April 13, 2005

Elder Abuse

Before an injunction was issued that forced Judy Sellin to remove a video clip from her website, I viewed it and was shocked. Amongst other indignities the film taken by a hidden camera in the room of Sellin's father, Stephen Piccolo, portrayed a nurse telling the feeble man that what he was about to drink was horse urine. Sellin installed the hidden camera after health officials failed to respond to her complaints regarding how her father was being treated.

Excellent reporting and editorials by Cam Fortems and Susan Duncan in the Kamloops Daily News Online has kept attention focused on the alleged treatment of the late Stephen Piccolo. The Interior Health Authority, which is responsible for the Overlander Extended Care facility, has assigned an investigator to look into Sellin's tape and it has suspended two employees, but it has also had its lawyers aggressively go after Sellin, who is not represented by legal counsel, for videotaping inside the care facility without their knowledge. U.S. websites are reported to be making the banned tape of Piccolo's treatment available although it is not easy to find those sites.

The case of Judy Sellin and her late father cannot be seen in isolation from changes the Campbell government made to health care in BC. On April 8, 2002, Katherine Whittred, then Minister of State responsible for Community Care, tabled an exposure bill titled "Community Care Facility Act". The stated purpose of the bill was to facilitate "a more outcome based community care service delivery system as it relates to the use of facilities." In July 2002 the Campbell government released a discussion paper and gave the public one month to respond to its invitation to consult on the exposure bill and draft regulations. The paper discussed the legal implications of outcome based regulations. It essentially said that outcome based regulations can pose difficult enforcement problems, but no one should worry about that if the consequences of enforcement are anything short of closing the facility. In the words of the discussion paper (page 4), "The legal implications associated with an outcome-based model arise largely where the consequences of provisions are more severe. This would include provisions which provide for permanent closure, revocation or refusal of a license, or for prosecution." The discussion paper for community care outcomes was probably the first time the Campbell government came close to specifying what it means by outcome based regulations. It turns out that its concern was for the outcomes for business running a care facility rather than for the outcomes for residents of the facilities.

In the fall 2002 legislative sitting the exposure bill was replaced with Bill 73, the "Community Care and Assisted Living Act". On November 5, 2002, speaking on second reading of Bill 73, Whittred said:

Of course, we now know that announcement was false, later to be recognized as a broken promise, and what the Campbell government sees as "overly prescriptive" may be seen by others as essential health and safety protections.

Health Authorities are in an inherent conflict of interest when it comes to protecting frail seniors. The prime directive for the Authorities is to balance their budgets. The same entity that funds and sometimes operates care facilities is also responsible for licensing and inspecting them as well as dealing with complaints from patients and their families. When the treatment of Stephen Piccolo received publicity, the Interior Health Authority appointed an investigator only to have to appoint a second investigator when it was revealed that the first was not truly independent of the Authority. Whatever is found with respect to the treatment or abuse Mr. Piccolo received, his case illustrates the need for a powerful health advocate that can receive complaints and hold health authorities to account. Currently that role falls to families who can be faced with well funded legal action from a Health Authority; that kind of action turns victims of Campbell's health policies into second time victims when they face the legal system. Judy Sellin and those like her need the power of the media to even the balance of power.