Thursday, February 23, 2006

Abbott needs to start giving real answers to health questions

VICTORIA - Health Minister George Abbott could land the government in trouble.
Abbott is seen as hard-working and knowledgeable.
But his standard response to questions in the legislature is a mix of partisan bluster and smart-alecky jokes. Actual answers are rare.
It didn't matter much in past cabinet posts, but it could be disastrous in health.
Even as the government hoped attention would be on the budget, the NDP raised legitimate questions about health care, and their effectiveness was boosted by Abbott's responses.
On budget day Question Period is usually irrelevant.
First up, NDP MLA Norm McDonald. The Interior Health Authority promised to keep Moberly Manor, a seniors home in Revelstoke, open until replacement beds were ready, McDonald said. Now they're closing it before there is anywhere in the community for people to go. Will the government keep its promise?.
Abbott's response was tiresome. The Interior Health Authority and the Liberal government has done a great job, he said, and anyway the NDP didn't invest in long-term care when it was in power. Not a word in response to the actual question.
McDonald appeared genuinely angry by the brushoff. He pointed out the obvious to Abbott: "If the people of Revelstoke were happy with Interior Health, (defeated Liberal) Wendy McMahon would be here, not me."
McDonald got a slightly clearer answer on the second attempt, but Abbott fell on the tired charge that the questions were somehow "fear-mongering." They weren't.
NDP MLA Chuck Puchmayr asked about the closing of 150 seniors'' beds in his riding. Abbot didn't answer, and suggested the question somehow insulted health care workers. It didn't.
And then North Coast MLA Gerry Coons asked about a Prince Rupert man who waited three days in a hospital hallway with a broken wrist and fractured jaw. When a chance for treatment became available in Prince George, his family drove him there - 1,800 kms - for treatment.
Abbott tried harder, but chided Coons for not asking for his help privately before raising the issue.
Except Coons had, and read from Abbott's letter in response that said it was the health authority's problem, not the government's.
The next day the first questions were about the terrible treatment of a Rossland couple, both in their '90s, wrenched apart by the Interior Health Authority days before the woman died. They were to celebrate their 70th anniversary in June. "After that long marriage she didn't even get a kiss or a hug goodbye," said NDP MLA Katrine Conroy.
Abbott apologized, and announced an investigation. But he couldn't resist partisan sniping as well, and a barely relevant reference to how bad things were under the NDP.
But the New Democrats weren't done.
Why is it, asked health critic David Cubberly, that the only non-government person going on a European health fact-finding tour with Gordon Campbell and Abbot is Les Vertesi - the premier's brother-in-law and, according to Cubberly, an advocate of two-tier care.
Fair question. The government only announced that Vertesi would be going along on the four-country tour the day before the premier was to leave. Why him, and not the head of one of the health authorities, or the legislature's health committee, or a New Democrat? (Vertesi is paying his own way.)
Abbott noted Vertesi is a respected ER doctor who has spoken widely on health care issues and is B.C.'s representative on the Canada Health Council. Then he blustered about the NDP being afraid of new ideas and wanting the tour to include Cuba. Blah, blah, blah, as the young people say.
Outside the legislature, Abbott could do little better. He hadn't read Vertesi's book, which Cubberly cited. But even without knowing anything, he was convinced the NDP was wrong. And he didn't know who invited Vertesi.
Health matters to people, and they don't expect partisan attacks and jokes to replace real answers. If Abbott doesn't do better, it will be a long session for the Liberals.
Footnote: Vertesi is not quite the two-tier advocate the NDP claimed. He argues competition is needed to produce health efficiencies, and that until that is built into the public system private two-tier care should be allowed. He's an interesting and thoughtful analysts. But he is also a mysterious choice as the tour's sole expert advisor.

Tuesday, February 21, 2006

Sherry's legacy shows up in boost for children's ministry budget

VICTORIA - Call it the Sherry Charlie budget.
Sherry Charlie was beaten to death days after being placed in care under a new ministry policy. The failures in her case - by the ministry, and the First Nations agency responsible for her protection - forced the government to admit the facts.
And the response was evident in the budget.
For years the government has maintained that everything was fine in the ministry of children and families. Even earlier this month a senior ministry official briefing reporters was maintaining that the ministry had enough people, and enough front-line social workers, to do the job.
Now the government has acknowledged the obvious. Things were not fine. The ministry was starved of funds and short of staff. And children and families suffered as a result.
The budget confirms that. The ministry will get a 12-per-cent increase, another $200 million. A large chunk of the money will be set aside to respond to recommendations for change expected in Ted Hughes' report on the ministry. About 180 new staff will be hired.
It's a welcome step, but perhaps still not enough. Even with the increase, the ministry will have less money in real dollars this year than it did in 2001.
Overall, the 50-odd journalists (insert your joke here) in the budget lockup complained this was a boring document.
That's not a bad thing. It reflects the fact that for the most part the government is executing its three-year plan. There is no merit in budgets that constantly lurch off in new directions. This one appeared to balance spending and modest targeted tax cuts.
Health gets a 3.9-per-cent increase, enough to fund improvements, and education spending will rise 2.4 per cent.
Both those are on top of wage increases, which will be covered from a separate fund. That means there should be enough money to hire additional staff to deal with issues like class size and composition.
The wage issues remains a problem. Finance Minister Carole Taylor has set aside $420 million for increases this year, enough for an average 2.7-per-cent increase.
But contracts with some 300,000 government employees are expiring in the next few months. Many - teachers, doctors, health sector workers - are looking for much larger settlements. Their demands will test the government's commitment, especially given increasing public dissatisfaction with the Liberals quickness to substitute legislation and imposed contracts for negotiation.
There are other areas of concern. Despite a growing economy and population, Taylor is forecasting that government revenue will fall next year.
The finance types point to sound reasons, and risks like falling natural gas prices. And it is better to err on the side of caution.
But only up to a point. The government's budget for this year under-estimated actual revenue by $2.7 billion. That money that could have funded a tax cut, or increased services; now it will mostly go to debt repayment without a real public debate on the options.
What was missing from the budget?
An increase in welfare rates for starters, and a recognition that those left on the welfare rolls at this point will be hard to move into the workforce. It is time to reduce the desperation in their lives.
There was also little in this budget clearly earmarked for B.C.'s regions.
Even the pine beetle crisis continues to get insufficient attention. The province's funding is increased to $46 million, but the emphasis remains on harvesting the damaged wood and replanting. Little money is going to help communities prepare for decades of reduced timber supply one the beetle wood is harvested.
The Heartland, flavour of the month a few years ago, is now a forgotten concept.
Overall, give the budget a B.
A few tax cuts, split between business and individuals fairly even. Spending increases that will address some of the biggest problem areas.
And - thankfully - a recognition that the government's decisions had played a part in the death of a little girl.
Footnote: The budget forecasts that the province's debt will increase by $5 billion over the next three years. Taylor says the infrastructure spending is needed, and the debt is still manageable. Given the low revenue forecasts, larger surpluses will also likely reduce the real debt increase.

Monday, February 20, 2006

Campbell just can’t admit Children’s Commission error

VICTORIA - Why is it so hard for the government to accept the obvious - that it made a serious, damaging mistake in eliminating the Children’s Commission in 2002?
The inquest into the death of toddler Sherry Charlie has wrapped up, a two-week review that outlined a string of failures.
No one - not the government, the RCMP or the First Nations agency involved - emerged from the inquest with reputation intact.
All made serious errors, either in placing Sherry in the home where she was beaten to death or investigating her death.
Human error, systemic problems, shabby investigations, botched communications, sloppiness - it was a dismal, depressing two weeks.
Sherry, only 19 months old when she was battered to death, never really had much of a chance. The agencies and people that were supposed to support her and keep her safe failed. Their failures weren’t the result of bad luck, or a rare confluence of events. The system didn’t work.
Sherry was placed in the care of relatives, even though the father in the home had a long criminal record, including convictions for spousal assault. Even though the children and families’ ministry had investigated previous reports about the safety of other children in the home.
And even after Sherry’s death and an autopsy that found evidence of repeated abuse, her brother was left in the home for five months.
The jury’s 19 recommendations make a start at addressing the problems.
Sherry’s life was in the hands of Usma, a First Nations’ agency that operated under delegated authority from the ministry of children and families. That’s a sound approach, ensuring workers are more knowledgeable about local issues and more trusted. But the jury urged that social workers at those kind of agencies should not have lower levels of training than ministry staff.
Sherry’s placement was one of the first under a new ministry ”Kith and Kin” policy, which stressed the value of finding a family member to care for a child as an alternative to foster care.
Again, a positive policy. But it was introduced in haste, with inadequate training. Proper criminal record checks weren’t required. (That problem wasn’t fixed until the last few weeks.) Rules around home and reference reviews were inadequate. The ministry guidelines were incomplete.
Fix it, the jury said.
The jury made 19 recommendations in all, to police, coroner, the health care system, the ministry and Usma.
The last recommendation was sent specifically to Premier Gordon Campbell. Bring back the Children’s Commission, eliminated by the Liberals in September 2002 - the month Sherry was kicked and beaten to death.
The commission would not have kept Sherry alive and safe.
But it would have examiner her death. It would have reviewed the Kith and Kin policy when it was introduced, and warned of problems. The public would have known some one was watching. Just as the public would have known that 713 child death files were abandoned incomplete in a warehouse.
And all those things would have happened automatically.
Premier Gordon Campbell rejected the jury’s calls for an immediate restoration of the commission. He wants to wait, he said, until other reviews of the ministry by Child and Officer Jane Morley and Ted Hughes are complete before making a decision. The final report from Morley is due at the end of June.
Campbell could plead for time to determine the best way to restore what was lost when the commission was eliminated, and a chance to incorporate Hughes’ recommendations.
But almost everyone involved in child protection and supporting families has called for the restoration of effective independent oversight.
Campbell could easily have acknowledged the error in eliminating the commission, and promised to accept the spirit of the jury’s recommendations. The details could await the various reports still to come.
Getting rid of the Children’s Commission was a mistake. It weakened protection for children, and removed an important independent voice that celebrated ministry successes, and warned of problems.
It’s time to face the facts, and fix the problem.
Footnote: The NDP pretty much called for minister Stan Hagen’s resignation this week. That’s the last thing the ministry needs after a decade of instability. But Hagen has to begin dealing publicly with the wide concerns about the issues facing the ministry, something he has been unwilling to do.