Wednesday, June 22, 2005

James' shadow cabinet continues moderate push

VICTORIA - Everybody got some sort of prize when Carole James announced her shadow cabinet this week, just like one of those elementary school track and field days where everyone leaves with a ribbon.
All 32 NDP MLAs got a post or position that gives them a role beyond the basic duties of an opposition backbencher.
That's an obviously smart thing to do. The NDP caucus is bigger than most people expected before the election, but still small enough that leaving out a handful of MLAs would sting.
But while everyone got jobs, James still put her stamp on the caucus by deciding who got the good jobs. And the message continued to be that the NDP is moderate, and has broken with its past.
So despite having two former health ministers to call on - Corky Evans and Mike Farnworth - James gave the main critic's job to David Cubberly, a rookie MLA from Saanich South. (Though a rookie with 12 years on municipal council and
seven years as an assistant to several cabinet ministers in the last NDP government.)
James also signalled a big emphasis on health. The Liberals eliminated junior minister positions for seniors' care and mental health and addictions. James made Cariboo South MLA Charlie Wyse critic for mental health, a natural fit given his work on mental health issues in the North. Katrine Conroy takes on seniors' health issues; she'll have lots of issues to raise given the Liberals' broken promises and missed deadlines on long-term care.Farnworth wasn't left out of the picture. He's House Leader, and will deal with
Liberal counterpart Mike de Jong on when and how things move through the legislature. It's an encouraging pairing; the two could deliver on both party leaders' claims they would like to see a more productive, positive atmosphere
in the House.
Evans ends up with energy and mines. That's an important post for his Kootenay region, where coal and coalbed methane development plans are sparking protests. But it's not a prime post.
There other early winners. Adrian Dix, the former Glen Clark strategist, is the children and families' ministry critic, a tough but important job. Jenny Kwan gets finance, facing off against Carole Taylor. Shane Simpson, a Vancouver rookie with experience in sustainability issues, gets environment.
John Horgan - another former NDP government staffer - gets education, and Scott Fraser, from Alberni-Qualicum, is the aboriginal affairs critic.
But not everyone fared so well. Yale-Lillooet MLA Harry Lali, a fervent Clark loyalist to the end, is critic for citizen services, a tiny part of Mike de Jong's labour ministry.
And some MLAs seem underemployed, like Powell River MLA Nicholas Simons, critic for tourism, sports and the arts, and Gregor Robertson, in advanced education.
James said she asked the MLAs to do written reports on their areas of interest, why they believed they were qualified to tackle those issues and the goals that should be set. She then interviewed them before naming the shadow cabinet.
Expect lots of changes in the line-up. James said the NDP caucus support staff - despite a much larger budget - is still small enough that she's expecting the critics to do effective research on their own.
And it's hard to predict which MLAs are going to emerge as effective critics, holding ministers to account in the legislature and getting the party's position across in the media. It takes a special set of skills to do the job
But the critics start with a couple of advantages. By the time the legislature resumes in September, they'll have a wide range of issues and problems to raise.
And they will be facing Liberal ministers who are just as green as they are. Only Children and Families Minister Stan Hagen and Income Assistance Minister Claude Richmond have face a real opposition. The rest are in for a new, and
challenging experience.
It's going to be a more interesting, and more effective, legislature.
Footnote: James disputed Gordon Campbell's claim that he had consulted with her on the choice of Bill Barisoff as Speaker; Campbell just gave her the news in a brief call 20 minutes before his cabinet announcement. But she noted she had
found Barisoff reasonable when they were both school trustees; he'll likely have NDP support when MLAs formerly elect the Speaker.

Monday, June 20, 2005

Abbott faces quick test from clinics pushing two-tier care

VICTORIA - A posh Vancouver clinic that promises better health care - for a steep annual price - is going to be one of the first tests for new Health Minister George Abbott. .
The Copeman Healthcare Centre is pushing the boundaries for two-tier care, promising an elegant waiting room, Internet access and most importantly "unparalleled levels of patient care."
The centre, set to open this fall, sounds great. But to get the benefits, you'll have to come up with a $1,700 initiation fee, and $2,300 a year. (Tax-deductible, of course.)
It may well be worth it, for those with the money.
But their gain comes at the expense of the rest of British Columbians.
The clinic is selling is access to better health care. Salaried doctors will see a dozen patients a day, instead of the typical 30 or 40. They will work on keeping clients healthy and do lots of testing to allow early diagnosis of problems.
But there is - or should be - a problem. The intent of the Canada Health Act is to prevent some people from slipping doctors, or hospitals, a big tip to make sure they get faster, better care. So far, Canadians have agreed that health care should be delivered on the basis of need, not on who can write the biggest cheque.
That principle has been steadily eroded, in B.C., and across Canada. Both NDP and Liberal governments in this province have turned a blind eye to the increasing number of private surgical clinics. The clinics offer paying customers - like Environment Minister Barry Penner - a chance to jump the queue and get speedier treatment, for a hefty price.
The Copeman clinic is a bid to take two-tier care to the next level, offering better basic health care for people with money, while still collecting from the Medical Services Plan at the same time.
Abbott will have to decide whether the clinic is legal, and two-tier health care is in the best interest of British Columbians.
Ministry staff met clinic owner Dan Copeman last week, but so far the government has taken no position on the private care centre.
That's surprising.
The clinic, and others like it, will actually ensure British Columbians who can't pay will get poorer treatment than they do today. (Effectively increasing the market for private clinics.)
Look at just one aspect, the effect on the doctor shortage in B.C.
The clinic wants to hire 12 doctors from within the province by the time it starts operations. Right now those doctors are practicing somewhere, and typically providing care to about 15,000 British Columbians.
But the clinic promises doctors will see one-quarter the number of patients.
Not only will the 15,000 patients lose their doctors, but the overall capacity of the system will be reduced, in order to improve the care for a small number paying a premium for better care. Some 200,000 people in the province can't find a family doctor today, and BCMA head Dr. Michael Golbey says the clinic will make the problem worse.
And there is the basic underlying principle.
So far, Canadians have agreed that equal access to health care is part of a fair society. We've said that if two children are sick, they both deserve the same treatment. Having parents with less money shouldn't mean a greater risk of sickness and death, or second-class medical treatment.
The clinic violates that basic principle. If parents register, their children are also covered. They receive the same promise of superior treatment.
The track record of B.C. governments is not good in this area.
Private surgical clinics opened under the NDP, and grew to more than two dozen under the Liberals. They provide faster treatment for thousands of people who can pay to jump the queue, while waits in the public system have risen.
The government has taken no action.
British Columbians will find out quickly if Abbott is prepared to act, where his predecessors waffled.
Footnote: Private clinics are proving that people are willing to pay more money for better health care. In this case, they are paying directly. But their willingness could equally extend to higher taxes  -- if they were convinced the money would result in benefits to them. (The clinics will automatically push up overall health care costs.)