Jim Prentice will soon be sworn in as premier. During the leadership campaign, Albertans heard much about the misuse and personal use of taxpayers’ dollars, but very little about Alberta’s health-care system, where 45 per cent of Alberta’s operational budget is spent.
We know what the system’s character has evolved into. It has become a highly centralized, insensitive system that uses intimidation to further political goals. Good people inside the system have to fight to hold progress on patient care at risk of career-limiting or career-ending reaction. We have met with people who are delivering genuine patient-centred care, but have been asked not to refer to them, because of their fear of potentially negative consequences for them and their patients.
We lost Greg from our family to this so-called health system through multiple avoidable failures. (Greg, 31, died in May 2012, three days after surgery for testicular cancer, and an investigation by the Health Quality Council of Alberta found multiple gaps in the quality of his care). Our own investigations have shown us how naive our assumptions were that this system was keeping pace with worldwide developments in communication, measurement, benchmarking, quality control and improvement practices. That Alberta’s health system is so far behind is astounding to us.
The HQCA experts investigated and recommended major improvements in their Continuity of Patient Care report. Our family’s perspective and lessons are posted on our HealthArrows.ca website. This all provides the foundation for fundamental change.
It is very clear that the intimidation factor is a huge impediment to improvement and accountability. This is not surprising, for if the Health minister on former premier Alison Redford’s watch can arbitrarily fire the independent board for taking their responsibility seriously, then absolutely no one is safe from political action. This firing put the minister (and the premier) firmly and directly in charge and they must be held fully accountable for all that happens in the health-care system.
Last December, following the release of the HQCA’s report, Minister Fred Horne asked the players named in it what they were going to do about the recommendations. Some of the players have moved slowly to respond, in spite of the obvious political risks. Others have not.
Some recommendations clearly require government action. The most fundamental is the universal individual electronic patient record system. We understand this has been discussed for eight years, and yet there is no universal system in Alberta, which amazes us and everyone we talk to. The government continues to dodge this step while making matters worse by adding other bits and pieces which cannot and do not talk to each other, or to other existing systems.
What can we expect from Prentice’s government when it comes to health care?
Will the system continue to be managed directly by the premier and his minister with political opportunism at the forefront, while avoiding accountability? Or will the premier follow through on his comments, and put in place and fully empower a truly independent board of the best and the brightest managers of large, complex organizations and expect them to pursue the goal of genuine patient-centred care?
Will this premier’s government finally commit to fully funding the universal, electronic health record system for each patient; a system that must be completely patient accessible on a real-time basis, and available to all appropriate health-care providers? Or will we see the continued avoidance of transparency and accountability, while patient care is compromised and the system’s ability to improve itself is handicapped?
Will this premier’s government prioritize the shift to enable family doctors and primary-care physicians to quickly refer their patients to a co-located team of specialists who can efficiently diagnose and help the patient deal with critical and complex health issues? Or will we continue to see long waits for specialists to respond to referrals, resulting in family doctors and primary-care physicians forced to recommend that their patients line up at often overloaded urgent care clinics or emergency departments to try to make progress in their care?
Will the premier commit to funding world-class, leading, multi-disciplinary diagnostic and patient care facilities where teams can work with patients to deal with virtually any potentially life-threatening condition? Or will the premier be satisfied with today’s top-down approach, where fully staffed facilities serving patients are closed and multibillion-dollar political legacy facilities are built that are not patient-centred, are difficult to staff, and we believe are the most expensive to operate per patient treated?
Our family wants to see Premier Prentice move quickly to put in place a system that fundamentally changes the current culture of management and delivery of health care — one that builds on the strengths of the many great people inside the system and the best management minds available from the public to quickly and dramatically evolve health-care delivery into a universally safe, continuous, collaborative, and truly patient-centred system.
Our family knows from sad experience that Albertans’ lives are at risk without this change.
Also printed in Calgary Herald September 9, 2014.