Health resignation a challenge to Campbell

VICTORIA - When the government's top health care manager quits in protest over Premier Gordon Campbell's "unsound" plans for health, the public deserves answers.
Dr. Penny Ballem isn't just another bureaucrat. Campbell recruited her to run the health ministry in 2001. Since then she's been at the centre of all the health care changes, with strong support from Campbell.
Until last week, when Ballem quit and went public with her concerns in a letter delivered to Campbell (and quickly leaked).
"As I have advised you, the plans that you and your deputy minister have established for the organization of the Ministry of Health are unsound and reflect a lack of confidence in my leadership on your part," Ballem wrote. "This, combined with the lack of satisfaction you have expressed in the work the ministry has brought forward to cabinet, has clarified for me that it is time I moved on."
It's a major attack on government health policies from a senior manager who has been steadfastly loyal. Ballem has taken the lead in defending the government's health policies, a job usually reserved for politicians.
Ballem's resignation raises important questions for the public. The premier's office apparently plans major health-care changes that Ballem believes are so "unsound" that she has no choice but to resign. What are they?
Cabinet was apparently unhappy with the proposals coming from the health ministry. What were they, and why did cabinet ministers get so exercised about them?
And was the government's move to shift thousands of surgeries to private clinics one of the areas of conflict?
Campbell's response so far has been lame. He says he doesn't know what policies Ballem was referring to when she used the "unsound" label. Ballem was involved in developing all the current policies, he says.
It's a worrying response. There's clearly a significant policy question - Ballem didn't quit a job she devoted five years to on a whim. Neither Campbell nor Health Minister George Abbott apparently know what the policy question is and had not picked up the phone to call her and find out.
There are other factors at play. Ballem's letter of resignation specifically mentioned that the unsound policies are being promoted by the premier and his deputy minister, Jessica McDonald.
The premier's office under McDonald has been pushing into policy areas that were the preserve of ministries. Its budget has increased 40 per cent over the last two years. About $2.5 million of the increase has gone to set up the "deputy minister's policy secretariat."
Campbell say the secretariat lets his office take a broader look at policy questions than any individual ministry can do. But it also concentrates power within a small group reporting to the premier and undercuts ministries.
Health care remains the top issue for the public and a problem for the government. The spring session of the legislature was dominated by questions about ER problems, crowded hospitals and a shortage of long-term care spaces.
The Liberals hoped that setting up the five regional health authorities would spare them some of the inevitable health-care controversies.
But that hasn't worked. The health authorities aren't responsible to anyone but government, which sets the budgets, appoints the directors and calls the policy shots. When 91-year-old Fanny Albo was pushed from a Trail hospital and died far from family and friends, Ballem was sent to the Kootenays to find out why. (Her review identified major public dissatisfaction with the Interior Health Authority.)
Some Liberal MLAs - taking the brunt of the criticism in their ridings - have been grumbling about the health problems.
All this is unfolding against the backdrop of Campbell's big, vague plans for health care change. He travelled to Europe to look at alternate systems, but hasn't provided any report to the public. He plans some sort of "dialogue" on health care this fall, but again details are non-existent.
Ballem's resignation raises immediate, important questions. The public needs real answers.
Footnote: Ballem's resignation caught Abbott by surprised and the health minister was left looking out of the loop when reporters caught with him late Thursday. Ballem sent her resignation letter to the premier that morning; by day's end Abbott still didn't know she had complained of unsound plans from the premier's office.