Saturday, January 27, 2007


One firing, two resignations. And that's just in the past 3 weeks.

Make no mistake about it - British Columbia's Health Care, which accounts for half of all provincial spending, is in crisis. Even the near-Billion Dollar top-up from Finance Minister Carole Taylor won't do the trick.
First it was the Deputy Health Minister, Dr. Penny Ballem who walked. She warned Premier Campbell that his plans for rejuvenating the system were unsound.
Then, last Wednesday, Health Minister George Abbott, back from a vacation barely long enough to put away the paba oil for another year, fired Trevor Johnstone, the chairman of the Vancouver Coastal Health Authority.
And last night, Keith Purchase, the chairman of the Fraser Health Authority, walked out.
All three of these people were recruited by the Premier. All are seasoned professionals, and in the case of Johnstone and Purchase, business executives with winning track records in the private sector.
All three have said there is not enough money in the system.
That may, indeed, be so.
But are there not some other core issues that neither the Premier nor the Health Minister have the wit or courage to address?
The first problem is the 5 regional Health Authorities and one provincial authority themselves. Are they not yet another needless, expensive, meddling level of bureaucracy needed by absolutely no one? This current obsession in government local, provincial and federal, with "an integrated approach" is getting us all nowhere at lightening speed.
Hospitals are big enough and stiff enough with paper that grouping 4 or 5 hospitals in a locale together under a centralized authority only adds to the waste of essential resources - money, people and time. Let hospitals be responsible. Let them be answerable. If they're not doing the job or over-spending or buying the wrong stents, then let the province deal with them.
The Regional Health Authorities do for the Provincial Governments exactly what School Boards do. They provide a Fall Guy when the stuff hits the fan.
The second problem is that nobody - and that includes doctors, hospitals, health boards, or the provincial or federal governments - is willing to eyeball the costs of service.
At Jiffy Lube, the operator knows how much a gasket costs him and he knows how much it costs him to install one in your car. If he didn't, he'd have to close his bay doors.
But we are absolutely unwilling to assess the cost of an angioplasty or hip replacement. We know how many surgeons, nurses, orderlies, and cleaners we'll need. We know the cost of the equipment used and the equipment installed and the equipment discarded, the costs of the tubes, gasses, cylinders, etc.
Why then the reluctance to say an open heart procedure will cost the commonweal $6,718.43 or whatever the amount truly is? When Ujjal Dosanj was the Federal Health Minister, he said openly on the radio with me that this kind of accounting was impossible.
I would say it is impossible if you want it to be!
We may in fact need to transfuse our health care system with more green. But we might start with a little grey matter and a lot of vigorous red-blooded honesty.