On Wednesday, Justice John Vertes released his Health Services Preferential Access Inquiry Report on allegations of health-care queue jumping in Alberta. The inquiry’s terms of reference ordered it to consider:
• Whether improper preferential access to publicly funded health services is occurring.
• If there is evidence of improper preferential access to publicly funded health services occurring, make recommendations to prevent improper access in the future.
We knew the answer to the first question before the inquiry spent its first nickel. Yes, it’s occurring. But probably not as much as had been hyped in the media.
And what were the conclusions of the inquiry report? Yes, it’s occurring. But not as much as had been hyped in the media. Ten million dollars to confirm the hopelessly obvious.
But what about the second question? The value of this report lies in the recommendations. Recommendations designed to ensure what largely didn’t happen before will never happen again. Here are all 12 recommendations with some clarifications.
• Strengthen the queue-jumping provisions of the Health Care Protection Act.
We need to better define and broaden the scope of what does, and does not, constitute queue jumping. Right, because those working the system weren’t quite clear on the definitions.
• Expand whistleblower protection.
Whatever one thinks of Liberal Leader Raj Sherman’s politics, he was a whistleblower on this affair. The inquiry made sure no one will be so stupid as to act as a whistleblower again by singling him out and stating his allegations were unfounded. Although the inquiry waited all the way to page two before doing so.
• Clarify the scope and application of professional courtesy.
Doctors shouldn’t let other doctors get preferential treatment, unless it’s really necessary, in that case its fine. Whew, that clarifies it.
• Reduce wait times.
A recommendation that will actually do something. After all, you can’t have queue jumping if you don’t have a queue. The inquiry didn’t add much detail here because, you know, AHS has done such a bang-up job at this so far.
• Develop and implement wait list management strategies.
The first component of which is “standardized concepts and terms.” Oh I get it, there was queue jumping because we hadn’t standardized the concept of queue jumping.
• Develop standardized referral procedures and booking systems.
Operations management experts, queuing theory and existing empirical evidence all suggest this will make things worse. So it’s perfect for AHS.
• Consider creating the position of Health Advocate.
The advocate will provide “advice and advocacy assistance to patients.” To do what? Jump the queue!
• Develop a policy on courtesy calls.
When was the last time developing a policy on an issue actually fixed the issue? Expect the same here.
• Develop a policy on special accommodation during a pandemic.
What’s the distinction between ‘special accommodation’ and ‘preferential treatment?’ Whatever it turns out to be, let’s call it the Calgary Flames difference.
• Develop policies for the private patient path.
The report states that it is unclear whether the private patient path is a problem or not. But as long as we’re creating policies, let’s make one for this, too.
• Strengthen access, triage and booking procedures.
In other words, do what we are doing now, but do it better. This is a group hug recommendation. Next, world peace. I recommend everyone just get along.
• Develop a policy on preferential access.
Doctors and nurses didn’t know that queue jumping was wrong. This has just been a gigantic misunderstanding. We were simply lacking a policy to make it clear. Next, a policy on claiming expenses for personal butler services. Wait, no, we got that one.
I agree that it pays sometimes to admit the obvious. But $10 million? For this?
Troy Media columnist Robert Gerst is a partner in charge of operational excellence and research and statistical methods at Converge Consulting Group Inc. He is author of The Performance Improvement Toolkit: The Guide to Knowledge-Based Improvement and numerous articles in peer-reviewed publications. See more at troymedia.com.