Last week when the arbitrator contracted to settle union jurisdiction issues for Nova Scotia’s re-aligned health care system failed to submit his findings on time we saw a really pissed off health minister. The Minister’s pique and anger was a real emotion.
I have heard political operatives say that’s a bad move, but I disagree. For one thing, the operative I heard was from a party no longer in office. It’s great to see someone in government actually express what the public feels and thinks. If only it signals a new era in government where contractors, consultants and executives will be held accountable for their failure to meet deadlines, budgets and, in the case of health care, outcomes. A few firings and dismissals might not be a bad thing. As it is now, there are no consequences for those who don’t perform; since the public purse remains open there is little incentive to work to deadline.
We have spent so much time and money debating which union represents which group that we can only wish that the same amount of focus be given to patients.
Workers have union representatives. The higher-level professionals, like the doctors, have their various colleges to represent their interests. The health care executives have contracts and lawyers to protect their financial interests. But where are the patient advocates? If something goes wrong with a patient’s care, the system closes ranks to make them or their family think that no you didn’t understand what you were told or these things happen or whatever. It’s never the fault of the system or professional. The way we work it’s the patent’s fault for getting sick or the government’s fault for not providing proper funding – the lack of funding has been a trusty canard health executives have used for a generation to deflect failure of care.
It was recently suggested to me that we may not cut as many health care executives as hoped because of the cost of their severance packages. It had nothing to do with the need for their services or their abilities or weaknesses, but to spare the books a perceived hit in one fiscal year. How prudent is that? Keeping under-performing and/or superfluous executives would seem to be fiscally misguided as well as not in the best interests of the patients.
Before the last provincial election, and since, some people, myself included, talked about the need for an organization to represent patient interests. We toyed with the idea of calling it “So So”: Shout Out for the Shut Out, because even in the new re-aligned system, we’re not hearing about patients.
We are 35 days from the unveiling of a new health care system in Nova Scotia and patients still seem a secondary, if that, consideration. So far it’s all about making health care and union executives happy.