VICTORIA - We're jaded out here, accustomed to seeing Ottawa as some strange distant land, kind of like the Emerald City in Oz.
There are gatekeepers, and shiny buildings, and men behind curtains pulling at levers to create the illusion of the great and powerful wizard, and it's all surreal and far away.
Then along comes Jean Brault, tugging on the curtains.
Brault is the first blockbuster witness at the Gomery Inquiry, naming names and dates and amounts. His testimony was at first secret, then public. It's very bad.
Brault ran Groupaction, a middling ad agency in Montreal. He wanted work from the federal government. So Brault says that in 1995 he hired Liberal fundraiser Alain Renaud, who promised federal contracts for Groupaction.
Over the next five years, Brault paid Renaud $1.1 million. More than $200,000 a year for part-time consulting, with no specific duties.
It worked. Federal contracts, big ones, came to Groupaction. Renaud introduced Brault to the big guys, including Jean Chretien advisor Jean Carle. Renaud spent most of his time working for the Liberal Party, Brault says, but who cared. Everybody was making money. Brault was told to buy some tickets for fundraisers, then hire some Liberal workers and write some big cheques, he testified. Big wheels from the Liberal party’s Quebec organization kept asking Brault for money and favours in return for federal government contracts. He kept saying yes.
So he paid the salaries of three Liberal party workers, gave $4,000 to Jean Chretien’s brother, hired Chretien's niece and agreed to pay $100,000 to get a contract to promote the gun registry. (Albertans faint in indignation here.)
It was sordid. Brault said Benoît Corbeil, the executive director of the party's Quebec wing, asked for a $400,000 donation and promised a $3-million sponsorship contract in return. Jacques Corriveau, a Chretien confidante, got $500,000.
"When it comes to sponsorships, it's clear in my mind. If it wasn't for the investments of all types that we made towards the party, despite our abilities, our share of the pie would have been very small," he testified.
His actual share was very large. From 1995 to 2001 he got $112-million in advertising contracts and $60-million in sponsorship contracts from the federal government.
It all has a Sopranos quality to it, lots of cash and mystery and nods and winks, an envelope of money left on a restaurant table while Brault goes to the washroom, gone when he gets back. The Liberal Party got $1.2 million in all, Brault says.
None of this is ancient history. It was all going on up to three years ago, when the news of the scandal broke and everyone went to ground.
None of this is proven either. Maybe Brault, facing criminal charges, is lying. Maybe, as the Liberals claim, they're the victims, unwitting dupes of clever, bad men who took advantage. Maybe other evidence before the Gomery Inquiry will provide a different view.
But today Canadians are left with the image of sleazy governing party that enriched friendly businesspeople and channelled tax dollars to itself. And they are wondering how an operation of this scale could be invisible to those at the top - why they didn't wonder, for example, about those operatives who seemed able to work full-time for the party without ever expecting a salary.
The New Democrats and Conservatives face a decision. Will people be more upset by the scandal now, or in the fall when Gomery reports? (The Bloc Quebecois does not have to worry. The anger in Quebec is lasting.)
The fairest course - and the best one - would be for them to wait until all the evidence is in before sending us back to the polls.
They don't have to worry about memories fading. Even for jaded British Columbians, this all seems too grand to be waved off as just one of those Ottawa things.
Footnote: The scandal is devastating to Liberal prospects in Quebec, and ironically - given the sponsorship program's stated aim - a boon to separatists. But the question figuring heavily in the parties' calculations is whether even this kind of damaging evidence can persuade Liberal voters in Ontario - or B.C. - to vote for Stephen Harper and the Conservatives.
Friday, April 08, 2005
Thursday, April 07, 2005
Waits still longer for most surgery, future still vague
VICTORIA - I guess it's good news that the government has discovered that 11,000 of the 80,000 names on surgical waiting lists shouldn't be there.
At least the problem has been identified, and is apparently being fixed.
But that's the extent of the good news, and there's much that's discouraging in the discovery, and in the fact that waits for many procedures are still up over the last four years.
The number of names on a wait list shouldn't matter much. Most of us care about how long it takes for us to get the procedure done, not how many others are on the list with us.
But wait lists matter to people who manage the system. If the list for one procedure keeps growing, then managers devote more resources to the treatment. And if the decisions are based on bad information, then money may be misspent.
The health ministry says it's identified the problem, and will have a new wait list system within the next year that will offer patients and managers accurate information. But it's 2005, long into an era when health care and waiting lists are supposed to be a priority, and basic management information isn't available. (A situation that is true across Canada.)
The news is also gloomy on the wait time front.
Deputy health minister Penny Ballem stresses the progress in providing treatment. The system provided 33 per cent more knee replacements in 2003-4 than it did three years earlier, and 41 per cent more angioplasties.
But the system has not kept up with demand.
The latest data shows that median waits have increased for 11 types of non-emergency surgery since the election, and fallen for five procedures. The wait for cardiac surgery has been cut by about four weeks, to two months.
But other waits have increased substantially. People are waiting one-third longer for knee replacements, with the media wait now 28 weeks. Since the median wait measures the time it takes for half the people to get surgery, that means that many are waiting much longer. The median wait for hip replacements has increased by a month, to almost 22 weeks. Both waits are shorter than in Ontario, acording to a new review; both are much longer than the standard recommended by the Canadian Orthopaedic Association.)
Lots of factors have driven the increased demand. The most significant, Ballem says, is an increase in the rate at which most procedures are being performed. Surgeries hurt less, require less rehab time and provide more consistently successful results. More people are candidates. In 1990, about 1,300 people had knee replacement surgery in B.C.; the annual number is almost three times that today.
The procedures work, so people in pain or with other problems expect treatment.
And since we are not paying for enough surgeries to meet the need, waiting lists grow. In the long term, we can find ways to keep people healthier and reduce demand, and increase efficiency. But now, either governments provide more money or waits increase.
That decision deserves much more open public debate, starting with a clear statement of how long it's reasonable for people to wait for different types of treatment, based on the severity of their condition and the impact on their overall health and lives.
The Wait Time Alliance of Canada, a doctors' group, has just released its proposals. Health Canada is supposed to have a list of acceptable wait times by the end of this year as part of the last health accord signed with the provinces.
We are fumbling with the issue of wait times, with too little information - as the wait list problems showed - and too little honesty.
People need to know what their governments are prepared to deliver, and at what cost.
Only then can they decide if that is enough to meet patients' needs.
Footnote: The model that has worked in at least some other jurisdictions is wait guarantees - knee replacement for moderate case within nine months, for example, of the government pays for surgery outside the system. The process forces an open, honest debate on what we are prepared to promise, and pay for.
At least the problem has been identified, and is apparently being fixed.
But that's the extent of the good news, and there's much that's discouraging in the discovery, and in the fact that waits for many procedures are still up over the last four years.
The number of names on a wait list shouldn't matter much. Most of us care about how long it takes for us to get the procedure done, not how many others are on the list with us.
But wait lists matter to people who manage the system. If the list for one procedure keeps growing, then managers devote more resources to the treatment. And if the decisions are based on bad information, then money may be misspent.
The health ministry says it's identified the problem, and will have a new wait list system within the next year that will offer patients and managers accurate information. But it's 2005, long into an era when health care and waiting lists are supposed to be a priority, and basic management information isn't available. (A situation that is true across Canada.)
The news is also gloomy on the wait time front.
Deputy health minister Penny Ballem stresses the progress in providing treatment. The system provided 33 per cent more knee replacements in 2003-4 than it did three years earlier, and 41 per cent more angioplasties.
But the system has not kept up with demand.
The latest data shows that median waits have increased for 11 types of non-emergency surgery since the election, and fallen for five procedures. The wait for cardiac surgery has been cut by about four weeks, to two months.
But other waits have increased substantially. People are waiting one-third longer for knee replacements, with the media wait now 28 weeks. Since the median wait measures the time it takes for half the people to get surgery, that means that many are waiting much longer. The median wait for hip replacements has increased by a month, to almost 22 weeks. Both waits are shorter than in Ontario, acording to a new review; both are much longer than the standard recommended by the Canadian Orthopaedic Association.)
Lots of factors have driven the increased demand. The most significant, Ballem says, is an increase in the rate at which most procedures are being performed. Surgeries hurt less, require less rehab time and provide more consistently successful results. More people are candidates. In 1990, about 1,300 people had knee replacement surgery in B.C.; the annual number is almost three times that today.
The procedures work, so people in pain or with other problems expect treatment.
And since we are not paying for enough surgeries to meet the need, waiting lists grow. In the long term, we can find ways to keep people healthier and reduce demand, and increase efficiency. But now, either governments provide more money or waits increase.
That decision deserves much more open public debate, starting with a clear statement of how long it's reasonable for people to wait for different types of treatment, based on the severity of their condition and the impact on their overall health and lives.
The Wait Time Alliance of Canada, a doctors' group, has just released its proposals. Health Canada is supposed to have a list of acceptable wait times by the end of this year as part of the last health accord signed with the provinces.
We are fumbling with the issue of wait times, with too little information - as the wait list problems showed - and too little honesty.
People need to know what their governments are prepared to deliver, and at what cost.
Only then can they decide if that is enough to meet patients' needs.
Footnote: The model that has worked in at least some other jurisdictions is wait guarantees - knee replacement for moderate case within nine months, for example, of the government pays for surgery outside the system. The process forces an open, honest debate on what we are prepared to promise, and pay for.
Tuesday, April 05, 2005
Liberals shovel money off their own campaign truck
VICTORIA - Premier Gordon Campbell showed why he’s everybody’s favorite visitor this week, rolling into Kelowna for a 30-minute speech and showering some $65 million on the region before guests finished dessert.
Kelowna, you get $6.5 million for a pool, complete with 1,000 spectator seats. Penticton, $9.7 million for an arena with two ice hockey surfaces - one Olympic size, and one for good old Canadian hockey. Vernon got its share a day earlier - $1.4 million for the cross-country ski club.
And, the big one, $50 million for an economic development trust for the Southern Interior, largely locally controlled.
Of course the premier can’t be everywhere. So while he was in Kelowna others got to announce that Smithers would get $1.7 million fo a second sheet of ice at the arena, Kimberley $1 million for a mining museum, Surrey $500,000 for YMCA improvements, Chemainus $350,000 to fix the wharf and Saanich $120,000 for a climbing wall.
All in, figure $70 million in spending and just another day on the unoffical pre-election campaign tour. Last week, the total was about $200 million - including a similar $50-million economic development fund for Vancouver Island and the Sunshine Coast.
There’s lots to be enthusiastic about in the spending announcements. The government has the money. And most of the spending, I think, offers long-term benefits.
But there is lots that’s troubling too.
Start with the fact that this was supposed to be a New Era. It was in Kelowna, back in 1996, that the Liberals staged their own campaign stunt to mock the NDP’s pre-election spending spree. They had a guy in a bad Glen Clark mask slinging gold coins off a dump truck. Campbell was there with a shovel, scraping the coins up off the pavement and throwing them back.
There are differences, of course. The NDP didn’t actually have the money they were tossing around. They said the budget was balanced, and it wasn’t.
Still, the claim was that the Liberals would be different, and they look much the same.
Then consider the fact that none of this spending has been approved by the legislature. The MLAs could be sitting now, conducting the usual detailed review of spending plans, including all these projects. Instead the Liberals shut down the house.
Consider also that much of the spending being announced now could have been provided months ago. The government had an assured surplus. If a $50-million economic fund for the Southern Interior was a good thing - and it likely is - the work could have begun last year.
Finally, consider that all this electioneering is at taxpayers’ expense. Once the official campaign starts, the Liberal party will have to send out the press releases and fly the premier and company into places like Kelowna. Right now, it’s your dime.
Campbell’s position is that the Liberals are just following their plan. Tough decisions, service cuts, improving economy, chance to spend. The proximity of the May election, he says with a small wink, is a coincidence.
Not many people will buy that claim. But it probably doesn’t matter that much politically. If the only way a community can get funding for priority projects is to wait for an election campaign, it will wait and be glad of the money. (This kind of behaviour - especially the contrast between the way the Liberals pledged to do business when they were in Opposition and the current same-old style - likely does increase general cynicism about the political process. That’s good news for the ‘yes’ side in the STV referendum.)
And all this spending activity - and the taxpayer-funded announcements - have let the Liberals control the agenda, and keep the NDP largely out of the news during this unofficial campaign.
Meanwhile, you might as well hope the premier drops by your town for lunch over the next two weeks. He brings nice gifts, even if you ultimately pay for them.
Footnote: The $50-million development trust will be spent by a board including eight municipal representatives and five provincial appointees. The idea is that people in the region can make their own decisions on investments to develop the local economy without going through the process of winning provincial approval each time.
Kelowna, you get $6.5 million for a pool, complete with 1,000 spectator seats. Penticton, $9.7 million for an arena with two ice hockey surfaces - one Olympic size, and one for good old Canadian hockey. Vernon got its share a day earlier - $1.4 million for the cross-country ski club.
And, the big one, $50 million for an economic development trust for the Southern Interior, largely locally controlled.
Of course the premier can’t be everywhere. So while he was in Kelowna others got to announce that Smithers would get $1.7 million fo a second sheet of ice at the arena, Kimberley $1 million for a mining museum, Surrey $500,000 for YMCA improvements, Chemainus $350,000 to fix the wharf and Saanich $120,000 for a climbing wall.
All in, figure $70 million in spending and just another day on the unoffical pre-election campaign tour. Last week, the total was about $200 million - including a similar $50-million economic development fund for Vancouver Island and the Sunshine Coast.
There’s lots to be enthusiastic about in the spending announcements. The government has the money. And most of the spending, I think, offers long-term benefits.
But there is lots that’s troubling too.
Start with the fact that this was supposed to be a New Era. It was in Kelowna, back in 1996, that the Liberals staged their own campaign stunt to mock the NDP’s pre-election spending spree. They had a guy in a bad Glen Clark mask slinging gold coins off a dump truck. Campbell was there with a shovel, scraping the coins up off the pavement and throwing them back.
There are differences, of course. The NDP didn’t actually have the money they were tossing around. They said the budget was balanced, and it wasn’t.
Still, the claim was that the Liberals would be different, and they look much the same.
Then consider the fact that none of this spending has been approved by the legislature. The MLAs could be sitting now, conducting the usual detailed review of spending plans, including all these projects. Instead the Liberals shut down the house.
Consider also that much of the spending being announced now could have been provided months ago. The government had an assured surplus. If a $50-million economic fund for the Southern Interior was a good thing - and it likely is - the work could have begun last year.
Finally, consider that all this electioneering is at taxpayers’ expense. Once the official campaign starts, the Liberal party will have to send out the press releases and fly the premier and company into places like Kelowna. Right now, it’s your dime.
Campbell’s position is that the Liberals are just following their plan. Tough decisions, service cuts, improving economy, chance to spend. The proximity of the May election, he says with a small wink, is a coincidence.
Not many people will buy that claim. But it probably doesn’t matter that much politically. If the only way a community can get funding for priority projects is to wait for an election campaign, it will wait and be glad of the money. (This kind of behaviour - especially the contrast between the way the Liberals pledged to do business when they were in Opposition and the current same-old style - likely does increase general cynicism about the political process. That’s good news for the ‘yes’ side in the STV referendum.)
And all this spending activity - and the taxpayer-funded announcements - have let the Liberals control the agenda, and keep the NDP largely out of the news during this unofficial campaign.
Meanwhile, you might as well hope the premier drops by your town for lunch over the next two weeks. He brings nice gifts, even if you ultimately pay for them.
Footnote: The $50-million development trust will be spent by a board including eight municipal representatives and five provincial appointees. The idea is that people in the region can make their own decisions on investments to develop the local economy without going through the process of winning provincial approval each time.
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