How Do You Spell Accountability?

It’s all over the news.  Dr Duckett has been fired over the cookie incident.  This was a decision of his employer, the AHS Board, not the Health Minister, even though:

  • the AHS Board reports to the Health Minister
  • the Board wanted to wait two weeks to see if the public furor would die down but Zwozdesky directed it to act immediately because waiting two weeks wasn’t going to accomplish anything—probably true if he’d already decided to fire the man
  • Ken Hughes, Board Chairman, was quoted as saying “The minister made his directions clear to us.  That was one of the important considerations that we took into account.” 
  • three AHS Board members resigned

But, as the Premier said when this mess started, he couldn’t discipline Dr Duckett because it was up to the AHS Board, not the Premier, to take action.  In other words, the Premier and by extension, the Health Minister, are not accountable for this decision.

So let’s talk about something the government is accountable for—providing decent health care for Albertans.  The Legislature has been locked in debate for 18 solid hours on various amendments to Bill 17, the Alberta Health Act.  The most significant amendment was proposed by Dr Raj Sherman.  He wants to add maximum ER wait times to the Act:  4 hours for standard patients and 6 hours for seriously ill or injured patients with both targets to be met 95% of the time. Dr Sherman’s targets come straight out of the Canadian Association of Emergency Physicians Position Statement on ER overcrowding published in 2007.  The 2007 position statement restates an earlier one published by the CAEP in 2000.  Obviously the problem of overcrowding and how to rectify it has been around for a long time.

Why is Minister Zwozdesky fighting this amendment?  He’s given three reasons:

  • If you include a target for ER wait times then what’s to stop others from demanding legislated wait times for cancer care, eye surgery, access to continuing care and the like?  This is the floodgates argument–you let one target in the door and before you know it they all come pouring in.  But what’s wrong with opening the floodgates in a measured fashion to add new targets as the health care system stabilizes?  Wouldn’t that ensure quicker access to treatment?
  • Including the amendment is not practical because it would make the Act unresponsive to new improvements and, to quote the Minister, “What are you going to do?  Bring that act [into the Legislature] every few months for changing, for updating, [and] go throuugh the whole rigamarole of yet another debate?  Many pieces of legislation require a high degree of flexibility in order to respond to a changing environment.  That’s why the government passes regulations.  If the Minister is fussed about putting the targets into the Act, he can expand the Lieutenant Governor in Council’s power to pass regulations under section 12 to include regulations relating to wait times.  It’s heartening to note that section 14 requires the LGC to get public input before any regulations are changed, except in the case of an emergency.
  • The amendment would invite even more lawsuits.  This is puzzling because I don’t know who the Minister is trying to protect from those nasty lawyers.  It’s not the government because the government is immune from litigation or prosecution by virtue of the Legislative Assembly Act.  It’s not the hospitals or doctors because they are already exposed to medical malpractice litigation under common law.  Adding a legislative target won’t change tort law.  It certainly has no impact on contract law.  So who’s the Minister protecting?

And what does the Health Minister recommend as a solution?  Another policy.  Something that sounds impressive on paper but is of little use when it comes to getting results.   So how do you spell accountability?  Well, it’s definitely not spelled Z-w-o-z-d-e-s-k-y.

This entry was posted in Alberta Health Care, Politics and Government and tagged . Bookmark the permalink.

2 Responses to How Do You Spell Accountability?

  1. Rose Marie MacKenzie says:

    In reading your blog I have noticed that the Alberta government appears to play by the same rules as the BC government. They gather together and make “how to lists” on how to approach resolving the problem of wait times. Instead of dealing with the actual problem of “waiting times” they skirt around all the issues that “could” possibly compromise change.

    Hopefully you won’t end up like BC, our way of taking the pressure off emergency ward wait times was to establish clinics. My husband recently went to a clinic to have stitches removed. The clinic closed at 9:00pm making it convenient to drop in after work. He arrived at 6:30pm to be told that the clinic was not taking anymore patients tonight because the patients that were already there would take them until 9:00pm to treat. So apparently the answer to “wait times” is to simply shut the door.

  2. Good point, Rose Marie. We’re all in the same boat, unfortunately its the Titanic. If the government fails to see the need for more beds, more staff and more diagnostics it is simply shifting the problem of overcrowding from one facility to another. It’s not enough to simply “shut the door” and hope we all go away.

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