Refuge Centres for Campbell's Government

February 17, 2006

Refuge Centres for Campbell's Government

When asked by Carole James about his position on user fees and salaried physicians during the first question period of the new legislative session, Premier Campbell took refuge in the Canada Health Act and said:

"We tried to be very explicit yesterday in the throne speech. Everything that we do will be within the Canada Health Act. It will respect the five principles of the Canada Health Act."

Unfortunately, the Premier was not at all explicit in the throne speech which said:

"That Act holds out the promise of universal, accessible, comprehensive, portable, and publicly administered health care. Yet after four decades of public health care, supported by over $1.5 trillion dollars in public expenditures, those five principles remain largely undefined."

The Campbell government's hand was tipped in the throne speech when it posed the question: "What does the principle of "universality" mean when some citizens have special access to services and surgical options that others do not have, for lack of extended or private insurance?" British Columbians who have "special access" to surgical options are those whose injury is covered by ICBC, the WCB, a federal agency or who pay out of pocket in defiance of the Medicare Protection Act. Those inequalities are serious problems but they are not problems caused by a "lack of extended or private insurance". If private insurance were allowed to cover the private surgery centres, it would be the death of Medicare. The inequalities could be eliminated if Campbell kept his promise to make health care available when and where people need it. If the public system performed as it should, there would be no market for queue jumping through private clinics or private insurance. Alternatively, public health insurance could cover private clinics just as it covers private doctor's offices. Don't expect to see that happen except on a limited contract basis for a specified number of procedures because the government would lose its ability to ration health care if it treated surgical clinics like it treats services provided in doctor's offices. Supply would increase to meet demand and the result might devastate the budget. The issue is about rationing much more than it is about public vs. private but vested interests distort the debate.

On the second day of question period Stan Hagen, Minister of Child and Family Development, sought refuge behind the social workers who are employed by his ministry. Instead of answering why the Premier's office is running his ministry and not keeping him in the loop, Hagen said:

"We depend on 4,400 workers in the ministry to make the system work. I take my hat off and compliment social workers for the job that they do. I have travelled the province and met with social workers from one end of the province to the other, the four corners of the province, and I tell you I have so much respect for what they do. I would not be able to do the job that they do because I don't have that training, but I really respect what they do and I hold them up as examples of great citizens, because they do a tough job. Our job is to make sure that they have the resources to do their work, and that's exactly what we're doing."

That is from a minister in the government that treated child protection like any other government service whose budget was blindly slashed so as to finance tax cuts. Reports commissioned by the Campbell government on the repeated delays in implementing the controversial change in community living said that it was difficult to manage organization change at the same time that budgets were being cut. Just last month, the BC Association of Social workers released its submission to the Child and Youth Review being conducted by Ted Hughes. The introduction to that submission said:

"Social workers practicing in the field of child welfare social work are concerned about the current state of the child protection and family preservation system. Members note that many of the elements in the child welfare system, such as the legislation, are well crafted with the potential to provide excellent services to at risk children. Unfortunately there has been degradation in services, budgets and staffing levels and the current system shows signs of severe stress which is regularly leaving children at risk."

Employees of the ministry are not free to speak publicly, but MLAs, reporters and bloggers like me regularly receive emails that say what is happening on the front line of child protection. Fortunately the government cannot retaliate because of what is said by the Social Workers' professional organization. If Hagen bothered to read the submission he would see that it offers him no refuge. The BCASW report said:

"During 2005 it became public knowledge that the government child protection agency had failed to protect children who died while in care. MCFD audits also indicated that child welfare investigations were not being completed until well after the 30-day time frame. BCASW as well as former ministry social workers reported that staff shortages and government cutbacks were contributing to ethical dilemmas, low morale, the fear children would die and social workers' resignations. The public became aware of the Coroner's office failure to conduct child death reviews on 713 child deaths files. This occurred after the government consistently denied any child death review concerns and then incrementally revised the number of missing child death files from 80 to the final 713 total."

An open and honest government would be clearer about its agenda, and it would admit mistakes. References to private health insurance in the context of transformative change for health care are not helpful, and raise anxieties that the government is not being clear. Denying that the Ministry of Children and Family Development is descending into further chaos is not reassuring. Trading would be suspended in any private company that lost its two senior officers within a week with no satisfactory explanation to shareholders. British Columbians are not getting the answers they deserve.