Mismanagement, bullying hurt health system: panel

Bureaucratic mismanagement and bullying of doctors have knocked Alberta’s health system off the rails and brought much patient suffering, a government panel reported Wednesday.

EDMONTON — Bureaucratic mismanagement and bullying of doctors have knocked Alberta’s health system off the rails and brought much patient suffering, a government panel reported Wednesday.

Dr. John Cowell said that five years after the province was told how to fix the core issue — poor management of hospital beds — the problem remains.

“Wait times in Alberta urban (emergency departments) are still far too long,” said Cowell.

“Patients waiting for a hospital bed is the single most important factor contributing to (emergency department) crowding.

‘Sadly this was found in 2007, this has been known for a very long time. What needs to happen is: solve this problem. Manage the beds you’ve got in a far more strategic and tactical manner.”

Cowell made the comments after releasing the results and recommendations of a study ordered up 10 months ago by former premier Ed Stelmach to investigate allegations of avoidable patient deaths, cover-ups and bullying of doctors in the system.

Premier Alison Redford has since promised that an independent public inquiry will follow with its mandate shaped around the Health Quality Council findings.

Cowell’s team said they found widespread bullying of doctors who spoke out on substandard patient care. The backlash ranged from doctors being ignored to some losing their hospital privileges.

Cowell said the result has been doctors either leaving or continuing to work but as cynical clock-punchers no longer willing to fight for a system they felt was unfixable.

“Interviewees and survey respondents alike described a culture in which physicians felt disengaged and alienated from the system,” he said.

“There is a great deal of anger, frustration, and alienation.”

The council was also asked to investigate allegations made by Liberal Leader Raj Sherman, himself an emergency room doctor, that 250 patients died needlessly while awaiting lung cancer surgery.

Cowell said they could find no evidence of that.

The issue has become politically charged with a general election call expected within a month or so and opponents saying the government has lost the ability and the moral authority to fix health care.

Redford has promised to call the public inquiry before the election. Cowell’s report, however, said an inquiry on intimidation may not be needed because his panel has done all the spadework.

The report instead urges the government to use the money to fix the problem of bullying through programs and a task force.

But opposition critics say that recommendation is an attempt by Cowell to give political wiggle room to Redford to allow her to avoid calling a public inquiry that would bring scrutiny on potentially embarrassing and outrageous behaviour of her government.

They also say it won’t get to the root of the problem.

Danielle Smith of the Wildrose party said if doctors don’t feel they can speak up for reform, all is lost.

“We have to get to the bottom of the bullying and intimidation to free up physicians to be able to advocate on behalf of their patients,” said Smith.

Liberal critic David Swann, himself a medical doctor, said that only a public inquiry will root out the problem. Without it, he said, the problem will reappear in a few years time.

“Hold these people’s feet to the fire. Get the people who have been making bad decisions, continue to make bad decisions, continue to intimidate people in the health system — get them out,” said Swann.

NDP Leader Brian Mason said it’s not surprising Cowell’s team didn’t sort out the problems at the political level.

“This body is a creation, a creature, of the provincial government. And they will not — and do not — have the capacity to lay the blame for this culture at the foot of their masters,” said Mason.

Cowell said his panel did interview politicians. He said they found politicians “meddled” on behalf of individuals or groups but found nothing more sinister or substantive.

Health Minister Fred Horne said that while he was still going through the Cowell report, he agreed that moving the health system from regional boards to one superboard in 2008 brought some instability.

“I think it’s been a difficult transition for a lot of people,” said Horne.

“A lot of it happened in a hurry. A lot of our physicians in particular felt some confusion about where they fit in, how they have input.”

He said the government will proceed with a public inquiry.

“The fact is this government has made a commitment and this is a government that lives up to its commitments,” he said.

The government has already taken steps to address the concerns outlined in Cowell’s report.

The province is in year two of a five-year plan to reduce waiting times.

The plan is to have serious cases assessed and admitted within eight hours of arrival 90 per cent of the time by March 2015.

However, last week Horne confirmed they are failing to meet even interim targets of 60 per cent of cases within the eight-hour window.

Horne has said the government is also making progress by opening up a thousand new continuing care spaces.

Alberta Health Services set up a 1-800 hotline number three weeks ago for staff and physicians to call with concerns.

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