When “The Duchess” says jump, you jump! Sheila Weatherill testifies at the Queue Jumping Inquiry

Has the public inquiry into preferential access (queue jumping) into healthcare been a colossal waste of time?  Not on your life!

The inquiry created a window, rather like that in the cannulated cow, into the byzantine and sometimes Machiavellian antics of our MLAs, the ministry of health, the government-controlled Alberta Health Services (and its predecessor health regions) to see how they responded to Albertans desperately seeking healthcare for themselves and their families.

Ahh, where to start…?  Well, how about Sheila Weatherill, or The Duchess as she’s known in some circles.

Cover of "The Duchess"

Cover of The Duchessin some circles?

Sheila was the CEO of Capital Health (Edmonton region) until it was rolled into Alberta Health Services (AHS).  She picked up a cool $3.2 million in severance,* breezed through the revolving door of Tory patronage, resurfaced on the AHS board of directors (surprise) and then abruptly resigned in the wake of the Merali expense scandal.

At the queue jumping inquiry Sheila described a convoluted “back channel” protocol that was available to VIPs.  To be fair to Sheila she didn’t call it this.

Here’s how it worked.  A VIP (a “prominent person”, a financial donor, a celebrity, an MLA, an MLA’s constituent, or a member of a VIP’s family, staff, or entourage) would place a call directly to Sheila, the CEO of Capital Health, to let her know that they (a) were having difficulty getting treatment at a facility in her jurisdiction, or (b) would be admitted shortly to a facility in her jurisdiction, or (c) were, heaven forbid, stuck in the ER in a facility in her jurisdiction, or (d) disagreed with the clinical advice they’d received from a facility in her jurisdiction.

Sheila got right on it and made a phone call.

She characterized her calls as one of two types:  The first was the “navigational” or “advisory” call to help the VIP find his/her way through the morass of healthcare services.  She provided this service notwithstanding the countless individuals like Lynn Redford who were employed by the Capital Health Region to provide exactly the same service.

The second was the “heads up” or “awareness” call in the case of a VIP with “extraordinary privacy issues”. She provided this service notwithstanding the fact that the patient could be admitted under an alias if security or confidentiality were an issue.

Like a spark running along a lit fuse, Sheila passed the confidential information about the VIP to Michele Lahey, her Chief Operating Officer, or Deb Gordon, a VP who reported to Michele. (1057)**

The Duchess was blissfully unaware of what happened next.  Lahey and Gordon did not report back because Sheila “had full confidence that they would know what to do with that information” (1061).

So what did they do with that information?  Guess.  Yep, they made a “context” call to a senior executive at the facility, often the executive on call.  They told the exec on call that Sheila needed information; or that Mr VIP was going to be admitted or that Mr VIP was a donor who’d raised scads of money for the hospital or that Mr VIP’s spouse was worried about her husband who was in considerable pain and stuck in their overcrowded ER.  They asked: “Can you just check and see how he’s doing?” (753).

The executive on call would touch base with the front line staff to check on these patients and relay the information back up the chain to Sheila (who you’ll recall denies requesting feedback).

The front line staff thought this protocol was disruptive and annoying.  In the case of the VIP stuck in ER, the exec on call directed the triage nurse to check on the patient and bring in an ER physician to determine address his pain issues.  Yep, that would be disruptive.

Nevertheless, this level of intrusion was necessary because, in the words of Brigitte McDonough, a senior operating officer at the University Hospital, who reported to Deb Gordon, who reported to Michelle Lahey, who reported to The Duchess, “…it was very well known that when Sheila wanted something, you jump” (797). 

The big question is what did Sheila Weatherill hope to achieve?

Sheila says the purpose of her calls was to ensure the facility was aware that a VIP was coming so that it could factor this information into “their general knowledge of what’s happening in their facility.  There would be no expectation, no direction given, no expectation of any extra service.  That’s the role of physicians and clinicians to decide.” (1063).

So why are senior executives ordering triage nurses to pull in ER doctors to check whether a certain patient’s pain is manageable?

I’m confused.  And so is Judge Vertes, the Chairman of the inquiry.  He asked The Duchess a number of questions.  If hospitals have procedures in place to deal with privacy concerns and every patient is dealt with the same way, what makes a patient’s privacy concern “extraordinary” to the point where it requires a call from Sheila Weatherill?

Sheila’s response?  The patient would be more recognizable “…and it was – and it was – was a prior – was private and so –“… at this point she spluttered to a stop (1144).

Sheila Weatherill states that she “has no information” indicating that her phone calls resulted in a particular patient receiving expedited or preferential care (1130).

My concern is this: in a relationship where there is a power imbalance between the CEO of Capital Health who writes the pay cheques and the healthcare providers who work for her, there is no such thing as  a “heads up” or “courtesy” call.  There are simply “strings attached” calls.  Unfortunately these “strings” required healthcare providers to grant preferential access or preferential treatment to certain Albertans at the expense of others.

The fact that Sheila Weatherill and her staff failed to recognize this is disheartening.

How will we ever eradicate preferential access to healthcare if the MLAs, government bureaucrats and AHS executives don’t recognize that they’re providing it in the first place?

*http://www.canada.com/calgaryherald/story.html?id=a0049288-afe5-4971-8414-b5933497123a

**Numbers in brackets refer to page numbers in the inquiry transcript.

Here’s my very own “heads up” or “awareness” note to you:  The inquiry into preferential access to treatment is brimming with fascinating tidbits of information.  Stay tuned.

 

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13 Responses to When “The Duchess” says jump, you jump! Sheila Weatherill testifies at the Queue Jumping Inquiry

  1. Glad to hear that the enquiry has not been a colossal waste of time, that Sheila comes across to me as a very vindictive individual , this has been very informative and you are to be commended for digging into this mess Susan.

    • Thanks Tom…and yes it is a mess. I have a friend who’s attended every day of this inquiry (she deserves a medal!). She was amazed by how little the heath care practitioners seem to know about anything outside of their orbit of responsibility. Makes you wonder whether more cross-functional linkages would reduce the waste and inefficiency.

  2. Carlos Beca says:

    Susan I do not think the enquiry to be a waste of time and money at all. I agree with you 100% and astounds me that so many people do. This is just one more example of our so called first world spin diseased mentality. This is the new world of of garbage engineers rather than garbage pickers. The queue jumping call is now called courtesy call. What a bunch of predators. On top of it all no one recalls anything, no one heard anything and no one did anything to serve the duchess – yeahh right it sounds like the marijuana smoking without inhaling.

    • Absolutely right Carlos. What surprises me (although I don’t know why it should) is the media’s superficial coverage of the inquiry. Sure they’ve picked up some flashy headlines but they haven’t bothered to dig behind the story to understand how the health care system got into such a mess. Raj Sherman pointed out that queue jumping only occurs when there’s a queue, a queue forms because the health care system is overcrowded and overcrowding occurs because of a lack of funding or investment in health care. And for this we can thank Ralph Klein and the Tories who followed in his footsteps.

  3. Phil Elder says:

    Well done, Susan. It will be interesting to see what the inquiry does with this information.

    • Phil, I was talking to a friend about this. Our biggest fear is that the records, including the testimony, will be buried in an internet black hole and we’ll never be able to find it again. The transcripts contain some useful sworn testimony which could be read back to the politicians when they start twisting the truth again.

  4. goinfawr says:

    Susan pardon my cynicism but if it turns out that inquiries like this start having any teeth whatsoever I’ve got money on my flank that says Alberta will find itself at the tender mercy of a US style health ‘care’ system faster than you can say “Ronald Reagan”.

    The privileged do not take kindly to the hoi polloi questioning the preferential treatment to which they see themselves as entitled. In fact it is my opinion that the only reason public care has been allowed to exist in Canada as long as it has, and with such a high level of quality, is because the Big Shots get the same level of VIP treatment as they would under a private system, but with the rest of us doing all the (proportionally) heavy lifting for them when it comes to the price.

    Rock the boat though….

  5. Goinfawr, you raise a valid point. I did not fully comprehend just how “privileged” the privileged were until I starting reading these transcripts. If you’re a philanthropist, a politician, a doctor, an athlete, a celebrity or a friend, family member or employee of such person you’re golden and on the fast track. In the US everyone knows this, but in Canada we don’t find out about it until something goes off the rails and the matter goes to a public inquiry. We were naive once, but no more!

  6. Julie Ali says:

    I am surprised by the level of fear that folks have about talking about anything with reference to the Tories –either the regular version or the Wildrosies.
    But I guess I shouldn’t be looking at what happened to the physician who yapped about cancer rates in northern Alberta.

    The level of fear and discomfort about speaking in public spaces about the oil industry and the oil industry parties— must say something about the control that the oil industry has over everyone that no one will even talk about matters like the oil royalty rate.
    And yet we own the resources.

    Here is a public inquiry which is full of the lies or 1984 speak of one oil industry front party.
    I suspect that most Albertans will look at this and shrug and ignore it.
    This sort of dishonest manipulation of the system—using the system is so accepted now in Alberta that we would be surprised only if it did not happen.
    The body of democracy is corrupted in Alberta –in my opinion.
    And imagine if we had an inquiry into doctor intimidation!

    If the current oil industry folks in government lose their jobs in the next election, the next set of oil industry folks in government will finish the job in education and health begun by the current oil industry folks. Public health care is already gutted. And with the Wildrosies, we would have private health care for the rich as well as the poor and unable to pay. We’d better start buying lottery tickets to fund our own health care then.

    In Alberta—only the oil industry is happy—all the major political parties are representing them.

    As for citizens? Well if you vote for the same version of the same sort of abuse in government–you are going to get the same sorts of black eyes and broken bones. Progressive Conservative Party or Wildrosies–they’re both different forms of the same virus.

    Time to vote for a non-oil industry party and then keep a sharp eye on them.

    • Right. The oil industry, well the entire energy sector, has far too much influence over our government. Witness how they destroyed Stelmach’s attempt to increase royalties. Stelmach called it getting our fair share, but the oil and gas industry wasn’t prepared to part with a penny more than they had to. They threatened to leave if the royalties were hiked, then backed up their threat by shutting in wells (primarily gas) and moving to Saskatchewan where the royalty regime was more favourable. What they didn’t tell us was that natural gas prices had started to tank and they’d have shut in production anyway. So they took advantage of a slump in the natural gas market to make a point and the government (fools that they were) decided not to increase the royalty as much as it had originally planned. Very unfortunate. All of which supports your point Julie that we need smarter people with some backbone in the Legislature.

  7. Carlos Beca says:

    Talking about the oil industry, here is some more interesting reading.

    http://www.huffingtonpost.ca/2013/01/16/oil-industry-canada-norway_n_2491761.html?utm_hp_ref=canada

    • Excellent article Carlos. It eloquently makes the point that if the government is in the driver’s seat, the people may actually see some real benefit from the resource that belongs to them. I see that Horne is traveling to England, Ireland and Brussels to learn about efficient health care management. What a shame that the government didn’t travel to Norway to learn something about the efficient development of our natural resources before it started giving it away for a song.

      • Carlos Beca says:

        Susan – they are not allowed to travel to Norway for two reasons:
        First the Oil Companies want them as stupid as possible in terms of royalties. They want them affraid of any move in that direction. You mention that on your post in relation to Stelmach’s government
        Secondly Norway is a Social Democracy remember. They are like the vampires in the Vampire series on TV – they take children at night and they have socialitis a very serious disease caused by too much exposure to socialism. Just read the sun once in a while and you will know all about it. Albertans have to stay away from anything that sounds like it. I have to read it, or look at the pictures every morning because the owner of the Second Cup I go to does not like the Edmonton Journal. Way too Liberal I guess.

        Horne is going on another vacation to Europe. So many of them have travelled everywhere and we still do not have emergency rooms. Well of course if Horne gets sick he is not going to wait 6 hours to see a doctor right?

        Well the enquiry brought another new experience of the private clinic in Calgary and despite the fact that the two tier system is not in place yet, they have been kind enough to show us how it will work. 🙂
        These people are not even smart enough to hide their predatorial instincts.

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