Dr Raj Sherman is a passionate man. He’s been an outspoken advocate for healthcare since 2006 when he told the Edmonton Sun that an 11 day wait in ER was unacceptable. He came to the attention of the PCs who urged him to “get out of the headlines” and “come inside” where he could truly make a difference.* He was elected MLA for Edmonton-Meadowlark in 2008 and became the junior minister for health. He thought he could transform the system. He was dead wrong.
Healthcare services were slashed. Health ministers came and went. Small improvements were made, only to be lost again under a new regime. And the population of Alberta kept growing. Dr Sherman was reduced to pleading with healthcare professionals to work “within the system” in the hope that the PCs would someday recognize the depth of the crisis. At the same time a culture of intolerance and retaliation spread throughout the health regions.
It makes you wonder: who is Dr Sherman and why does he continue to fight for healthcare? Rajnish Sherman grew up in India. He comes from a family of doctors on his mother’s side. He describes his father’s family as “freedom fighters” and credits his paternal grandfather with convincing a group of dissidents that bombing the Indian Assembly was a bad idea (they set off a symbolic firecracker instead).
Raj speaks of his grandfather, a rural doctor, with great respect. He describes an evening when the moon was high, the sky was soft and hyenas were baying in the background. His grandfather said: there are three things in this world you cannot hide—the sun, the moon and the truth. His grandfather told him that Raja means king. Nish means night, moon. You are the king of the moon.
Fast forward to today. Raj Sherman has learned a harsh lesson—being “on the inside” did not equate to having the power to fix the healthcare system. In fact, by going inside Raj was silenced. His efforts to find a middle ground between the politicians and the ER doctors were thwarted. His colleagues, frustrated and disappointed, took matters into their own hands and wrote numerous letters to the Premier and health minister between 2008 and 2010.
The public was blissfully unaware of these letters until Oct 2010 when Dr Parks wrote to the Premier and health minister describing 322 cases of compromised care in an overburdened ER in Edmonton—and the letter was leaked to the press. Finally Dr Sherman had had enough: the values of the Tory party and his loyalty to that party collided with his values as a physician and the values his grandfather taught him on that starry night in India. He took his arguments to the Premier and was expelled from the party.
Passionate people are well advised to work closely with dispassionate people when navigating through volatile situations. Initially Dr Sherman attacked the Tories head on. His allegations of a cover up of cancer deaths went pear-shaped and threatened to destroy his credibility. Luckily he was saved by the growing controversy over the stalled Alberta Health Services (AHS) review of the 322 cases and the Premier’s flat out refusal to conduct a public inquiry into the matter.
Dr Parks played a pivotal role in this process. His response to the Premier’s statement that the AHS was capable of conducting the 322 review was clear and unequivocal—it won’t happen. Dr Parks also rejected the Tories suggestion that the Health Quality Council (HQC) could conduct the investigation. His rationale makes sense for a number of reasons.
First, a culture of intimidation and retribution permeates the AHS (and the government for that matter). Doctors who advocate for their patients or criticize government plans to close beds, downsize staff and mothball facilities find themselves the target of smear campaigns and complaints to the College of Physicians and Surgeons. Retribution is swift and sure.
Take the example of Dr McNamee. He raised concerns about wait times for cancer surgery with the Tory caucus in 1999. He lost his position and his reputation when his mental and professional capabilities were impugned. Dr McNamee sued the health authority and the two doctors who managed it. The case was settled and Dr McNamee moved to the US. He now teaches at Harvard. The important point here is that Dr McNamee and others like him whose advocacy will “… no longer be tolerated**…” are required to sign a confidentiality agreement when their battle with the health region is settled.
A confidentiality agreement is a legal contract requiring silence. The only way to speak on the matter is if the other party waives the obligation of confidentiality or disclosure is ordered by law. Given that the AHS is not about to release the doctors it has punished so that they can give a public account of their failed efforts to advocate for their patients, the only way to hear this testimony is to compel it by law, namely a public inquiry with subpoena power.
Second, doctors who are not bound by confidentiality are afraid to speak for fear of retaliation. Protection from retaliation is standard in all whistleblower legislation and is a key element of whistleblower policies for all major corporations. It exists in the AHS policy as well. However, doctors know from personal experience that the “protection” offered by the AHS policy is about as useful as an umbrella in a hurricane—just ask Dr McNamee. Since the immunity provided under the AHS policy is worthless, the doctors are well advised to request immunity from the government on the public record.
Returning now to Dr Raj Sherman. The King of the Moon has found a compatriot in the King of the Sun. Whether by accident or design, Dr Sherman’s passionate advocacy has been reinforced by Dr Parks’ analytical approach with the result that the King of the Moon and the King of the Sun are now in alignment. They are pushing for a public inquiry into the 322 cases and the 200 deaths on the wait list. They will accept nothing less to uncover the truth. And neither will we.
*Hansard, Nov 24, 2010, pp 1548-1554.
**Calgary Herald, Mar 11, 2011, p A4