Justice Vertes released the results of the Preferential Access (Queue Jumping) Inquiry this week. Health Minister Horne heaved a huge sigh of relief. Vertes found that allegations raised by Dr Duckett (former head of Alberta Health Services) and Dr Sherman (Liberal leader) were unfounded and there was no evidence that MLAs used their influence to get preferential treatment for themselves or their family and friends.* Whew!!
Mr Horne was so busy gloating that he failed to tell the public that Vertes had indeed found numerous cases of queue jumping right up to the time of the Inquiry itself.
The queue jumping incidents fell into two categories:
- the gong show that passed for the government’s response to the H1N1 pandemic: Alberta Health Services (AHS) improperly inoculated the Calgary Flames hockey team and their friends and families, the friends and family of a group of Edmonton nurses and the non-essential administrative staff at the Red Deer Michener Centre, and
- an influential Calgary doctor (Dr Bridges) used byzantine booking and referral practices to fast track colonoscopy screening tests for his own patients and those from the Helios concierge clinic.
Mr Horne also failed to explain that Vertes found a system riddled with opportunities for queue jumping, including:
- AHS executives making “courtesy calls” to hospital staff to give them a “heads up” that a VIP was in the building
- expediting treatment for elite athletes
- allowing doctors and AHS executives to interfere with the emergency care and triage process for certain patients and
- allowing doctors to send patients to Emergency through the “private patient path”. Heads up, my patient is coming through.
Most importantly Mr Horne failed to mention that these queue jumping and near-queue jumping episodes occurred on his watch.
Justice Vertes did a remarkable job given that he was hamstrung by the PC government from the outset—the Inquiry was restricted to queue jumping that “is occurring”.
Vertes did his level best to consider “background circumstances” despite strenuous objections from the government, the AHS and the Alberta Medical Association. He created a public uproar when Mr Horne tried to shut down the Inquiry prematurely.
Vertes identified serious systemic issues and issued 12 sensible recommendations to address them. They should have been adopted in a heartbeat without qualification; but Mr Horne balked on three, saying that he’d accept them “in principle”, but not as written because “they involve legal changes potentially and …some consultation.”**
“In principle” is legalese for wiggle room. Apparently there’s something about these three recommendations that troubles Minister Horne.
The “in principle” recommendations***
Recommendation #1 closes loopholes in the law that could otherwise allow improper queue jumping. It also requires people to report queue jumping violations and protects them from reprisal if they do so. Mr Horne balked.
Recommendation #2 provides whistleblower protection to all healthcare workers, including doctors who are contractors. Interestingly this change would provide whistleblower protection well beyond the queue jumping issue and would allow a contractor to sound the alarm over any improper behavior without fear of reprisal. Brilliant! Mr Horne balked again.
Recommendation #7 protects patients by creating an independent Health Advocate to advise them and help them resolve complaints. Hello accountability and transparency! Mr Horne balked a third time.
Whistleblowing and independence. Notice a trend here?
Mr Horne’s objections
Mr Horne says he accepted these recommendations “in principle” only because they may require legal changes and consultation. Let’s talk about consultation. He’s accepted, without qualification, five other recommendations that require consultation so the consultation excuse is a red herring.****
All that’s left in Mr Horne’s quiver is the excuse that these recommendations may require legal changes. This is rich coming from a majority government that slammed through the .05 drunk driving legislation and throttled the public’s right to be heard under the new Alberta energy regulations.
By requiring doctors to report abuses of the system and protecting them from reprisal, Recommendations 1 and 2 give our doctors “air cover”. They can speak out, notwithstanding their confidentiality agreements and are protected from bullying if they do so.
Recommendation 7 gives the public access to better healthcare by creating an independent advocate who will help them navigate through the healthcare system and resolve their complaints. This is a stark contrast to Mr Horne’s proposal for a puppet Health Advocate who is paid by and reports to the Health Minister.
Where’s the harm in that?
Mr Horne had a choice. He could have accepted Recommendations 1, 2 and 7 without qualification, in accordance with Justice Vertes’ belief that they give healthcare professionals “added safety” and “increase transparency and public confidence in our healthcare system.*****
Instead he reverted to form and is working feverishly to maintain iron-fisted control over the healthcare system. No doubt a smoke and mirrors “consultation” process and legislative tweaks purporting to implement these recommendations will be announced soon.
Then Mr Horne can bury the Vertes’ Inquiry Report in the same place that the PCs stashed the AHS Governance Report and the Groeneveld Flood Mitigation Report…and call it a day.
The Inquiry cost $7 million. Countless brave witnesses came forward to tell their stories. We deserve better.
*Government News Release, August 21, 2013
** Calgary Herald, Aug 22, 2013, A3
***Recommendation 1 would amend section 3 of the Health Care Protection Act; Recommendation 2 would amend the Public Interest Disclosure (Whistleblower Protection) Act
****Recommendations 3, 5, 8, 10, and 12 all require consultations among one or more of the government, Alberta Health Services, other sectors of the health care system and the public.
*****Inquiry Report, pp 116, 153, 154