Health gag orders hurt the public interest

VICTORIA - It’s happening again. Another health authority is trying to gag doctors and nurses and front-line workers.
If a reporter - or MLA or mayor - calls a hospital in the Vancouver Island Health Authority and asks how wait times are in the emergency room today, the ER doctor is supposed to refuse to answer. Hang up, and call the communications department, says the edict from CEO Howard Waldner. They’ll tell you how to answer.
Or if a physician or cleaner becomes gravely concerned about conditions in a long-term care home - and gets no response internally - she’s supposed to stay quiet. The organization comes before the patients.
VIHA says the memo was just a reminder of existing policy and many organizations have similar rules.
And that’s true. In a past life I ran newspapers and sometimes, when controversy came along, said no one else could do media interviews.
But there were a few critical differences in circumstances. The newspapers weren’t monopoly providers; if people weren’t happy with us they could go elsewhere. That’s not true for the health-care system.
I was accountable to elected directors, put in place by the people who were paying for the whole operation. That’s not true for the health-care system.
And despite our airs, what newspapers do isn’t a matter of life and death, not remotely. That’s not true of the health-care system.
It gets stranger. Some reports suggest the memo was aimed at VIHA’s chief medical health officer, Dr. Richard Stanwick. His job is supposed to be talking about risks to health, based on his professional judgment. He hardly needs to clear his health warnings with communications types or authority executives.
But more likely it’s belated fallout from a devastating letter to the Victoria Times Colonist this summer by Dr. Anthony Barale, then VIHA's director of psychiatric emergency services. Barale went public with his concerns about the authority's substandard services for the addicted and mentally ill. The authority had failed in its responsibility, he said. Resources were pitiful and VIHA’s response was inadequate, "even by so-called ‘Third World standards.’"
Barale’s comments, backed up by colleagues, sparked a needed critical examination of VIHA’s efforts. The health authority never denied the issues were real A gag order, if followed, could have kept the serious problems from public view.
It’s not the first effort to silence health workers. Last year a veteran emergency room doctor at St. Paul’s Hospital in Vancouver told a CBC reporter that ER conditions were the worst she had seen in 14 years. The adminstration’s response wasn’t to address the problems; it sent a memo to staff warning that talking to reporters could be grounds for discipline. (The comments might have displeased the health minister, a senior administrator complained, who would as a result turn down funding requests from the region.)
Nurses and other employees in the Interior Health Authority have reported the same fear of reprisals for speaking publicly about problems in the system.
And Fraser Health employees say they have been told that all newsletters, internal and external, must now be approved by the health minister’s office before they are released - if not a gag, at least a micromanaging muzzle.
It’s natural enough for managers to want to hush up problems. And it’s true that complaints sometimes come from disgruntled or misinformed employees.
But health authorities and other organizations have the ability to deal with those issues. Employees who knowingly level false charges, for example, can be subject to discipline.
More importantly, the health authorities why employees don’t trust that there is the will or ability to deal with their concerns.
But a gag order - no matter how its characterized - is not the answer.
We are the owners and customers of the health-care system. We want and need to hear directly from people on the frontlines when there are problems that the health authorities aren’t fixing.
Footnote: The problem could best be addressed by provincial whistleblower legislation providing protection for health employees raising concerns about issues that affect patient care and safety. At the same time, the legislation could make it clear that people who make unfounded or malicious complaints would not be protected. The government has rejected past requests for such laws.