Liberal Leader Christy Clark posed for cameras in an excavator breaking ground for a new hospital on Vancouver Island and New Democrat Leader Adrian Dix shook hands at a seniors activity centre in Vancouver as health care became the latest battleground in the British Columbia election campaign.

Dix promised $238 million over three years for seniors, children with mental health issues and rural health services in an effort to relieve pressure on the province's health care system.

The money pales in comparison to the $16.5 billion the province has budgeted for health care this year, but Dix said Tuesday the focus on primary and community care is the future of health care.

"This plan does not have big-ticket items but it does what's necessary and focuses on the things that are necessary," Dix said at a campaign stop at the South Granville Seniors Centre, located in the Vancouver-Fairview riding of Liberal Health Minister Margaret MacDiarmid.

Dix pledged $70 million over three years to home support and community care for seniors and those with chronic conditions. Another $35 million would go toward improved residential care services and $35 million for mental-health treatment for children and youth. Lack of mental-health services for children and youth under the Liberals has been the focus of strong criticism by the province's children's watchdog.

An NDP government would also invest $45 million to improve rural acute-care services and for rebuilding surgery, obstetrics and critical care departments in rural hospitals, Dix said.

Dix had some rare praise for his Liberal rivals, commending the previous government for placing nurse practitioners in communities throughout the province.

"There has been some good work done by the present government in this regard. We need to build on that."

The praise ended there.

The New Democrat leader said the Liberals have significantly underfunded health care, and the spending projections in the last budget are not realistic.

"If they're re-elected they'll do one of two things: One, acknowledge that their budget isn't credible, which is very likely and two, cut health care services and that's a key issue in this election," he said.

In Comox, Clark disagreed.

Despite the tight rein her government is keeping on government expenditures, she said they have committed to an increase in health spending.

"We're adding $2.4 billion to the health-care budget over the next three years," she said during the campaign stop at Comox Valley Hospital, a new 153-bed facility that will replace St. Joseph's Hospital, which opened its doors in 1913.

The hospital is expected to be in operation by 2017, a $334-million project with the province picking up 60 per cent of the cost and the Comox-Strathcona Regional Hospital District the rest.

"We have by far the smallest growth in government spending over any government across the country. But that doesn't mean we don't add to the health care budget. We do," Clark said.

The provincial budget released in February held health spending growth to 2.6 per cent annually in the coming years. The last time growth was that low was in 1996 during a major recession.

By 2015-16, the annual price tag for health will be $17.4 billion.

Clark said Dix has not explained where the quarter of a billion dollars for his health care promises will come from.

"We've doubled the health-care budget the last 12 years in B.C., and we've done it by keeping taxes low across the province. We've done it by growing the economy," she said.

Asked how he will control spending on health, Dix said there will be "tough negotiations" ahead in the health-care system.

He also suggested the programs announced Tuesday are less expensive options that will relieve an overburdened and more expensive acute-care system.

Bonnie Pearson, of the Hospital Employees' Union that represents about 20,000 residential and home care support workers, said the NDP plan will reduce costs and pressures on the health care system.

In particular, she lauded the funding for residential care for seniors.

"By increasing standards of care in residential facilities, and reversing cuts to home support in the community, we can reduce the number of seniors who end up in emergency rooms and hospital beds."

Every jurisdiction in Canada and around the world is trying to move toward primary and community care, said Kimberlyn McGrail, associate director of the UBC Centre for Health Services and Policy Research.

"I don't think I'm in a position to say whether $238 million in spending is actually what can get you there, but the logic is that you can effect a whole lot of change by dealing with that one particular aspect of the system," she said.

B.C. has started on that path, but there is not a great deal of flexibility from year-to-year to make the change.

"You can't just all of a sudden take a billion dollars out of acute care," she said, likening the change to trying to fix and airplane and fly it at the same time.