I joined hundreds of fellow Edmontonians today for an afternoon rally for public healthcare at the Alberta Legislative Assembly building. Speakers included MLA Raj Sherman and his lawyer, Brian Beresh, who announced that he was starting an investigation into the whisper campaign to discredit Dr. Sherman.
I sure picked an interesting time to leave the province for a few days. After a short absence, it has been exhausting catching up on all the political games and intrigue that happened over the weekend and earlier this week.
Leaked Private Health Care Agenda
The Liberals released an internal government document (pdf) showing a drive towards increased privatization of health care in Alberta through private insurance. The document was presented to the Minister’s Advisory Committee on Health and also reported that the months-long province-wide consultation spearheaded by Edmonton-Rutherford PC MLA Fred Horne encountered a “high level of skepticism.” This skepticism was widely reported in the media and was not reflected in the committee’s final report released in September 2010.
I was surprised to read Liberal leader David Swann‘s quote that this was the first time he had seen any evidence that the government was even considering a more private approach to health care, especially since he spoke at a rally in front of the now bankrupt private-for-profit Health Resource Centre only a few months ago (HRC sits across the street from his constituency office in Calgary-Mountain View).I am willing to believe that Dr. Swann may have been misquoted, but if not he should have a chat with his caucus colleague Kevin Taft, who co-authored the book “Clear Answers: The Economics and Politics of For-Profit Medicine” in 2000.
Earlier this year, former Premier Ralph Klein admitted that he had tried and failed to privatize Alberta’s health care system:
“I tried it twice — the Third Way and the Mazankowski report — and I failed.”
– Former Premier Ralph Klein (Source: “Klein urges two-tired health system,” Edmonton Journal, January 26, 2010)
Emergency Room wait-times amendment fails
Now Independent Edmonton-Meadowlark MLA Dr. Raj Sherman‘s amendment to enshrine emergency room wait times in Bill 17: The Alberta Health Act has failed. After a long debate that started last Wednesday, continued overnight until Thursday, and resumed this week Dr. Sherman, members of the three opposition parties, Independent MLA Dave Taylor, and St. Albert PC MLA Ken Allred voted in favor of the amendment (it failed). I understand the intention of Dr. Sherman’s motion and his good intentions in general, but I have to agree with the Tories that enshrining wait-times may create more problems than solutions (or more lawsuits).
After the amendment failed, the Alberta Health Act quickly passed third reading by the PC MLA majority in the Assembly. This new law concentrates a concerning amount of authority over our health care system into the hands of the Minister of Health & Wellness, instead of the elected Assembly.
The plan sets out some goals for emergency room targets and continuing care spaces, but does not address some of the key capacity issues that are creating the problems in the health care system. With this government’s habit of constantly tinkering and re-announcing projects and plans, Albertans should not be blamed for being skeptical about politically convenient re-announcements and health care policy created on the fly.
Was Fred Horne just being “Fred friendly”?
Rumours began to emerge late last week questioning Dr. Sherman’s mental health. The whispering began after MLA Mr. Horne placed a phone call to the head of the Alberta Medical Association, Dr. Patrick White, concerning the state of Dr. Sherman’s mental health. A self-described friend of Dr. Sherman’s, Mr. Horne held a media conference last Friday clarifying that he did make the call, but it was not to discredit the Doctor.
It might just be me, but am pretty sure that calling up the head of your friend’s professional association to question the state of his mental health and then talking to the media about it does not make you a good friend (especially when this friend is an MLA and medical doctor who has just been suspended from your party’s caucus for being highly critical of their health care policies).
Like the belle at the ball, newly Independent MLA Raj Sherman is being courted by the Wildrose Alliance and the Liberal Party as MLAs continue an all-night debate on Emergency Room wait times (see the below messages sent out by the two parties on Twitter this morning).
Of course, this love is not extended by the PCs, who indefinitely suspended Dr. Sherman from their caucus earlier this week after he went public with his concerns about Emergency Room wait times and criticized former Health Minister Ron Liepert. Dr. Sherman apologized to Minister Liepert, but the Minister refused to accept anything less than a complete retraction of the comments.
On The Rutherford Show this morning, AHS Board Chairman Ken Hughes said that “we did receive very clear directions from the Minister,” which suggests that the AHS Board’s autonomy disappeared once Dr. Duckett became a political liability for the PC Government. Speaking on CBC Radio this morning, AlbertaScan editor Paul McLoughlin said that the AHS Board had initially decided to suspend Duckett for two weeks until Minister Gene Zwozdesky ordered them to revisit their decision and terminate Dr. Duckett.
In what can only be described as bizarre day, the AHS press conference announcing Mr. Duckett’s future was rescheduled at least four times yesterday. Originally scheduled for 1:00pm, the conference was first rescheduled for 10:30am, then 3:30pm, and finally 4:45pm when the announcement was finally made.
A similar incident occurred later that evening, when a media conference scheduled for Premier Ed Stelmach and Minister Zwozdesky was moved from 5:15pm to 6:30pm. Unfortunately, the media room at the Legislative Assembly was half packed with reporters by the time Liberal caucus Communications Director Neil Mackie waltzed in to let the media know that the conference had been rescheduled.
There has to be some irony in that for everything he did during his time as CEO, it was the now infamous “I’m eating my cookie” video on YouTube video that was the catalyst for his dismissal. It used to be said that you should never pick a fight with someone who buys ink by the barrel. This experience lends some credibility to a new saying, never pick a fight with anybody who has a free YouTube account.
For all his faults as the chief administrator of Alberta’s health services, removing Dr. Duckett from his position will not solve the challenges facing the system. Although Dr. Duckett was not even close to universally loved in the health care system, he did not create many of the large problems in health care. The sole responsibility for many of the problems facing our health care system fall to a government that has become accustomed to constantly restructuring, and even creating near-chaos, within a public health care system that all Albertans depend on.
Meanwhile, MLAs were in the Assembly for an extended all-nighter until early this morning to debate an amendment to Bill 17: The Alberta Health Act (the amendment was introduced by now Independent Edmonton-Meadowlark MLA Raj Sherman). Dr. Sherman’s amendment would introduce legislated wait-times for emergency room visits.
It works like this: when the number of patients in the Emergency Room hits a magic number, patients are put on stretchers and pushed to wards in the hospital where they are placed in hallways or in rooms (in many cases with patients already admitted). It does not take a health economist or health care professional to understand that pushing patients away from the Emergency Room into hallways is not a solution to this problem. This “out of sight, out of mind” approach may decrease the number of patients physically waiting in the Emergency Room, but it does not do much to actually increase patient care. It also does not deal with the root causes of why Emergency Room wait times have increased in Alberta.
Anyone who has had the misfortune of having visited an Emergency Room will see that there is a serious under-staffing problem. In many hospitals, doctors, nurses, and other health professionals are being run off their feet trying to make up for a lack of proper staffing levels. If new beds are to be introduced, so must an appropriate number of new staffing positions. Patient care will only be improved if there are medical and nursing staff to accompany new beds.
The challenges facing Emergency Rooms go beyond just Emergency Rooms.
It is becoming increasingly difficult to find a family doctor in Alberta. This challenge and limited access to urgent care centres in many communities leaves Emergency Rooms as the only option for many Albertans. When fully operational, the new East Edmonton Health Centre could provide a good model of the kind of accessible family and urgent care that people are currently turning to the Emergency Rooms for.
The reality is that many of the problems faced by our health care system have been created by constant political restructuring of the administration of the system over the past 15 years.
As I wrote last week, stability is something that has been lacking in our public health care system since Ralph Klein became Premier in 1992. Since 1995, the administration of our system has been changed from around 200 hospital and local health boards before 1995 to seventeen, to nine in 2001, and then one centralized province-wide health authority in 2008.
As the health authorities were being restructured in the 1990s, over 10,000 health care staff were laid off or had their jobs downgraded, which has led to much of the staffing issues Albertans are witnessing today.
Current Minister Gene Zwozdesky has tried to put a kinder face on the Health & Wellness portfolio, but the last major restructuring, the creation of AHS took place under the guidance of Minister Ron Liepert in 2008.
In what some political watchers believed to be an extension of a public battle between Calgary Health Region CEO Jack Davis and the provincial government, Minister Liepert dissolved the nine remaining regional health boards and centralized them under AHS (Mr. Davis received a $4 million retirement package when his position was eliminated). Minister Liepert, who was recently criticized by his former parliamentary assistant Dr. Sherman, was not known for his diplomatic skills while serving as Health Minister:
Created only months after the March 2008 provincial election, there was no mention of intentions to dissolve the regional health authorities anywhere in the PC Party election platform. The largest overhaul of Alberta’s health care system was not made in consultation with Albertans, but in closed-door meetings.
As Albertans saw with the bankruptcy of the Health Resource Centre in Calgary, the flagship for the private health care industry in Canada, introducing more private-for-profit health care is not a viable alternative. I do not believe that this is a solution to improving our health care system. The solution is to fully support and provide stability to a public system that is accessible and accountable to the general public.
While I am disappointed that the Wildrose has taken a negative tone when talking about health care, it has helped remind many Albertans about why they support a public health care system and why it is important to our society.
“Alberta Health Act”
Eclipsed by the past month of health care news is Bill 17: the Alberta Health Act, which is up for third reading this week. This Act is vacuous on details, but as enabling legislation it will allow for more decisions about our health care laws to be made in closed-door cabinet meetings, rather than in the public and open debate on the floor of the Assembly.
As we have learned from the past month and the Alberta Health Services experience, our health care system needs decision makers who are not driven by private agendas behind closed doors, it need openness, transparency, and stability. It needs some TLC.
As the only medical doctor in the PC caucus, Dr. Sherman shook the political establishment last week with a bluntly worded email to the Premier, cabinet ministers, and his medical colleagues about the state of Emergency Room wait times in Alberta. On Friday, Dr. Sherman told the Edmonton Journal that he’d “had enough” and was “fed up.” In that interview, Dr. Sherman reserved some particularly harsh criticism for Alberta Health Services Board Chairman Ken Hughes and former Health Minister Ron Liepert.
Dr. Sherman is the fifth PC MLA to leave or be ejected from the governing caucus since the 2008 election.
Long-time Calgary-Glenmore MLA Ron Stevens retired in 2009. Fort McMurray-Wood Buffalo MLA Guy Boutilier was kicked out of the PC caucus after speaking out about the state of health care in Fort McMurray in 2009. Airdrie-Chestermere MLA Rob Anderson and Calgary-Fish Creek MLA Heather Forsyth left the PC caucus to join the Wildrose Alliance in January 2010. Mr. Boutilier joined Mr. Anderson and Ms. Forsyth this summer.
There are now two Independent MLAs in the Legislature. The other is Calgary-Currie MLA Dave Taylor, who left the Liberal caucus earlier this year.
After a week-long break, MLAs returned to the Assembly for a week that started with three-sided tailing ponds and ended with an emergency debate on health care.
Emergency Debate on Health Care Edmonton-Meadowlark PC MLA and parliamentary assistant for Health & WellnessRaj Sherman got the attention he was looking for when he wrote a blunt email to the Premier, and several MLAs, cabinet ministers, and medical colleagues. The letter continued a month long media firestorm on the state of emergency room wait times in Alberta.
As Question Period ended yesterday, Edmonton-Centre MLA Laurie Blakeman succeeded in her bid to hold an emergency debate, which lasted for just over an hour and showcased some of the most passionate debate I have seen in the Assembly this year. This was the second attempt by the opposition during this session to initiate an emergency debate on this topic. A motion to extend the debate during the afternoon was defeated when a number of PC MLAs who did not want to extend their four day week on the Assembly floor (Ron Liepert, Jeff Johnson, and Barry McFarlandas tweeted by Liberal caucus Chief of Staff Rick Miller). UPDATE: Mr. Miller has commented below that his tweet was naming the three PC MLAs for not standing in support of the initial vote to have an emergency debate, not to vote against extending the debate past 4:30pm.
For Dr. Sherman, the big question is what does his political future hold? After embarrassing the Premier and his caucus on this sensitive file, it is questionable how much longer his colleagues will tolerate an independence streak. With three former PC MLAs having crossed to the Wildrose Alliance in the past year, the Tories need to balance maintaining caucus unity without being too disciplinary with their more independent-minded MLAs. This is a balancing act that has proved difficult in the 68 MLA PC caucus.
Liberal Party AGM
The Liberal Party is holding its annual general meeting on November 27 and will elect three of its executive committee members, President, Vice-President (Policy), and Secretary. Edmonton Regional Director Erick Ambtman has declared his intentions to run for President. Current President, Debbie Cavaliere, was appointed on an interim basis after former President Tony Sansottaresigned in July. Ms. Cavaliere will be seeking election as VP (Policy) and current Secretary Nancy Cavanaugh will be seeking re-election for her position.
New NDP Communications Guy Richard Liebrecht started his new job as the Communications Director for the NDP Caucus this week. Mr. Liebrecht is a former reporter for the Edmonton Sun and editor at the Hinton Parklander. Mr. Liebrecht replaces another former Sun reporter Brookes Merritt, who recently left the NDP Caucus for a job at the Public Affairs Bureau.
Alberta Party (new) media coverage
If you missed the coverage of last weekend’s Alberta Party policy conference, there is no shortage of online news stories and blog posts. Here is a run-down from media and participants of the policy convention and recent Big Listens.
Edmonton-Meadowlark PC MLA Raj Shermanshocked political watchers and his own party’s establishment this week when he sent out a blunt email taking the government and Alberta Health Services to task over emergency room wait times. Dr. Sherman, a doctor and parliamentary assistant for Heath & Wellness, had been quiet about the wait times situation until this week. Dr. Sherman told CBC that he was on the verge of quitting the PC caucus this week, a road he decided against taking after discussing his concerns with the Premier.
From: Raj Sherman
Date: November 17, 2010 7:29:44 AM MST
To: Ed Stelmech, Gene Zwozdesky , jay ramotar , “email@example.com” , dave hancock , “firstname.lastname@example.org” , Lloyd Snelgrove , “email@example.com” , “firstname.lastname@example.org”, Doug Elniski , “email@example.com” , “firstname.lastname@example.org” , “email@example.com” ,”firstname.lastname@example.org”
Cc: “email@example.com” , “firstname.lastname@example.org” , Lau Huynh , David and Elizabeth Ariano , Robert Terry Kruhlak , “email@example.com” , “firstname.lastname@example.org” , “email@example.com”, “firstname.lastname@example.org” , “email@example.com” , “firstname.lastname@example.org” , David Bond , “email@example.com” , Stan Poplawski , “firstname.lastname@example.org” , Brian Holroyd , Paul Parks, Chris Evans , Ross Purser , “email@example.com” , “firstname.lastname@example.org” , PJ White, Dave Coutts , ‘Uwe Welz’ , sandy gillis
Subject: RE: The Overcrowding Crisis
Please accept my aoplogies.
I have forwarded many old emails to the current minister and deputy minister to place into context again for the fourth minister, the fourth CEO, and the third deputy minister, the underlying causes of the healthcare system woes leading to the emergency crisis that we have on our hands today (and have had for the past 5-6 years).
Many of the emails received by me as section president and as an elected member of the legislature, from our emergency colleagues, were received in confidence and many wished for me to keep their name out of it for fear of what the government or Capital Health and now AHS would do to our privileges. With AHS’ code of conduct, I did not want to put you or anyone at risk. I am sorry that I did not remember our conversation and your willingness to share your name.
I am whole heartedly in agreement with you. Three weeks ago, I offered the current minister my resignation as the parliametary assistant as I can no longer support the halthcare decisions made by AHS as well as some of those made by our government.
The premier made a promise to the ER doctors in writing and has broken his promise not only to the ER doctors, but also to the seniors, the 1.8 million Albertans who present for emergency care and their 2 million family members, and to all frontline healthcare professionals.
I will be meeting the premier today and my progressive conservative caucas colleagues tomorrow to discuss my future in his government as my trust in him and his cabinet is severly tarnished.
I must thank you for your passion and your rebuke of me (usually, I got heck for not hiding the names. Ask Chris Evans) as well as your courage to put your neck on the line. It’s time that I also take one for my the team that I trust, the front line ER doctors. Please stay tuned for my public comments.
Thank you for reminding me why I ran for public service in the first place!
Dear Political colleagues….meet my lifelong physician colleagues.
I hope that you don’t mind, I will be passing this letter onto my elected colleagues as well.
If it is any consolation, please feel comforted with the fact that I still work on Sundays and see the disaters happening including those of my father where he waits in the emergency room like anyone else….and he has had 5 near death experience this year alone in the emergency departments. A few months ago, his ambulance was diverted from a few blocks near the UofA hospital and he arrived to your emergency department, on the other end of town and had a wonderful tour of South Edmonton when he arrived ashen grey, sweaty, suffocating, with an oxygen saturation of 70% on 16 L of oxygen….and seconds away from death!!! Thanks to the efforts of Dr. Lau Nguyen and the Grey Nuns staff…he lives today, barely!
…and please do NOT feel comforted that healthcare will be any better with AHS’ inadequate plan to deal with the crisis and disasters that we will be facing in the 4 winter months ahead.
…and now, after this email, I will await my rebuke from my political colleagues….geeeeesh…a brown guy just can’t win…As Russel Peter’s says…”SOMEBODY GONNA GET HURT”….LOL…..a little bit of humor into what is a sad and very tragic situation…
Feel free to forward to whomever you wish
A big thanks to a daveberta.ca reader for passing along this email.
– A promise is a promise, except if it’s a Carl Benito promise.SEE Magazine and the Edmonton Journal are taking Edmonton-Mill Woods PC MLA Carl Benito to task over not fulfilling his election promise to donate his entire MLA salary to a scholarship fund. According to Mr. Benito, when he promised to donate his entire salary, he did not really mean his entire salary. Mr. Benito is having a pretty tough time arguing against his own statements from election night in 2008:
On Monday night, Benito repeated his promise to donate his MLA salary (about $75,000) to a scholarship program. The idea was created to sway young people into more positive areas and away from youth-related crime, he said.
“We’ve put that in writing and we’re 100-per-cent committed to it. I strongly believe in giving back to the community. The young people in Mill Woods are the future of our community.”
This morning I enjoyed free pancakes and coffee with around 1000 other Edmontonians at Premier Ed Stelmach‘s 2010 Capital Ex Pancake Breakfast on the south lawn of Alberta’s Legislative Assembly Building. Below are some of the photos I snapped in between my first and second servings of pancakes at 7am this morning. You can see more photos from this morning on the Flickr set Premier’s Capital Ex Pancake Breakfast 2010.