Thursday, February 01, 2007

A dangerous disease

The Tyee has had another couple of excellent articles this week on the damage being done to B.C.'s health-care system by Gordon Campbell's Lib government. Will McMartin started off by pointing out the incestuous relationship between big B.C. business and the health-care structure set up by Campbell. But even more striking is Tom Sandborn's report today that Campbell's anti-public sector stance has been so extreme as to force one of the province's big-business appointments (among others) to resign over the constant interference:
Top officials at the Fraser Health Authority opposed the provincial government's preferred P3 form of privatization in health care this summer, only to have Premier Campbell overrule their recommendations, recently released documents show.

The chair of the Fraser Health Authority at the time, Keith Purchase, made headlines last week by resigning his post, a move said to be caused by his frustration at being "out of the loop" in the budget process.

The revelation that the Fraser Health Authority also was at odds with the premier's office over how to finance facilities may shed further light on Purchase's frustration.

Excerpts from minutes of the health authority's facilities committee meetings in February and June of 2006, obtained through a freedom of information request by the B.C. Health Coalition and released to the public Jan. 31, 2007, show that Purchase was directed to meet with deputy health minister Penny Ballem and deputy finance minister Tamara Vrooman to convey the view of the Authority's top officials that "P3s are not the first choice of the committee."...

Both Ballem and Purchase have since resigned from their positions, Ballem in June and Purchase last week. Ballem cited her disagreement with the direction B.C. was taking in health care as reason for her resignation, and Purchase's unexpected resignation last Friday was widely reported to be in response to the government's decision to fire Vancouver Coastal Health Care Authority chair Trevor Johnstone, a longtime friend and business colleague.

In (an) excerpt from committee minutes dated Feb. 13, 2006, the point is made that "...if we undertake the traditional partnerships strategy (P3) there is a lesser ability to control design, longer lead times and additional risk."...

Today's revelations come at a time when some observers say the administrative structures controlling B.C. health delivery are in serious disarray. Vaughn Palmer reported in a column in the Vancouver Sun Jan. 31, for example, that Purchase had explained his sudden resignation from the Fraser Health Authority in an e-mail to senior colleagues that said he was leaving in part because of Johnstone's firing, but also because of government demands that he follow "a budget process which compelled me to keep my board colleagues out of the loop."

Purchase went on to say "I feel that decisions beyond our control are about to take Fraser Health rapidly backwards and this has become an affront to my personal integrity."
Now, if Campbell and his administration really believed that the P3 structure was the most efficient based on a fair comparison, it would only make sense that they'd try to make that case for B.C.'s health regions rather than simply imposing it by fiat. Instead, though, it appears that those who know the health-care system best have been able to see through the empty promises of P3s.

In response, given the choice between pushing his preferred structure or allowing the province's health-care system to operate effectively, Campbell has made clear that the former is going to be his top priority. Which should only offer yet one more indication that the only reasonable outcome of B.C.'s current health-care "conversation" is a conclusion that the greatest obstacle to a sustainable system is the party currently in power.

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