$10-million queue-jumping inquiry off to troubled start
On Dec. 6, 2010 — exactly two years ago — Stephen Duckett made a speech to an audience of 150 senior physicians and health administrators. Twelve days earlier, he had come to the end of his contract as head of Alberta Health Services.
In his speech, he lambasted the media. He lashed out at Ken Hughes, then the AHS chairman. He mocked the Friends of Medicare. Most damningly, he accused the disbanded regional health authorities of “manipulating waiting lists” for political reasons.
Six months later, he repeated those allegations in a Toronto speech, accusing his predecessors of making “discreet waiting list adjustments on request from MLAs.”
Those claims gave birth to the Health Services Preferential Access Inquiry, now underway in Edmonton.
Now, after three days of testimony, it appears Duckett’s accusations were based on little more than hearsay and gossip.
On Tuesday, Duckett — speaking via video from Melbourne, Australia — named Brian Hlus, the former head of government relations at Capital Health, as the “Mr. Fix-it” who manipulated wait lists, at the behest of Tory MLAs.
A man with a reputation for fiscal probity, Hlus is now employed by the City of Edmonton as manager of intergovernmental and external affairs. He declined to comment Wednesday, but is expected to testify next week.
Hlus never worked for Duckett; in fact, Duckett testified, he’d never met Hlus at all.
Yet when pressed by Michelle Hollins, the inquiry’s lead counsel, Duckett could provide no evidence Hlus had ever manipulated anything. Duckett couldn’t recall who had ever told him that Hlus arranged for special treatment for VIPs.
Nor could he provide the name of any MLA — or any other prominent person — who’d ever received preferential access, from Hlus or anyone else.
Duckett offered not one concrete example, not one second-hand anecdote, not even one juicy rumour. His testimony against Hlus was unsourced innuendo — apparent ly because government MLAs, who’d seen Hlus as a useful conduit for constituent concerns about health care, expressed dismay when Duckett named no one to replace him.
Duckett also told inquiry commissioner John Vertes that in June 2009, he’d directed David Megran, then the senior physician executive for AHS, to draft a letter to senior staff, saying queue-jumping wouldn’t be tolerated and directing that all such requests be forwarded to Duckett himself. Duckett testified he requested the memo be written, after Megran told him the previous health regions allowed VIP preferential access.
But Megran told the inquiry he only drafted the memo because Duckett told him to, that he never approached Duckett with any queue-jumping concerns.
“I had not ever been asked to arrange preferential or expedited care for individuals,” Megran testified. “At the time, I was not aware of information or rumours or innuendoes that had occurred or was occurring at AHS.”
So are we really only having this $10-million inquiry because Duckett, angry at what he felt was ill-treatment here, made unsubstantiated insinuations of wrongdoing? It’s not that simple. On Wednesday, the inquiry heard testimony from two senior emergency physicians from the University of Alberta Hospital. One day in 2007, when the ER was severely overcrowded, they testified, a mid-level hospital manager pressured the charge nurse to expedite care for an unnamed VIP. Neither doctor witnessed the incident — they reported it, second-hand. They also testified emergency room staff refused to give the VIP special treatment.
Allegations a hospital administrator pressured staff to act against their best clinical judgment are terribly troubling. Yet in this instance, no one actually received preferential care. And one incident five years ago, no matter how ugly, doesn’t demonstrate a high-level conspiracy.
Ironically, the biggest queue- jump took place well after Duckett wrote his memo — in November 2009, when the Calgary Flames were given special access to rationed H1N1 flu vaccine. Was that a violation of Duckett’s own policy against preferential access, Hollins asked. He didn’t think of it in those terms, Duckett said, because his memo dealt with elective surgery and emergency room access.
“I didn’t think about it as a violation of policy.” It’s astonishing. Duckett is absolutely right when he says a public healthcare system must be fair to all. A two-tier system inevitably means second-class care for most of us.
Sadly, the careless way Duckett levelled his unsupported accusations, without evidence or foundation, means that the inquiry itself has lost its own foundation, and much of its credibility, at its very start.
Is there now, or has there ever been, a culture of queue-jumping in our hospitals? It will be no easy task for this inquiry to find the truth — now.