4.6 million. Executive pay beyond that, about $15 million a year, is counted as excess. It is shared among the authorities in proportion to what each pays its executives now.

Head-office overhead. Each authority reports a "Corporate" expense in its audited financial statements, separate from spending on hospitals, long-term care, community care, mental health and public health. For 2024–25, the six provincial authorities reported corporate costs of about $3.4 billion, or roughly 11% of their total spending. Excluding executive salaries, the clock counts 25% of the rest as excess, about $844 million a year. The statements do not break the corporate line down by function, so the 25% is Coastal Front's estimate, not a government figure. It reflects running one head office instead of six, purchasing, accounting and technology savings at a larger scale, lower office costs, and the scope for modern tools, including artificial intelligence, to reduce administrative work. The corporate line also covers functions any health system needs, such as payroll and information technology, so the clock does not assume they could be eliminated.

First Nations Health Authority. FNHA does not publish its executive salaries in the same form or report a comparable corporate figure. Its executive pay is estimated at eight non-clinical vice presidents paid the provincial average of about $262,000. No overhead is counted for FNHA. It is funded largely by the federal government and operates under a separate agreement with First Nations, so any merger would need their agreement.

The live counters start at zero on January 1 and run to December 31 Pacific time, then reset. Annual amounts are spread evenly across the year. They are based on fiscal 2024–25, the most recent year with published executive salaries, so the live figures are estimates.

Mergers elsewhere suggest caution. Nova Scotia merged nine health authorities into one in 2015 and Alberta created Alberta Health Services in 2008. In both cases, the administrative savings fell short of expectations or remain disputed. A merger in B.C. would need to be designed to avoid those problems.

The authorities may not classify costs the same way. The Provincial Health Services Authority's corporate costs, about $1.36 billion, include services it runs for the whole province, such as information technology, supply chain and drug purchasing. Some of this is billed to the regional authorities, so part of it may also appear in their figures. Without PHSA, the estimated excess would be about $508 million a year.

The provincial government points to Canadian Institute for Health Information data showing B.C.'s administrative spending is among the lowest in Canada. CIHI uses narrower national definitions than the corporate category in the authorities' financial statements, so the two are not directly comparable.

Found an error? Corrections are welcome and will be made promptly. Contact Coastal Front.

Sources: audited 2024–25 financial statements from Fraser Health, Interior Health, Northern Health, Vancouver Coastal Health, Island Health and the Provincial Health Services Authority; Financial Information Act salary schedules for 2024–25 from Fraser Health, Interior Health, Northern Health, Vancouver Coastal Health, Island Health and the Provincial Health Services Authority; B.C. Public Sector Executive Compensation Disclosures; the First Nations Health Authority leadership team; and, on mergers elsewhere, Fierlbeck, "Amalgamating Provincial Health Authorities: Assessing the Experience of Nova Scotia", Health Reform Observer, 2019.