VICTORIA - Random notes from the front.
Good news, bad news for NDP leader Carole James. The good news is the nomination of Gregor Robertson in Vancouver-Fairview, the kind of candidate the NDP needs to establish credibility. Robertson is a entrepreneur, with a successful whole earth juice business and 55 employees. He's running against Finance Minister Gary Collins, and is a distinct long shot. Collins took 55 per cent of the vote in 2001, but that's lower than the Liberal share in Surrey-Panorama Ridge. Look what happened there. (Bonus points for James because the New Democrats in the riding chose Robertson over Judy Darcy, the former national CUPE president. Voters are concerned the NDP is dominated by big public sector unions, and a Darcy candidacy would have added to the problem.)
The bad news is that Harry Lali will run for the party in Yale-Lillooet. Lali was a cabinet minister in the Glen Clark government, and made the most headlines when he claimed Clark was the victim of a media-RCMP-Liberal conspiracy (if there was such a thing, why wasn't I invited?). Lali didn't run in 2001, complaining that the party had been hijacked by the right when Ujjal Dosanjh won the leadership. James has to show that the party has changed; Lali would argue it never needed to in the first place. (For hardcore political types, the extremely useful www.publiceyeonline.com offers the only definitive list of NDP nomination competitors, a list long on union activists - not that there is anything wrong with that)
Say, didn't those Liberals promise to quit using taxpayers' money for political propaganda?
Hard to buy when you as you're recycling that four-page sales pitch that the Campbell party has just mailed to every household in the province on your dime. The ostensible purpose - to gather information about how you want to spend the surplus - is bogus. A legislative committee has just toured the province asking the same question. The Liberals didn't ask you what you thought last year, or the year before. And they spent a big chunk of this year's surplus on a tax reduction, before you even had a chance to offer your views. What did the mail out cost? It's a secret, says Gary Collins, even though it's your money.
The flyer is an obvious pitch for votes, touting the Liberal record and indirectly slagging the former NDP government. Leave aside the hypocrisy, won't this really do more harm than good with voters?
The Liberals' latest contracting out deal is a $133-million 10-year contract with a recently created Telus subsidiary to take over payroll services. Nothing wrong with the principle, the only question being whether the terms are fair for the taxpayers. (The government says the deal will save about $3 million a year compared with doing the work in-house.) The USA Patriot Act privacy risks seem less than in the MSP deal with U.S.-based Maximus. Telus' links to the U.S. are weaker, and the personal information is less sensitive.
You should hope the Liberals know what they are doing. They plan to chop more jobs and sign contracting out deals worth more than $800 million to private companies in the next six weeks, bringing the total value of work transferred to the private sector to more than $1.2 billion.
The BC Teachers' Federation is right. The government is moving far too slowly in investigating concerns about the treatment of women and children in a controversial religious community near Creston. Bountiful is the home to a polygamous splinter group from the Mormon Church.
It's complex issue, involving issues of religious freedom. The RCMP is investigating - slowly - allegations of sexual abuse and human trafficking, some linked to the practice having very young girls marry old men.
But the province could also take a role by ensuring that the publicly funded independent school on the commune is teaching the approved curriculum and operating within ministry guidelines, and that all children are being given a chance at an education. Critics point to a dismal graduation rate and charge that the school teaches racism. The school gets $460,000 in provincial funding; the province has a right to know how it is being spent.
Thursday, November 11, 2004
Tuesday, November 09, 2004
Public health system walking into disaster
VICTORIA - The threat to our public health care system isn't from private clinics, or contracting out.
It's from within.
The people in charge - not just the politicians, but the professional managers in the system - have done a bad job, and their failure has undermined confidence.
The public has difficulty judging the system's performance. We don't know if the doctor makes the right decisions when it comes time to fix us up.
But there are some clear measures, like wait times. And they are enough to shatter our confidence.
It's not just the length of wait, though that is a concern. Median wait times for 10 of the 16 surgical procedures tracked by the government have increased in the last three years. Waits for two procedures have stayed the same, and the wait for four others is shorter.
That's a problem. But the greater problem, in terms of confidence, is the impossibility of getting a clear answer about why they are increasing, and what can be done.
Some answers are obvious. In many areas we're simply doing fewer operations than we were three years ago, despite a population that has grown by almost three per cent.
The case of a Vancouver woman who had waited eight weeks for surgery for a brain tumour, and been cancelled twice, sparked headlines and hand-wringing.
How could this be?
One obvious answer is that health care system is doing fewer neurosurgical procedures. Three years ago 4,369 people got the neurosurgery they needed; in the last fiscal year the number of procedures was six per cent lower. For five of the 13 procedures that can be tracked on the government's wait time web site the story is the same. Fewer operations were performed in the four months ending this March 31 than in a comparable period in 2001. Fewer surgeries means longer waits.
Not all areas of surgery have been cut back. The number of hip and knee replacements are up about 50 per cent over three years ago.
But why? Is it because baby boomers who want to get back to tennis are pushy and politically effective, or because there's a lot of good knee doctors right now eager to keep busy? There's certainly no evidence to suggest that the best professionals sat down and made an informed decision, system-wide, on what kinds of surgeries should be performed given limited money.
Health Minister Colin Hansen doesn't help build confidence. He responds to questions about wait times in part by saying he doesn't believe the data compiled by his government. He also dismisses other studies that show lengthening waits.
That raises a couple of questions. Why hasn't Hansen - after more than three years - able to come up with data he considers reliable on how long people are waiting?
And more critically, how can the government and health authorities manage wait times when say they don't even know what they are?
Health care costs each British Columbian an average $2,700 a year - $11,000 for a family of four. But the health care system can't say what people can expect for their money. We'll do what we can, they say. Maybe you'll get needed surgery this year, maybe you won't. Take what we give you, and don't ask questions because it's complicated and anyway we don't have answers.
It's not good enough.
Certainly, the system provides an extraordinary level of care. The problems are complex. And some excellent work is being done, like the Western Canada Waiting List Project.
But waits and access have been a concern for a dozen years, and there is still no accurate measurement of how long people wait, no definition of acceptable waits, no fair queue and no guarantee of treatment with a reasonable time.
The result is increasing frustration, and more demands for changes that undercut the important principle or universal, equitable access to health care for all Canadians.
Footnote: The system's inability to provide decent information means the public can't make an informed choice about spending priorities. Most British Columbians would have gladly foregone the sales tax reduction if there was a clear promise of reduced wait times for specific procedures. The health care authorities can't deliver.
It's from within.
The people in charge - not just the politicians, but the professional managers in the system - have done a bad job, and their failure has undermined confidence.
The public has difficulty judging the system's performance. We don't know if the doctor makes the right decisions when it comes time to fix us up.
But there are some clear measures, like wait times. And they are enough to shatter our confidence.
It's not just the length of wait, though that is a concern. Median wait times for 10 of the 16 surgical procedures tracked by the government have increased in the last three years. Waits for two procedures have stayed the same, and the wait for four others is shorter.
That's a problem. But the greater problem, in terms of confidence, is the impossibility of getting a clear answer about why they are increasing, and what can be done.
Some answers are obvious. In many areas we're simply doing fewer operations than we were three years ago, despite a population that has grown by almost three per cent.
The case of a Vancouver woman who had waited eight weeks for surgery for a brain tumour, and been cancelled twice, sparked headlines and hand-wringing.
How could this be?
One obvious answer is that health care system is doing fewer neurosurgical procedures. Three years ago 4,369 people got the neurosurgery they needed; in the last fiscal year the number of procedures was six per cent lower. For five of the 13 procedures that can be tracked on the government's wait time web site the story is the same. Fewer operations were performed in the four months ending this March 31 than in a comparable period in 2001. Fewer surgeries means longer waits.
Not all areas of surgery have been cut back. The number of hip and knee replacements are up about 50 per cent over three years ago.
But why? Is it because baby boomers who want to get back to tennis are pushy and politically effective, or because there's a lot of good knee doctors right now eager to keep busy? There's certainly no evidence to suggest that the best professionals sat down and made an informed decision, system-wide, on what kinds of surgeries should be performed given limited money.
Health Minister Colin Hansen doesn't help build confidence. He responds to questions about wait times in part by saying he doesn't believe the data compiled by his government. He also dismisses other studies that show lengthening waits.
That raises a couple of questions. Why hasn't Hansen - after more than three years - able to come up with data he considers reliable on how long people are waiting?
And more critically, how can the government and health authorities manage wait times when say they don't even know what they are?
Health care costs each British Columbian an average $2,700 a year - $11,000 for a family of four. But the health care system can't say what people can expect for their money. We'll do what we can, they say. Maybe you'll get needed surgery this year, maybe you won't. Take what we give you, and don't ask questions because it's complicated and anyway we don't have answers.
It's not good enough.
Certainly, the system provides an extraordinary level of care. The problems are complex. And some excellent work is being done, like the Western Canada Waiting List Project.
But waits and access have been a concern for a dozen years, and there is still no accurate measurement of how long people wait, no definition of acceptable waits, no fair queue and no guarantee of treatment with a reasonable time.
The result is increasing frustration, and more demands for changes that undercut the important principle or universal, equitable access to health care for all Canadians.
Footnote: The system's inability to provide decent information means the public can't make an informed choice about spending priorities. Most British Columbians would have gladly foregone the sales tax reduction if there was a clear promise of reduced wait times for specific procedures. The health care authorities can't deliver.
Monday, November 08, 2004
Liberals test out new nice-guy image for Campbell
VICTORIA - It's like the Grinch headed off to the magical land of the $1-million starter home, and suddenly turned into a cross between Santa Claus and Mother Teresa.
Gordon Campbell and the Liberals have just wrapped up their pre-election convention in Whistler, a party and high-tech pep rally for about 1,000 of the faithful.
The big theme was the emergence of the new kinder, gentler Campbell, who after three years of cutting spending and attacking government is now ready to write some cheques and get a little activist.
It's easy to proclaim yourself changed, and hard to get people to believe you.
Campbell signaled the new focus with an announcement that British Columbians who qualify for disability benefits would get an extra $70 a month, the first increase in a decade.
It's a welcome and overdue change. The current disability benefit for a single person, unable to work, provides up to $325 a month for housing and $460 a month for everything else. It's a tough, often demeaning life. (By way of comparison, a minimum wage job provides a 40-per-cent higher income.)
Still, the Liberals have made the positive change. And during their three years the number of people on disability has increased by more than 20 per cent, in part because of willingness to acknowledge individual need.
But then there was the big disability review. The Liberals wasted more $4 million - and created a huge amount of fear and uncertainty - on a review that established that 98 per cent of disability claimants were fully entitled. (A review may have been a good idea, but could have been accomplished simply with a random audit of files.)
It wasn't just the disabled who got some good news. Campbell used the convention to promise free hearing, sight and dental tests for every B.C. child before Grade 1. It's a good measure, although only if help is available when problems are detected.
Schools will be made earthquake-safe within the next decade, and junk food banned within the next four years, the premier promised.
Along with the kinder stuff came a little emphasis on law and order, notably plans to seize peoples' stuff if they can't prove they didn't buy it with the proceeds of crime and to do something about grow ops.
And, naturally, the convention featured some NDP-big union bashing along the way.
The Liberals are in a position to spend some money. The economy in much of the province has improved significantly in the last year, and the government is expecting a surplus of more than $1 billion this year, increasing in the next two.
But there are a couple of question marks around the image remake.
The first is that the government has always been in a position to improve disability benefits, or ensure all children get a good start in school. A tax cut of 24 per cent, instead of 25 per cent, for example, would have fully funded the disability benefit increase.
The bigger problem is that Campbell is saying trust me, and he's already broken trust on some big issues. Halt the expansion of gambling, he said. Instead, they've tripled the number of slot machines. No sale of BC Rail. No ripping up of contracts. No taxpayer-paid political advertisements. All broken promises.
Which makes it hard for the premier to ask for trust.
Conventions are mostly about getting the troops pumped up, and the Liberals put a lot of effort into that, with seven giant video screens around the hall and slick production values.
That meant, unfortunately, that there's a lot of useful self-scrutiny. It was considered impolite to raise the Surrey-Panorama Ridge byelection defeat, for example. Campbell alluded to the loss briefly, blaming the loss on union-financed ads promoting the NDP. That's insulting to the voters in the riding, and shuts off legitimate discussion of how the Liberals could do a better job of delivering the government that voters expect.
Footnote: The Liberals - already unpopular with women voters - voted down a policy resolution that said that since the party believes in fairness and equity, it should encourage measures to get more women into senior positions in government. Delegates also slapped the northwest by refusing to offer token support for the Kermode bear as the Olympic mascot.
Gordon Campbell and the Liberals have just wrapped up their pre-election convention in Whistler, a party and high-tech pep rally for about 1,000 of the faithful.
The big theme was the emergence of the new kinder, gentler Campbell, who after three years of cutting spending and attacking government is now ready to write some cheques and get a little activist.
It's easy to proclaim yourself changed, and hard to get people to believe you.
Campbell signaled the new focus with an announcement that British Columbians who qualify for disability benefits would get an extra $70 a month, the first increase in a decade.
It's a welcome and overdue change. The current disability benefit for a single person, unable to work, provides up to $325 a month for housing and $460 a month for everything else. It's a tough, often demeaning life. (By way of comparison, a minimum wage job provides a 40-per-cent higher income.)
Still, the Liberals have made the positive change. And during their three years the number of people on disability has increased by more than 20 per cent, in part because of willingness to acknowledge individual need.
But then there was the big disability review. The Liberals wasted more $4 million - and created a huge amount of fear and uncertainty - on a review that established that 98 per cent of disability claimants were fully entitled. (A review may have been a good idea, but could have been accomplished simply with a random audit of files.)
It wasn't just the disabled who got some good news. Campbell used the convention to promise free hearing, sight and dental tests for every B.C. child before Grade 1. It's a good measure, although only if help is available when problems are detected.
Schools will be made earthquake-safe within the next decade, and junk food banned within the next four years, the premier promised.
Along with the kinder stuff came a little emphasis on law and order, notably plans to seize peoples' stuff if they can't prove they didn't buy it with the proceeds of crime and to do something about grow ops.
And, naturally, the convention featured some NDP-big union bashing along the way.
The Liberals are in a position to spend some money. The economy in much of the province has improved significantly in the last year, and the government is expecting a surplus of more than $1 billion this year, increasing in the next two.
But there are a couple of question marks around the image remake.
The first is that the government has always been in a position to improve disability benefits, or ensure all children get a good start in school. A tax cut of 24 per cent, instead of 25 per cent, for example, would have fully funded the disability benefit increase.
The bigger problem is that Campbell is saying trust me, and he's already broken trust on some big issues. Halt the expansion of gambling, he said. Instead, they've tripled the number of slot machines. No sale of BC Rail. No ripping up of contracts. No taxpayer-paid political advertisements. All broken promises.
Which makes it hard for the premier to ask for trust.
Conventions are mostly about getting the troops pumped up, and the Liberals put a lot of effort into that, with seven giant video screens around the hall and slick production values.
That meant, unfortunately, that there's a lot of useful self-scrutiny. It was considered impolite to raise the Surrey-Panorama Ridge byelection defeat, for example. Campbell alluded to the loss briefly, blaming the loss on union-financed ads promoting the NDP. That's insulting to the voters in the riding, and shuts off legitimate discussion of how the Liberals could do a better job of delivering the government that voters expect.
Footnote: The Liberals - already unpopular with women voters - voted down a policy resolution that said that since the party believes in fairness and equity, it should encourage measures to get more women into senior positions in government. Delegates also slapped the northwest by refusing to offer token support for the Kermode bear as the Olympic mascot.
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