What to do?
I think there are three things we do:
- Complain. If you see waste in the system, send your provincial auditor general a note. If you are unhappy with the care you or your loved one receives, write the hospital administration (they may not do anything, but we start by laying a paper trail). And write the Minister of Health and copy that to your MLA. I have a niece in government who tells me that complaints are so rare that they use a formula to determine how many other voters have experienced the same problem or feel the same way about a topic. So it pays to complain.
- Share your ideas and stories with us on this website.
- Cut off their fundraising.
Health care is driven by money. That seems to be all administrators pay attention to. It’s the only language they understand. After all it pays them. When you read about belt-tightening in health care when has it involved the administration? (*) Where I live we have six vice presidents to oversee two small hospitals and three clinics. There are as many people working in the finance department (58 + managers) as in the labs (69). In fact, the are more people working in administration than nursing staff on the floor. One hospital has 120 nurses – not all of those are RNs. Doctors Nova Scotia says 19 percent of the province’s $3.5 billion budget goes to physicians. So a lot of the budget gets eaten up by non-medical costs.
Across Canada health care authorities and foundations constantly have their hand out for more money. One Nova Scotia health foundation recently asked the provincial government for permission to access patient files so they could directly appeal to former patients and patient’s families for donations.
Where are the cutbacks in administrative costs?
I think to make our point we stop the discretionary portion of their cash flow. We stop donating money and supporting their fundraising efforts – which are conducted by paid fundraisers – until we see provincial health care administrative costs reduced. In Nova Scotia if each health authority dropped their administrative costs to at least the national average that would probably free up a million dollars in each authority, if not each hospital.
Each morning when I read the obituaries, I see a line about donations in memory to be made to the charity of your choice or a particular group which had meaning to the deceased. This is a societal evolution. Years ago we would send flowers to a funeral home to show our respect for the deceased and their family. Then someone realized we could show respect and do good by diverting flower money to charity. Perhaps it’s time for a new evolution. Perhaps now obituaries can direct donations in memory to certain charities and specifically ask mourners not to donate to health care foundations or authorities.
I know that seems harsh for a Canadian or Maritimer, but the long-term effect could be very good. It is a tangible way to show we are not happy, that the status quo is not acceptable and we expect change. Sadly the only way in our society to effect change is to make the comfortable uncomfortable.
Society rewards these health care administrators with perks, privileges and pay. It’s time they did more than smile for photographs in the annual report and lobby politicians for more money.
Change starts with us.
(*) In the interests of accuracy, three days after I asked when had we ever heard of health authorities cutting their own administrative costs, an article appeared in the Halifax Chronicle Herald under the headline: South Shore Health cuts nine managers (Saturday, November 27, 2010, page A13).
The article says this cut, which included a vice president, will save half a million dollars annually out of their $74 million budget. That’s a cut of .7 percent.
The article says these cuts, added to others, “eliminated a total of 12 positions.” But did they? Dismissed staff can apply for open jobs with the authority and on the day this article appeared the South Shore Health Authority’s website (www.ssdha.nshealth.ca) listed 21 open positions: 10 managers, four supervisors, two district supervisors, plus a pharmacist, one RN, one paramedic, one physiotherapist, and one lab technician.
With 16 management positions up for grabs it’s hard to understand how they saved money and streamlined administration.