It’s like running with scissors. It’s only a matter of time before someone gets hurt.
On Oct 17, 2013, Duncan Campbell took over as interim CEO of Alberta Health Services, replacing Dr Chris Eagle who abruptly resigned with two years left to go on his five year employment contract.
Mr Campbell eagerly took up the challenge of rebuilding AHS. Within a week he’d downsized the senior leadership team and was planning to finalize the remaining leadership changes and review the functions of the zones and province-wide services by Oct 31.
He acknowledged the many parts of the organization had been in crisis mode and needed to turn to “calmer, safer waters”. He said clinical operations would be a priority. He was going to reinvest in “underserved” areas like children’s and adolescent’s mental health and hospital acquired infection. He wanted feedback and planned to set up a blog.
He also set up a twitter account…(cue ominous music)…and when the $3 billion Edmonton super-lab crisis broke Mr Campbell tweeted that AHS would not seek bids until it engaged in further consultation with staff and physicians. Health Minister Horne quickly “corrected” Mr Campbell’s tweet saying the $3 billion RFP was proceeding and Mr Campbell was simply commenting about consulting (huh?).
Two weeks later Mr Campbell was gone, well not gone, gone, but shuffled back to the CFO office to make room for two interim co-CEOs, Brenda Huband and Rick Trimp, who will hold the place together until the third CEO in three years climbs on board.
This Keystone Kops story would be funny if it wasn’t so downright dangerous.
The departure of a CEO unsettles any organization, even when the departure is a part of an orderly retirement/succession plan. It’s doubly unnerving when the CEO (Duckett) is replaced by the CEO (Eagle) who’s replaced by the interim CEO (Campbell) who’s replaced by two interim co-CEOs (Huband and Trimp) who are under the control of an Official Administrator (Cowell) who replaced the previous Official Administrator (Davidson) who replaced the board of directors (Stephen Lockwood) who were fired by the Health Minister (Horne) who replaced the previous health minister (Zwozdesky)—all in the space of three years!
What if Minster Horne trips while running with scissors?
Healthcare in Alberta is under siege. Emergency rooms are packed, patients are stacked up like cordwood in hospital corridors, surgical wait times exceed national standards, the privatization of home care is a bust, the “transformation” of the nursing profession is code for “cutbacks” and “de-skilling” and the Auditor General says infection prevention and control in our hospitals is below par.
So what happens if Fred Horne refuses to put down those scissors and someone gets seriously hurt? Can they sue the government?
The Supreme Court of Canada* held that law of negligence applies to governments just as it applies to individuals unless (1) the government is statutorily exempt from liability or (2) the governmental decision that resulted in harm or injury was a “policy” decision, not an “operational” one.
Historically the Crown (government) was an extension of the King or Queen and immune from litigation. Thankfully that was then, this is now. Today the Crown has the same liability for its acts and omissions as a person so we’ve cleared the first hurdle.**
“Policy” vs “operational” decisions?
In an example of delicious irony, we’re carried over the second hurdle by none other than former Health Minister, Mr Zwozdesky. He’s made it crystal clear that the Dept of Health is the strategic arm of the government, responsible for policy, strategic direction, global budgets and physician’s compensation and AHS is the delivery arm that puts it all into effect.”***In other words, decisions made by AHS are “operational” decisions which can be the basis of a lawsuit.
Duty of care?
And that gets us back to the law of negligence. The government, in the form of the Health Minister, owes a duty of care to Albertans to “promote and protect” their health.****
The constant meddling by the Health Minister in the effective operation of AHS culminating with the precipitous demotion of Mr Duncan (just one month after he assumed the CEO role) is a key piece of evidence supporting the argument that the minister’s desire to organize, re-organize and re-re-organize AHS has seriously compromised AHS’s ability to deliver health services to Albertans.
Albertans who have suffered or, heaven forbid, perished as a result of the minister’s interference will rise up and say that’s it, no more. And if they’re not prepared to wait until March 2016 to oust this pathetic government they’ll turn to lawyers for assistance. And when they win, and I’m wagering they will, the taxpayers will foot the bill.
And guess what, it will be worth it to pry those scissors out of the health minister’s grasp.
* Just v. British Columbia,  2 S.C.R. 1228 http://scc-csc.lexum.com/decisia-scc-csc/scc-csc/scc-csc/en/item/550/index.do
**Proceedings Against the Crown Act, section 3(a)
***Hansard, Apr 13, 2011 p 645.
****The Government Organization Act and the Regional Health Authorities Act, Mandate Letter from Premier Redford.