The Alberta Legislature is now back in session after a number of months of the MLAs being away. While the Legislature was quiet, some important events came to light. On the health system front, there are some outstanding questions that need answers. Over the next few weeks, we hope to see public explanations and responses by the system, and ultimately the Alberta Government, for both what happened and what is now being done to eliminate the possibility of it reoccurring in the future.

The first item to we are going to discuss is the report in July of the Edmonton North Town Medical Clinic operating for more than two years without being inspected to insure that it was following acceptable standards and that its personnel were trained well enough to complete the tasks the public expects of them. Individual patient’s safety and health as well as that of their family and friends were put at risk. We raised questions about this shortly after this situation became public and we have not seen any of the important answers publicly reported. Here are our current questions, thoughts and expectations on this issue.

How is it possible for a clinic to be allowed to open and to treat patients without having the facility and its equipment inspected and the competence of the personnel validated before allowing doctors and their staff to treat patients there? No other area responsible for public safety is allowed to operate this way.

It was reported that the initial situation arose through poor communication between Alberta Health and the College of Physicians and Surgeons. In addition to this glaring breakdown, it was apparent that this was not the first or only time this has happened.
Clearly it is the responsibility of the Government of Alberta to insure that its citizens are properly protected and cared for while being treated in public health facilities. The fact that this breach of insuring proper standards are met could happen (and it seems like it’s not a surprise to the players) shows that there is a huge gap in the overall management and supervision of Alberta’s health treatment facilities and people.

The reports included indicating that it was a very long time after the risk to patient’s health was known by Alberta Health Services (November 2015), that notification of patients took place (by mail July 2016). As a blood born risk, there was no comment on potential risk to family members and partners yet it would seem reasonable that some low level risk to them also exists.
Three major issues arise out of this whole situation.

  1. As Alberta citizens, we should expect the Government of Alberta to now have put in place policies and regulation to insure that when any facility opens and subsequently continues to operate treating patients that their facilities, equipment and personnel meet the current standards needed to safely work with patients. It is simply unacceptable for Albertans to be put at risk by public facilities inadequately supervised by the provincial government.
  2. As Albertans, we expect the Government of Alberta to insure that we know about the status of each of these facilities on a current and ongoing basis. It is evident that the reporting by the existing supervisors and operators is entirely inadequate. It is reasonable that as a minimum, a dated certificate of approval issued by the responsible third party inspecting body, be posted in a location publicly viewable by incoming patients. It also must be recorded in a public registry where we can search and find its current status. Health facilities must meet at least the minimum standards that are expected for other public facilities.
  3. As Albertans we expect the Government of Alberta to ensure that in the future, there is proper notification of patients and the Alberta public, in a timely, complete and transparent way. It is evident that this incident wasn’t reported to the patients or the public in a timely fashion nor in our opinion, nearly complete enough for Albertans to be informed and able to act to keep themselves and their families safe. The lack of action and of transparency erodes our confidence in our health system and those who are responsible for it.
  4. It is clear that Alberta citizens need the Government of Alberta to ensure that in the future, there is a completely independent body established and properly funded to investigate all incidents where this body judges there has been the potential of significant risk to the patient’s safety, where harm has been done to patients, or there has been a fatality. This body must be independent of government, the health treatment delivery system, and of the associations and representative bodies. It must report only to the citizens of Alberta on the results of its investigations and it must make public recommendations to all parts of the health treatment system and to the government of Alberta in order to effectively result in the reduction or elimination of the identified risks to Albertans in the future. Without this completely independent body, Albertans will not be any better served in the future.

We intend to continue to focus on these huge gaps in oversight, public transparency and accountability and we look forward to commenting on all publicly announced actions taken to deal with them.

Upcoming topics for comment include After Hours Care and the Standards established by the College of Physicians of Alberta, the recently reported status of the recommendations made in the 2013 Health Quality Council of Alberta Continuity of Care Study and developments in the world of personal electronic health records. Of course we will also do our best to add our thoughts on as any new initiatives or events that come to light.

Oversight required for patient’s safety