Thursday, June 16, 2005

Cabinet signals a different Liberal government

VICTORIA - It's a different looking Liberal government today than it was four years ago - or even 24 hours ago.
Gordon Campbell's cabinet has lots of new faces, and new ministries.
People who weren't around four years ago - like Carole Taylor, the new finance minister, and Wally Oppal, the new attorney general - have moved into key jobs.
Ministries that were important four years ago - competition, science and enterprise, management services, sustainable resources, long-term care - have vanished.
And new ones have popped up. B.C. now once again has an environment ministry, with perennial bridesmaid Barry Penner at the helm. Colin Hansen heads up a new economic development ministry, with responsibility for cashing in on the booming Asia-Pacific markets and the Olympics. Campbell says Hansen's role in his new job will likely be more sweeping than it was in finance.
And the Liberals - the people who started their first term with a destructive referendum on First Nations' treaties - have now created a whole new ministry of aboriginal relations and reconciliation.
Campbell hopes to make better relations with First Nations - starting with a willingness to recognize the need for government-to-government talks - a critical part of the this term, and a cornerstone of economic progress.
It's good that organizations adapt to changing circumstances, and learn from mistakes. But it also means things are going to be confused in government for a while, as people try to figure out who they now work for.
One of Campbell's challenges this time around was to come up with a balanced cabinet, one that represented all British Columbians.
He faced some immediate problems, starting with the number of defeated LIberal candidates outside the Lower Mainland.
Regional balance did get a good boost with George Abbott's big promotion to health minister. The Salmon Arm MLA joked about emerging from his "cloak of obscurity," but he has a chance - as Campbell noted - to respond to concerns that health care has deteriorated most sharply in smaller centres under the Liberals. And he faces the big challenge of responding to the Supreme Court of Canada ruling that it is wrong for governments to ration care, causing suffering and even death as waits for treatment climb.
Tom Christensen's new role in aboriginal relations also gives the Okanagan region a prime seat at the cabinet table, and Richard Neufeld stays in energy and mines, supported by newly appointed Kootenay MLA Bill Bennett, who becomes the junior minister for mining.
But a lot of the big jobs - attorney general, finance, economic development, forests, labour, transportation - will be filled by ministers from the Lower Mainland.
Even forests will be taken on by Rich Coleman, who represents the Vancouver suburb of Langley. It's a big challenge for Coleman. Red-hot U.S. markets have helped disguise some of the fundamental problems facing B.C's forest sector; things are likely to become more challenging on his watch.
(Coleman's move creates a big opportunity for John Les, who takes over as solicitor general and picks up responsibility for gambling, alcohol sales and ICBC. It also heads off potential conflicts between Oppal and Coleman, who differ on many policing and justice issues.)
One area of welcome stability is children and families. Stan Hagen made it clear that he wanted to stay in the challenging ministry, and he got his wish. The often-troubled ministry needs his experience and commitment after a rough ride through much of the Liberals' first four years.
Regional balance isn't the only issue. The number of women in cabinet has dropped from nine to five, with only two - Taylor and new Education Minister Shirley Bond - in key posts.
The verdict overall?
It's much too soon to say, really, with too many unknown details.
But at first glance Campbell appears to have done a good job of building a solid cabinet out of the materials at hand.
Footnote: Campbell pledged some sort of action on electoral reform, but it's unclear what. He noted that the single-transferable-vote system got more support than any political party in B.C., but left vague his plans for addressing the public's desire for change. It would be on the agenda when he meets Carole James later this month, he said.

Monday, June 13, 2005

Supreme Court put governments on notice on deadly surgical waits

VICTORIA - That big Supreme Court ruling doesn't mean the end of medicare.
Unless governments decide that's what they want.
The judgment simply said that if governments fail to deliver reasonable care, then people have the right to go elsewhere.
And the court found that governments have allowed the health care system to deteriorate so badly that reasonable care is no longer available.
Government policies have meant that people are suffering terribly, and dying, as a result of long waits for surgery and other treatment, the justices ruled. "A health care service that does not attain an acceptable level of quality of care cannot be regarded as a genuine health care service," the court found.
And under those circumstances, the justices ruled in a four-to-three decision, the Quebec charter of rights gives individuals the freedom to go and buy private insurance to guarantee care.
The judgment was a damning indictment of governments across Canada.
People are suffering "physical and psychological suffering and risk of death" due to long waits, the court found. "There is unchallenged evidence that in some serious cases patients die as a result of waiting lists for public health care."
Governments now face two choices.
They can make the public system work, by delivering reasonable care.
Or they can continue down the current path, knowing they are ensuring that people with money will be able to buy treatment while average citizens risk suffering and death as they wait for care.
Governments will likely stall for a while longer. Premier Gordon Campbell says the case shows the need to "modernize" the Canada Health Act, reducing the government's responsibility for providing care. Federal Health Minister Ujjal Dosanjh promised wait time guidelines by the end of the year.
The Supreme Court justices anticipated the politicians' responses.
"Governments have promised on numerous occasions to find a solution to the problem of waiting lists," the judgment noted. Despite all the talk, "governments have lost sight of the urgency of taking concrete action."
No kidding. In B.C., median waits for 11 types of non-emergency surgery have risen over the past four years; they have fallen for only five types. People are waiting one-third longer for knee replacements than they were four years ago. The LIberals, in opposition, complained those waits were too long.
The current ruling only applies to Quebec. The Supreme Court was split three to three, with one abstention, on whether the Canadian charter of rights carries the same implicit right to private surgery when governments don't provide reasonable care.
But it would be foolish for governments to stall.
Ultimately, the solution is simple. Governments need to define basic health care, including issues like how long someone must suffer while waiting for surgery, and how cases will be given priority. And then they need to deliver that level of care.
It will be tough for governments to dodge the issue, given the court ruling and the potential political consequences of coming out against equal access to health care.
Canadians have accepted that children from a poorer family are entitled to the same level of care as their wealthier neighbours. They recognize that if a shortage of doctors and nurses is one cause of the long waits, then the shift of medical staff to a parallel private system will make things worse for those who can't afford private care.
And they know that allowing two-tier care does nothing to reduce health care costs; it simply changes the way the services are paid for, and who gets treatment. In fact overall health spending would rise.
The Supreme Court did Canadians a great service by setting out the issue clearly.
Governments have failed to deliver acceptable health care, and refused even to offer a definition of what standard of care people have a right to expect. People have suffered as a result, and the problem is growing worse.
Now is is time for them to act.
Footnote: The Supreme Court noted that many European countries maintain successfully maintain side-by-side public and private insurance systems. But in each European example, a commitment to an excellent public health care system was the starting point, and the reason that the public system continued to be popular.