Question: when is a public inquiry not a public inquiry? Answer: when the controversial testimony must be given behind closed doors. Welcome to Bill 24—the Health Quality Council of Alberta Act.
We all remember Premier Redford’s breakout moment in the PC leadership race when she promised to call a public inquiry into the allegations of physician intimidation and queue jumping. Her promise inspired non-PC voters to come out in support of the one PC candidate we thought would shine a light on this horrific problem.
But as soon as Ms Redford moved into the Premier’s office she changed her tune. There would be no public inquiry under the Public Inquiries Act. Instead she tabled Bill 24. The question on everyone’s mind was why. Was it a bait and switch on Ms Redford’s part or had she been brought into the picture by the present and former Health Ministers and now realized that a true public inquiry was out of the question, especially in an election year?
In any event Bill 24 just doesn’t cut it. Here’s why.
At first blush Bill 24 and the Public Inquiries Act appear to be similar. Both provide the coercive power to compel the attendance of witnesses and force them to produce documentation. Both carve out exceptions which allow documents to be kept confidential and testimony to be given in camera. However, unlike the Public Inquiries Act, Bill 24 expands the power to shroud documents and testimony in secrecy and fails to set up a system of checks and balances to ensure that this power to remain hidden is not abused.
For example, both the Public Inquiries Act and Bill 24 allow an inquiry to go behind closed doors if making the information public “would be injurious to the public interest”. This is a nebulous concept at the best of times; but it is made worse in Bill 24 by the addition of a second exception. The HQC Panel may shield the information if it’s essential to do so “in the interests of justice”.
This raises the prickly question of what kind of information would be “injurious to the public interest” or against the “interests of justice”. The only way to determine whether the HQC Panel has interpreted either of these lofty concepts correctly is to take the question to a court of law.
Oops, sorry, that avenue is blocked. Bill 24 expressly prohibits any court from questioning or reviewing the HQC’s Panel’s decision to hear testimony in camera. The Public Inquiries Act on the other hand does not throw up barriers to judicial review.
Given that there’s no right of appeal at the back end, who decides what information should be disclosed in private at the front end? Under the Public Inquiries Act the only person who can make that decision is the Justice Minister—and he can’t do so at a whim. He’s required to certify that he believes the disclosure would reveal Cabinet deliberations, matters that would not be in the public interest or matters which can’t be disclosed without prejudice to the interest of others not involved in the inquiry. Making a false certificate is enough to get a lawyer disbarred so it’s not a step that is taken lightly and don’t forget—it is reviewable by a court.
Contrast this to Bill 24 which offhandedly refers to “an application” to hold the hearing in camera without ever identifying who the applicant is. Could it be Health Minister Horne who called the president of the Alberta Medical Association to express “concern” about Raj Sherman’s mental health which forced Mr Sherman to undergo a psychiatric evaluation? What about Mr Liepert who as Health Minister canceled a public awareness campaign about a syphilis outbreak—a number of public health officials and doctors were terminated and Alberta’s syphilis rates spiked to Third World levels. Or perhaps Dr Wright, the Head of the Dept of Pathology who told Dr Magliocco that he’d “regret” making waves over the closure of the Tom Baker cancer labs? The list is endless.
One last point of comparison, the Public Inquiry Commission is allowed to mention in its report that certain issues were discussed in camera. However the only way that the HQC Panel’s report can allude to the existence of private testimony is if it can convince itself that such a reference is essential to the completeness and integrity of the report and is in the public interest. Good luck.
That’s why an inquiry held under Bill 24 will be a mere shadow of an inquiry held under the Public Inquiries Act. The checks and balances which weigh the interest in disclosure against the interest in confidentiality are non-existent. As a result the HQC Panel is biased in favour of confidentiality. Significant parts of the inquiry will occur behind closed doors, unbeknownst to the public.
At the end of the day the HQC Panel will recommend a process for advocacy and perhaps more decentralized decision making—and our doctors will continue to struggle with the culture of intimidation.
Ms Redford promised a public inquiry. She delivered Bill 24. Like Harry Potter’s cloak of invisibility, Bill 24 appears to be transparent but once the HQC Panel puts it on they’ll be safely hidden from the prying eyes of the public.
So much for transparency and rebuilding public trust.
NOTE: Bill 24 also amends the Health Information Act to allow the HQC to use the health information in its custody or control to conduct investigations and disciplinary proceedings relating to members of the health profession. See Explanatory Note 26(4). The HQC did not have this power before it was empowered to conduct public inquiries…why does it need it now?
Susan on the Soapbox 
Thank you Susan for explaining so well what is happening here. Most people do not know the difference and think that she is actually making good on her promise. This is all done with that intention in mind of course. Deception is always the name of the game. The destruction of the public trust and in the process democracy itself continues year after year, decade after decade. What is even more infuriating about all of this is that then they continue asking why people are so alienated from the process. They pay millions for experts to figure out what is happening. I for one have had enough of this. I may not vote in the next election at all. This is my limit. I will from now on do the best I can to destroy this absolutely disgusting system. It is as bad as the dictatorships I experienced in my previous lives. It is all a dirty game to extend power and gain prestige on the backs of the people that work so hard to build this province. Just thinking that so many people are now dying to get out of their horrible systems to get into this type of political process, some people have the courage to call democracy. This is all an illusion. Gosh it makes me sick to think that once in my past lives I believed democracy really existed in the Western World. We are nothing but free voting systems. Shame on all of us for perpetuating this kind of corrupted process and extend the life of these pseudo democracies to our children.
Thanks for your comments Carlos. What’s sad about all this is that Ms Redford started off so well. Many people who hadn’t paid attention to Alberta politics for years listened to her message and decided it was time to get engaged. They worked on her campaign, became vocal supporters and were very pleased when Ms Redford was named PC leader. It will take a very special politician (obviously not a PC) to get them engaged a second time. This is especially true for the young voters who have not yet found a way to connect to any political party.
It would seem that Premier Redford’s alterations to the capacity of the Health Quality Council, rather than calling a bona fide Public Inquiry, amount to more than “putting lipstick on a pig”: it’s more like an extreme makeover, with plastic surgery, dental work and hair extensions. However, we still end up with a member of the porcine species.
You were probably “getting warm”, Susan, about this being related to an upcoming election, or future elections (as we have been told a Public Inquiry would take a long time). I’s definitely possible that information becoming public from a proper inquiry could be damaging to the Progressive Conservatives at the ballot box.
It concerns me that important information revealed through a HQC investigation could be conveniently and arbitrarily kept “in camera”, behind closed doors, and that the public may never get answers to the serious charges of physician intimidation and political manipulation in the delivery of health care services to Albertans.
Furthermore, I’m trying to understand the new powers of the Health Quality Council to investigate and discipline health workers. Does it mean that they can hold workers to task for intimidating other workers, for instance? Or does it mean that this will be a new tool that could be used to silence people? I’m sure the lawyers for the various health unions and professional associations will be examining this.
We will be watching the whole process with fascination, hope, but also with a degree of skepticism.
Elaine, yes, I think that’s all we can do…wait. The opposition parties are working hard in Question Period and in the debates trying to bring the deficiencies of Bill 24 to light, but it’s just a matter of time before Bill 24 becomes law. The opposition knows this of course and is carrying on the debate not so much to stop the passage of this bill but to educate the medical profession, the public and the media. I’d hoped the media would have worked harder to understand the impact of the legislation but they were bamboozled by the PCs adept positioning of Bill 24 and didn’t dig any deeper. Which brings us back to your porcine analogy (which was priceless by the way). So all we can do is wait.
Thanks for your comments Elaine.
Well I am glad that someone is still excited about the process. I have to confess I feel like in those organized meetings to listen to the public. The ones we have commented on before.The report has already been written and now they will have to fake a democratic process to get to whatever conclusion is on the report. They have lots of experience and they will get there. Furthermore with the 250 strong public relations department they can get whatever spin required.
Yes Susan she seemed quite different and courageous at first. Just like in many other cases, women feel that they have to outdo their buly male counterparts and soon everything derails badly. To be honest I am not sure that she is actually the person she portrayed during the race for premier or if all of that was prepared by Carter to get people on her side. It would be interesting to know for sure what is really happening because there is no doubt that the shift is quite dramatic and it has been noticed by everyone. One never knows these days. Elections, unfortunately, are now highly organized theatrical festivals.
Carlos, someone told me that the true Alison Redford will emerge after she’s elected Premier in the next election. I think the thought is that then she’ll have the broad support of the public as opposed to the 51% of the few that voted in the leadership race and be able to do the things we’d hoped she would do. I’m not so sure this is the case, because she’s already made moves (the non-fixed fixed elections, the Bill 24 public/non-public inquiry) which fly in the face of what we expected. In any event the opposition parties are well aware of the challenge facing them. I really hope that a few more of them will be elected and the balance of power in the Legislature is redressed to some degree.
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