The state of Alberta healthcare is the most important issue facing Alberta voters—and it’s resting in the hands of squints and politicians. Lord help us!
A “squint”, like his compatriots the geek and the quant, is a highly trained technical person specializing in data collection and analysis. They’re lovely people but have been known to miss the forest for the trees. A quick read of the Health Quality Council (HQC) report on the problems of our healthcare system makes it clear that the 20 odd (and I mean that in the nicest possible way) people who compiled the report are predominately in the squint camp.
The story of the squints and the politicians starts on June 7, 2011 when Ms Redford broke from the pack of PC leadership hopefuls and staked her political career on a promise to call for a public inquiry into “charges of political interference in the provincial health-care system”*. Remember that on June 7, 2011 the only way to call a public inquiry into healthcare was under the Public Inquiries Act.
Like so many Two Minute Tories, I made the mistake of voting for Ms Redford and helped her capture the premiership by a very slim margin. It simply hadn’t dawned on me that once elected Ms Redford would slip the noose of her political promise by enacting a new piece of legislation**to give the Health Quality Council (the squints referred to above) the power to hold a watered down “public inquiry”.
It took 3 months for the new HQC Act to be proclaimed. Meanwhile Ms Redford ordered the HQC to investigate the issues. When asked if this was a needless duplication of effort given that the HQC would soon be conducting a public inquiry, Ms Redford replied that the HQC report would set the terms of reference for the inquiry. This is a very important point that I’ll return to later.
The mandate of the HQC is to measure, monitor and report—this is what squints do best—and the HQC performed its duties well.
It found that emergency department wait times exceeded the Canadian guidelines by 10 to 20 times in a significant number of cases. No surprise there to anyone who’s spent 22 hours in the ED waiting for someone, anyone, to treat them. It found no evidence of needless cancer deaths, but noted there were legitimate concerns with managing the lists and that these concerns had been addressed.
Most importantly, it found substantial evidence of physicians being threatened, censured, bullied, ridiculed, punished and at risk of losing their hospital privileges or positions.
This is where being a squint has its limitations. Much to Ms Redford’s surprise, the HQC recommended against a public inquiry. Instead, it suggested two task forces be set up to sort out the roles of the government, Alberta Health Services (the doctors’ employer) and the College of Physicians and Surgeons (the doctors’ disciplinary body) versus the doctors. Rather like taking your kids on a long car trip and drawing a line down the middle of the back seat so that they can make it to your destination without killing each other.
The HQC’s mind is made up. It will not come to a different conclusion in the public inquiry. Lawyers call this fettering the jurisdiction of an administrative/quasi judicial panel. It would normally be grounds for appeal…but for the fact that the HQC Act prohibits appeals.
So where does that leave Ms Redford? Should she order the public inquiry anyway? If so how will she force the HQC to set terms of reference for an inquiry it says is unnecessary?
The only way out of this mess is to ensure that the HQC inquiry hears fresh evidence that might lead to a different outcome. Past and present health ministers, their top bureaucrats and the administrators must be called to testify. Did Mr Liepert roll up the 9 health regions into the mega AHS so the government would have more control over the doctors? Mr Zwozdesky and Mr Horne, please explain why, after 4 years of operation, the lumbering AHS bureaucracy has finally managed to bring the state of healthcare back to where it was in 2006. (No that’s not a typo.)
And most importantly, doctors who’ve been bullied must be called to identify who bullied them, how they were bullied and how this impacted patient safety. Once all the facts are made public, the bullying will stop because the bullies can’t hide.
The squints cannot set the terms of reference for the inquiry because they’ve already neutered themselves. It’s now up to Ms Redford. She must set broad terms of reference to capture this fresh evidence. If she does, her ministers and former ministers will testify. If she doesn’t, she’ll continue to tap dance, hoping that we’ll be dazzled by the coming election rhetoric and lose sight of what’s really going on here.
Over to you Ms Redford.
*Calgary Herald, Feb 25, 2012, A4
**Health Quality Council of Alberta Act, SA 2011, c H-7.2