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.
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?
**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.