The organization transitioned from a decentralized regional hub model to a centralized structure about 10 years ago. In 2013/2014, based on Council decisions at the time, the organization decided to return to regional hubs. Island Health also gives the public an impression of inequality and bureaucracy in its historical course. There is a strong concentration of specialist services and management in Victoria, the region's largest city. Its history of being Victoria-centric is well known to locals and is often lamented by staff and the public. Generally, staff advance within the organization based on experience, seniority, education level and relevance of skills. Employees are expected to support each other and follow “Respectful Workplace Policies”. When it comes to patient interaction, since the new CEO was appointed, the organization has placed a strong focus on patient care. Patient feedback is appreciated. They are encouraged to join the Patient Voices Network to share their experience and provide feedback to the site