Wait For It

Ed promises more doctors and the Harpocrites promise reduced wait times. Yet in Alberta hospital beds are closed and basic surgery wait times are increasing. That is the Conservative legacy. Including the legacy of building hospitals during the Lougheed/Getty era to garner votes and then blowing them up, closing beds and cutting staff during the Klein years. Chickens, home, roost.

And inquiring minds want to know what happened to that Liberal Federal funding Paul Martin gave the provinces to reduce wait times? Why it went into building new facilities named after old Tories like Don Mazankowski who called for more private health care.

The Tories legacy after 37 years is to build infrastructure to win votes, with no plan on how to staff that infrastructure once it is built. A sop to the construction industry in Alberta.

It's ridiculous for Premier Ed Stelmach to promise Albertans an extra 225 doctors a year when current surgeons are being sent home because operations are cancelled, two Edmonton doctors say.

"It's exceedingly frustrating that we can't do our jobs and it's getting worse, not better," said Dr. Clifford Sample, a gastrointestinal surgeon at the Grey Nuns Hospital.

Sample was sent home Wednesday after his two major surgeries were cancelled because of shortages in beds and nursing. Across the region, about two dozen elective surgeries were cancelled.

At peak times this winter, the problem has been even worse, with up to 40 operations cancelled over two days.

"We get announcements from Mr. Stelmach that he's going to bring on all these extra physicians and I ask him: Where are they going to work?" asked Sample, who is president of general surgery for the Alberta Medical Association.

"What are they going to do when the physicians in the system now can't do their jobs due to lack of resources?"

One of Sample's cancellations was a woman who has waited three months to have her stomach moved from her chest back into her abdomen. She can't eat without pain or bend over without losing her breath, he said.

A second woman has waited three months to have a paraesophageal hernia fixed, but will now have to wait at least two more. Sample said the operation ideally occurs within two months, since there's a risk of the stomach becoming twisted in the chest of patients with this hernia. That carries a 50-50 chance of death.

"If that happens between now and the time I can do her surgery, I'll feel pretty awful," Sample said. "I haven't seen any bad outcomes (from surgery cancellations). It will happen eventually."

Sample said the province and Capital Health need to focus less on building acute-care hospitals, such as those set for Sherwood Park and Fort Saskatchewan, and more on immediate creation of long-term care beds.

In Edmonton-area hospitals, 150 to 200 patients a day occupy emergency or acute-care beds while they wait for long-term care spaces. Coupled with a severe nursing shortage, that has kept hospitals from performing more surgeries.

Alberta Health's promise of $300 million in the next budget to open 600 new long-term care beds in the province falls short since the facilities won't open until at least 2010, Sample said.

"These are mythical, long-term care beds in the budget," he said. "I don't believe anything until it's actually built."

He said that until new, long-term care facilities open, beds should be converted in the soon-to-open Mazankowski Heart Institute, the joint-replacement centre across from the Royal Alexandra Hospital and the Lois Hole Hospital for Women.

SEE:

Ed's Ides of March


tags
health care, Alberta, Premier, Ed Stelmach,
wait times,PC, hospitals, Conservatives,doctors, politics, Alberta election,

Nova Scota Imitates Alberta

Alberta has the most regressive labour laws in Canada. It long ago banned hospital workers, including nurses, right to strike. That of course did not stop those workers from going on strike. The right to strike is an essential workers right and is defended by the International Labour Organization as such. It is as essential as the right to unionize.

If governments banned the right to unionize it would be seen as the actions of an authoritarian state. The same goes for banning the right to strike. Ironically unions were banned in the 19th Century as 'criminal conspiracies' to limit trade. It was several years after Canada became a nation that Britain changed its laws and Canada followed suit. That did not stop workers from organizing unions, as secret societies; like the Knights of Labor. It meant workers on the job organized, and went on strike because that is their right as workers. All we have to sell is our labour or our time, our presence on the job.

In Alberta hospital workers were declared an essential service that still did not prevent AUPE or the Nurses union from going out on 'illegal' strikes. And win wage and benefit gains.

In Nova Scotia the hospital employers are running TV ads, I have satellite so I get to see them when I watch the CFL or NHL on CBC Halifax, claiming it hurt patients and is in everyones 'best' interest to end the right to strike. They claim other provinces do it and it has brought labour peace. Actually they meant to say appeasement. However that being said these employers are just another arm of government. They are government appointees or hirelings. So while one arm of the government, the legislature, brings in anti-worker anti-union anti-strike laws the other arm of the government, its employer association running the public hospitals, does the PR for the law.

The fact is that if the employer, who is the government, would fund hospitals and medical services properly then workers would be assured of proper wage and benefit increases, and proper hours of work. Instead the employer, which is the government, wants to cut wages, benefits and contract out work, split shifts, end seniority etc. etc.

A group that does not face these draconian attacks is of course the Doctors who are a business monopoly. There are few doctors strikes in Canada, and if they do occur they are short lived because governments assure doctors their services are paid for. Then they turn around and cut services in hospitals and cut other workers wages and benefits and tell them to hold the line.

The reality is that mediation only works between equals. In this case the government and its hospital administration view doctors as indispensable, and other workers as dispensable. If they didn't they would fund hospitals fully so all workers got the pay, benefits and hours of work they deserve. If that was the case there would be no need to strike.

Mediation does not work. Nor does denying workers the right to strike. They will, as history has shown, strike when they get cheated and screwed whether it is against the law or not.

What is interesting is that this balanced and pro-union article is from a Business Journal.

Union Dues: Anti-strike bill 'political posturing'
BY BRIAN FLINN, TRANSCONTINENTAL MEDIA
The Nova Scotia Business Journal

Health workers, the NDP and the Liberals are lined up against the government's highest-profile bill as the Nova Scotia legislature ends a seven-month summer break. Premier Rodney MacDonald said he's pushing ahead with the doomed anti-strike legislation because Nova Scotians deserve to hear it debated and find out how their MLAs vote. But he's not putting his minority government's survival on the line.

"There won't be any confidence votes this fall," MacDonald told reporters.

The government has been working on a bill to replace health strikes with arbitration since a brief IWK walkout earlier this year. Health- and community-care workers don't want to lose collective bargaining rights, and plan to rally outside Province House today while Lt.-Gov. Mayann Francis reads the speech from the throne.

"We're pleased the opposition will defeat this bill," said Joan Jessome, president of the Nova Scotia Government and General Employees Union. "But it can come back again and again. We need to make our point strong and clear enough to put this to rest."

The premier said he does plan to revive the bill later. "I'm a patient person," he said.

Both the Liberals and the NDP plan to defeat the bill at the first opportunity, when it goes to a second reading vote. MacDonald said the Liberals are "stuck in the past," while the NDP is standing up for special interests.

"They receive a lot of funding from the unions. They generally tend to be the biggest contributor to the NDP and most of their candidates," he said. "It's unfortunate; you don't put that ahead of health and safety."

NDP Leader Darrell Dexter said MacDonald is trying to distract attention from bigger problems in health care, such as emergency-room closings and the shortage of nursing-home beds. He said it's unfortunate the government is wasting some of the few days it allows the legislature to sit, on a doomed bill. "This bill is purely a product of political posturing," Dexter said.

Liberal Leader Stephen McNeil said he doesn't hear Nova Scotians pleading for anti-strike legislation. He said his party wants to co-operate with health workers, not take away their rights. "Where's the crisis?" McNeil asked. "I have yet to understand why the premier and the government are hanging their hats on this issue."

The House has to sit for only two days to avoid the label of the laziest legislature in Canada for a fourth year in a row. Prince Edward Island's House sat just 24 days this year, one more than Nova Scotia. – The Daily News

EXTRA: Strike threats useful warning system
By Brian Flinn, Transcontinental Media

Taking the right to strike away from health workers would damage an important safety mechanism and jeopardize the care of Nova Scotians, according to a new study by the Centre for Policy Alternatives.

Saint Mary's University professors Judy and Larry Haiven wrote that health workers know when the system is being pushed beyond tolerable limits and can signal it by threatening to strike. They said it's similar to the "red cord" used to stop assembly lines when something goes wrong in a factory.

"Health-care workers must have a way of indicating that the conditions under which they work do not overstress them or the quality of health-care delivery," the Haivens wrote. "Thus, in the health-care system, the red cord can be said to be the power of health-care workers to threaten to, and if necessary, withhold their labour."

Labour Minister Mark Parent has argued a modern health-care system cannot tolerate work stoppages. The report says "management by stress" now predominates in health care, and an outlet is more important than ever. "If politicians and health-care administrators insist on running a system so close to the bone, then the ability of workers to strike, to pull the red cord, as it were, is an essential system mechanism to ensure patient safety in the long run." – The Daily News

And this is from the Dominion Blog

November 23, 2007

NS Government Faces Heat Over Anti-Strike Bill

In one of the more polite demonstrations I've attended, a union coalition lead by the Nova Scotia General Employees Union staged a sidewalk rally of about 500 in front of the province's legislature on Thursday. While members of the crowd, which included a strong contingent of nurses and healthcare workers, heckled Premier Rodney Macdonald's minority government (top pic), the military guard-laden arrival of Nova Scotia's Lt.-Gov Mayann Francis, due to read her first speech from the throne, on the other side of the building was met with no interruption (bottom pic). After Macdonald's assertion that the unions were being "disrespectful" for holding a demonstration during the ceremonial speech from the throne, the union leadership responded by urging demonstrators to remain quiet outside of the legislature while Francis made her speech.

The rally was called in response to a bill due to be introduced by the minority tories banning the right to strike for the 32,000 healthcare workers in Nova Scotia. Macdonald had promised to introduce the bill in May following a one-day strike at a children's hospital in Halifax. The bill seems to be on the verge of being junked as a result of the union campaign, as both the Liberals and NDP have pledged to vote against it, were it to be introduced by the minority government. As a result, Macdonald has admitted he is unwilling to see his government fall as a result of the proposed anti-strike legislation.

Regardless of this apparent defeat, the throne speech outlined the Tory government's plans to establish more publicly funded, private health facilities in the province.

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Legacy Of The Ralph Revolution

All those gold stars and awards the Fraser Institute gave Ralph Klein for his neo-con revolution in the nineties are revealed to be bronze.

Ten years after his cuts to health care and public sector workers the chickens have come home to roost.

A scandal has erupted in Alberta CEO' Ed Stelmachs backyard. The Hospital Authority and the local hospital in his hometown of Vegreville have not had adequate sterilization procedures in place since 2003. For four years it had been ignored until this spring when scandal broke.

The government has fired its appointed health board, claiming that the Premier and his Ministers did not know of the crisis in his backyard.

Premier Ed Stelmach and Health Minister Dave Hancock both suggested yesterday the government couldn't have done more to prevent a four-year outbreak of infectious disease at St. Joseph's Hospital in Vegreville because they weren't aware it was going on.

He is of course fibbing.

But area resident Connie Marcinkoski doesn't buy the province's promise to swoop in and save the day.

Marcinkoski is currently suing the hospital for allegedly exposing her father to a fatal infection a few years ago.

"The province, in fact Premier Ed Stelmach himself as our MLA, knew about the ongoing issues here years ago. I called him personally when he was our MLA to alert him to this issue and he never called me back," she said.

"The Conservative government has known about this problem for years and now wants to come in and look like they are everybody's saviour.

The government has brought in an old buddy who promotes the privatization of health care to oversee the board and hospital.

Effective immediately, Jim Saunders, of J.L. Saunders and Associates Inc., and Paddy Meade, deputy health minister, will serve as official administrators for East Central Health, replacing the board.

It has talked about hiring risk managers to assess how to avoid this kind of thing in the future.

The region is also looking to hire more staff in risk management.

What it failed to do was hire more cleaning staff, those folks who were either laid off or contracted out during the Ralph Revolution.

A scathing report issued this week found that the hospital and health board practices were a result of the 'culture of fugality', that is as Ralphs appointed buddies they knew that they had to keep costs down, which meant contracting out laundry services and cutting back house keeping services while paying big bucks to a top heavy administration. Now they want to bring in more management to resolve the crisis when what they need is more hospital cleaners.

In a “culture of frugality” the facility did not even have the proper equipment to sterilize laboratory gear, and ignored requests from the authority because of a turf war caused by fuzzy provincial legislation.

It also says the testing procedure for those potentially infected has been slowed by a lack of provincial support.

The sterilization area of the hospital was actually a converted portion of the laundry room. It wasn’t isolated from other areas. Basic procedures for sterilizing equipment were ignored as well, including using properly sterilized water instead of attempting to sterilize hospital tap water. The authority, meanwhile, did not follow up to ensure its requests were followed.

The Stelmach governments response has been more of the same. Which will not solve the problem.

In an era when hand-sanitizing stations can be found metres apart in places like the Capital Ex fair grounds, it is appalling to learn that the healthcare facilities that people in east-central Alberta count on have ignored or neglected even the most basic hygiene measures because of turf wars, confusion or because administrators were just too cheap.

Despite an outbreak of wildly contagious Methicillin-resistant Staphylococcus aureus (MRSA) at St. Joseph's that lasted years, neither hospital officials nor the provincially appointed health board took the crucial steps to bring the situation under control.

The public only learned about the problems in St. Joseph's and East Central Health when the region's Medical Officer of Health ordered the hospital closed to new admissions in March due to concern about the facility's central sterilization room and bits of flesh on hospital tools.

One of the key problems the Health Quality Council identified in its investigation is the fact that the province's varying pieces of health legislation have set up a system of rival bosses. That same conflict potentially exists throughout the province.

Despite the chilling report on East Central Health, Hancock rejected the notion this his government bears any responsibility for the problem. "This is not an issue that can be thrown back on the budget process," he said.

Hancock is ignoring the fact that when the Tory government he now represents first introduced its draconian cuts to health-care funding and decentralized the province's medical system to a series of regional boards, there were public demonstrations against the moves. Anyone with concerns was ignored by the then premier and his cabinet or portrayed as a Liberal crank.

The people overseeing the health authorities also were in a bind. If they didn't play ball, they were either turfed from their jobs or the region was simply disbanded. When budgets are everything, how can anyone be confident that a rigid budget allows administrators to spend extra for the best cleaning fluid or to buy the appropriate sterilization equipment when faced with a huge list of competing needs?

Vegreville's problems likely widespread: doctor

'These things happen everywhere'

Frank noted cardboard boxes were found in sterilization rooms in Tofield, Lamont, Two Hills and other health centres, creating concern for the buildup of fungus. Staff at St. Mary's hospital in Camrose wore jewelry while sterilizing. Frank said the cardboard could have been taken out and the jewelry removed in one day to prevent closure of the units.

But other problems were clearly more major, Frank said. Tables in the Lamont hospital's operating room weren't wiped down between patients, the report found. The sterilization room at Viking's hospital had holes in the wall and ceiling that hadn't been fixed in several years. In Provost, nail care supplies from community health clinics weren't being sterilized, only cleaned.

No sterilization records were being kept in Killam, and a January audit revealed that single-use cautery devices were being re-used after wiping the tip, even though they were meant to be disposed of after one use.

Frank, who doesn't work at these other centres, acknowledged such safety gaps may suggest a lack of a safety culture, which the report pointed out.

But he said, "I don't think there has ever been a don't-care attitude (among health care workers)."

He said such problems are likely happening across Alberta, especially since many centres are struggling with short staffing like St. Joseph's.

Self-evaluation of sterilization practices -- done by all Alberta health regions earlier this year after the health minister ordered them to -- isn't enough, he said. Government inspections and document reviews will also be needed.

Sterilization and cleanliness problems aren't limited to hospitals in Vegreville and the East Central Health Region, says the president of the union representing surgical processors.

Doug Knight, Alberta Union of Provincial Employees president, said a "culture of cutbacks" in the provincial government and health regions dating back to the mid-1990s has led to unfilled vacancies in surgical processing and cleaning departments across Alberta.

He has heard cases of Calgary licensed practical nurses getting their scrubs back from the washers with mop strings in the pockets.

"That means they're washing their scrubs with the mops," he told Sun Media.

Knight disapproves of hospitals sending their linens out to private cleaners where the hospital has little control of the cleaning process. He suggests immediately returning privatized cleaning and laundry services to the control of health regions.

Ed Stelmach--in good times and bad - has certainly been the recipient of Ralph Klein's legacy.

In the case of the staphylococcus infection at St. Joseph's General Hospital in Vegreville, the premier clearly got the dirty end of the stick.

Health Quality Council CEO Dr. John Cowell's damning report into the incident revealed that anomalies began showing up in East Central Health authority stats as early as 2003.

By the time Cowell's team finished their investigation, they found serious breaches of sterilization standards throughout the region.

The problem was so extensive that Alberta Health Minister Dave Hancock placed the region under direct government administration and fired the board.

But somewhere along the way, a fundamental aspect of the system - proper sanitation - has been allowed to slide.

This was clearly the case in the East Central Health region.

It also puts a spotlight on the role and responsibilities of health boards, which were partially elected at one time.

They have now deteriorated into Buddy Boards that are liberally stocked with friends of the PC Party as a reward for loyal service and dedication to the cause.

As part of his mandate from Stelmach, Hancock is now charged with reviewing the governance of health boards.

But even before it began, he ruled out a return to elected health boards.

Opposition parties say Premier Ed Stelmach must should some of the blame for the hospital sterilization scandal that has rocked Alberta's health care system and forced three-thousand former patients to be tested for HIV and hepatitis.

Liberal health critic Laurie Blakeman says it's ironic that the same Tory politicians who helped created this sterilization crisis now want people to believe they're in the best position to fix the problems.

NDP Leader Brian Mason said Stelmach must shoulder some of the blame for the "mess" that is now affecting thousands of Albertans.

"This is a legacy of neglect that has affected the health of Albertans and Premier Stelmach bears significant responsibility," said Mason.

The auditor general pointed out three years ago that the committee that checks Alberta hospitals is unqualified, yet the premier has done nothing to change this, said Mason.

The premier also confirmed Thursday that the government is reviewing a master agreement for Alberta's so-called faith-based hospitals.

The controversial deal more than a decade ago kept boards in place at hospitals with religious ties at a time when other hospital boards were being dismantled as the province created health regions with new boards that would run all health facilities in the region.

The facility is run by volunteers and is known as a faith-based hospital. It works under a separate master agreement with the province. The East Central Health Region, however, also has responsibility under different legislation to run the hospital.

That was the wellspring of the problem, said Dr. John Cowell of the Health Quality Council.

He told a news conference in Calgary there there was acrimony and bureacuratic turf wars between the hospital board and the health region board. The health region didn't feel like it could step in unless asked and the hospital treated orders from the region as requests that could be acted on or ignored.

"There was a problem of two bosses and no bosses," said Cowell.

"At certain levels of both organizations there seemed to be much more focus on turf and not a focus on patient safety."

That problem flowed to people on the front line, he said. Nobody knew whom to report to, problems weren't getting solved, doctors declined to step in, morale dropped and health and safety practices spiralled out of control.

Then Cowell took aim at the board which he said had a "dysfunctional" relationship with the hospital, and did not show a "clear understanding of the seriousness of the MSRA situation and did not take action to improve the situation."

For that and much more, they are gone. But how they got there in the first place, Cowell chose to pin the tail on the political donkey.

"In terms of how these individuals are discovered and chosen and appointed," Cowell winked, "I think that's a question you should place right to the minister."

So I did.

Hancock quickly confessed that since these folks get their jobs from the government "these are political appointees."

They weren't always appointed, of course. For a brief moment in Tory time, a portion of health boards were elected.

That means you can de-elect them if they step out of line, unlike Hancock's Buddy Boards.

Part of Hancock's damage control is to develop a "culture of excellence." Including something he calls a "governance review and accountability framework."

You mean like elected health boards?

That's where Hancock started getting nervous and making Freudian slips like calling health care "haircut."

"No," the health minister blurted. "I don't foresee that."

"I'm elected and my colleagues in the legislature are elected to help set health policy for the province."

If they got their jobs in a vote, those regional health boarders would almost certainly go wild. Just like elected school board trustees do. Except they don't.

"I don't believe there has been pork barrelling of the health authorities," Hancock insisted, even though as the Minister Responsible for Edmonton, Hancock is the Grand Poopah of Pork for the Capital Region.

"In making appointments, we've always had to make sure we appoint good people," he said.

And now he's had to fire "good" people too.

Hancock calls the sideshow "irreparable and untenable" and boots the provincially appointed board. He is also expected to can a couple suits with the health region.He says he will put in provincial standards for infection prevention and control and he says he will make sure health regions know they are the boss. He also doesn't feel the health region board is clueless because they are Tory appointees.

"I don't believe there has been pork barrelling," insists the health minister. Couldn't that be cleared up if the health boards were elected as they were supposed to be?

SEE:

Tories Health Plan Kills Albertan

Laundry Workers Fight Privatization

Feminizing the Proletariat

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