Friday, March 03, 2006

Turin shows how easy it is to blow Olympic business opportunities

VICTORIA - So have you booked your holiday to Turin yet? Made plans to invest there, or buy a villa and start a new life?
Those are important questions for B.C. The 2010 Olympics are supposed to make people flock here, and companies open businesses.
So the Turin Games should have stirred some of the same interest from you.
After all, the justification for spending some $1.5 billion in taxpayers’ money to put on the 2010 Olympics is that there will be a lasting economic benefits. They should make people want to visit, or choose Vancouver as their next corporate office.
The Games themselves will likely be a wonderful experience for people in Vancouver and Whistler, and leave a legacy of sports facilities and Lower Mainland transportation improvements.
But they are ultimately money-losers.
Vancouver organizers point to indirect benefits - from increased tourism to investment - that they say will be worth $6 billion to $10 billion. A government study predicted that the Olympics could bring an increase of $2 billion to $3.3 billion in tourism revenues over seven years. That’s an average four-per-cent increase over current levels, large but consistent with Calgary’s experience.
Auditor General Wayne Strelioff looked at all those projections, and said they seemed reasonable. But he added a warning, quoting consultants who did the review.
"These benefits will not materialize automatically," they said. "They must be earned by a focused, adequately funded and skillfully executed marketing program."
The Turin Games reinforce that warning. Everything went well. But there was little evidence - at least from here - that Italy, or the region, was seizing on the marketing opportunity.
Economic Development Minister Colin Hansen agrees. “I don’t believe Italy is going to benefit as much as they could,” he says. One of the jobs of the Olympics Secretariat, part of his ministry, is to make sure B.C. gets the maximum long-term value from the Games.
But it’s not easy. The effort will take co-ordination, a clear strategy and money.
And time is already getting tight, given the size of the task.
Start with the most basic questions. What message does B.C. want to send, and who are the main target audiences?
The controversy over Vancouver’s share of the closing ceremonies in Turin shows how tricky this can be. The classic - or cliched - images of ice-fishing and snowmobiles sent a message. But they reinforced existing stereotypes, rather than reaching out to new markets.
Hansen says the government is looking at a brand statement for B.C. for the Games. The existing tourism brand - Super, Natural BC - remains a starting point. But Hansen says the province’s cosmopolitan, modern cities and the diverse population need to be part of the message.
Those are the values - along with the Pacific location - that can attract not just tourists, but European investors or Asian companies looking for a new North American branch office.
Crafting the message is only the first part of the challenge. The second is finding ways to get it out.
Some will be narrowly targeted. “The Olympic Games have become a bit of a meeting place for the world’s business community,” Hansen says, not just the sponsors but other companies who see a chance to reward customers or do business.
And B.C. learned in Turin, with its log house and Mounties, that thousands of journalists all looking for easy, interesting stories are a great opportunity.
There’s still a lot to be done, and not a lot of money to do it with. The government doubled Tourism BC’s budget in 2004, to $50 million, but isn’t planning any extra money to seize the opportunities the Games provide. The Olympics’ Secretariat has a relatively modest budget, and is focused on immediate issues.
Hansen says the once-in-a-lifetime opportunity won’t be missed. “In 2011, I don’t want to be saying to myself if only we had done ‘X,’” he says.
But Turin shows how easily the chance for long-term gains can be lost.
Footnote: The other major - and very difficult challenge - is ensuring the Games benefits flow beyond the Lower Mainland. The government can’t afford to blur its main message, but there needs to be a clear strategy to ensure communities from Terrace to Trail share in the benefits of Games that they are paying for. And a scoreboard, or new seats at a playing field, aren’t enough.

Thursday, March 02, 2006

Tough talk on IHA brass softens overnight

What happened in the last 24 hours?

On Wednesday deputy health minister Penny Ballem released her review of the death of Fanny Albo, cruelly separated from her husband of 70 years without the chance for a proper goodbye and moved to a care home 105 kms away. She died two days later.

Ballem noted two senior Interior Health Authority medical leaders had failed to participate in the review, a fact she found "remarkable," and not in a good way. Health Minister George Abbott was there, and said he wasn't happy at their lack of participation.

But when NDP leader Carole James raised the problem in the legislature Thursday, Abbot downplayed the concern.

"Hon. G. Abbott: To be clear, the deputy — and I was there — referenced one or two officials who she would have liked to have spoken to, but she wasn't able to. One should not make more of that than what the deputy actually said. Again, the officials that I am meeting with later today worked very hard to ensure that the deputy had all of the information and all of the cooperation that was necessary in putting together a very constructive report."

Here's what the deputy actually said in her report:

”There is insufficient support and involvement of senior medical leaders from the Kootenay Boundary Health Service Delivery Area and corporate Interior Health in the area of quality of care and critical incident investigation.”

So why was Abbott ducking?

Albo's tragic case entirely predictable, and avoidable

VICTORIA - Almost seventy years they were married, Al and Fanny Albo.
But they died apart. Fanny was 91, and her heart was failing fast. Her sons knew she didn't have long to live. They wanted her to die with peace and dignity, and the couple to stay together for their last days.
Government policy and bad judgment by Interior Health Authority staff made that impossible.
There aren't enough acute care beds in hospitals, or long-term care beds in communities. If someone - like a dying old woman - is an acute care bed, she's blocking other patients.
So she gets moved, even if it's to a care home in a town 105 kms away over mountain roads, where she knows no one.
The government's "first available bed" policy says the priority is to clear the acute care bed. Someone who should be in long-term care has to take the first available bed, even if it's in a distant community, and wait for an opening closer to home.
Patents can pay for private care. But if they're counting on the government, they should be prepared to be moved.
In Fanny's case, that happened over the objection of her family and doctor. She was shuffled into an ambulance so quickly her husband had no time to hug her or kiss her goodbye.
And two days later she died.
Health Minister George Abbott dispatched his deputy to investigate, and this week she reported. It's a useful effort. But some of the biggest questions aren't answered, and the language is fuzzy.
Start with how both Albos ended up in hospital. Mrs. Albos was admitted in December because of her failing heart. But she rallied, and was sent home to be with her 96-year-old husband. They were supposed to get home care support to help him cope.
But it didn't happen. "The home support was insufficient in quality and time commitment," Ballem says. Within weeks her condition worsened, and Al suffered painful compression fractures of his vertebrae from trying to care for her.
They were both admitted to hospital. Ballem couldn't say why, but noted fewer home support services are available in Trail than in the rest of the province.
Why was Mrs. Albo moved? The main reason, Ballem says, is that no one took the time to think about what was best for her. They didn't consider a palliative care bed (though since Trail has only one, that's not surprising). They didn't question whether the first available bed policy made sense in this case.
The Interior Health Authority comes in for a slagging in the report. No one - nurses, family doctors, community - trusts the authority, or feels involved and consulted. (I'm offering a more direct paraphrase of the report.)
But the report doesn't really talk about the pressures. "There is a need for better alignment of home and community care and primary care resources with the health needs of the community," Ballem writes.
What that means, I think, is that it was mistake to close obsolete long-term care beds before replacements were ready. The Trail region has 90 fewer beds now than it did in 2001, according to local health care groups. They have been also been warning for three years about cuts to home care.
The Liberals promised 5,000 additional long-term care beds by 2006. In 2002, they said 4,200 beds were needed immediately to meet demand.
But the promise has been broken, and so far, they have added only 607 beds since 2001 - a record worse than the NDP's poor performance.
So health authorities juggle impossible demands. Leave someone in acute care while they wait for a local care placement, and they do badly and the bed is lost. Surgeries are cancelled, ER hallways fill up.
Push them into a distant long-term care home, and families are shattered.
Things may be worse in the Kootenays, but this is a problem across B.C.
Footnote: The government's apparent surprise at this case is could have been avoided by a subscription to the Trail Times. The newspaper has been reporting since 2002 on concerns about cuts to home care and long-term care, and the increasing risk to seniors and their families. Their dissatisfaction with the Interior Health Authority was also chronicled repeatedly.

Tuesday, February 28, 2006

Budget cuts, not child’s death, preoccupied ministry

VICTORIA - Read Jane Morley’s report on the death of Sherry Charlie, and you’ll be left scratching your head at the fumbling in the children and families’ ministry.
You’ll see that the government’s claim that budget cuts had not hurt the ministry’s ability to protect children is not true.
And you’ll have confirmation that the Liberals betrayed their 2001 campaign promise to stop “the endless bureaucratic restructuring” of the ministry.
Faced with an important task - learning from the death of a toddler - the ministry proved incapable of getting the job done, dragging the process out for more than two years.
Everyone knew it was taking too long. Periodically there would be brief bursts of activity, followed by long stretches where not much happened. About 18 months were lost to “periods of minimal productive work,” reported Morley, the province’s child and youth officer.
"But during the lapses, no one was monitoring and systematically asking the question - what is happening,” she reports.
Morley concludes there was no cover-up, or interference by politicians.
But the decisions politicians made - including the decision to cut the ministry budget - helped ensure the process dragged on. And the ministry fought to prevent scrutiny of its policies.
Sherry Charlie was beaten to death in September, 2002, weeks after being placed in the care of relatives under a new, poorly introduced ministry “Kith and Kin” policy. The placement decision was made by Usma, a First Nations agency operating under the ministry’s authority.
It was a bad decision. The father in the home - the man who killed her - had along and violent criminal history. The ministry had investigated other alleged problems. Systems to protect Sherry weren’t in place, or broke down.
The director’s review, an internal investigation, was supposed to look at the lessons that could be learned. (The Liberals had eliminated the Children’s Commission, which provided effective oversight when a child died. The Coroners’ Service is supposed to investigate child deaths, but has failed. An inquest into Sherry’s death was only held this month.)
The ministry’s internal review was plagued with problems. It hired Nicholas Simons to do the review. Simons, now a New Democrat MLA, was then executive director of child and family services for the Sechelt Nation then.
Simons hadn’t done a review like this before, and the ministry never clearly conveyed its expectations. The review went through 25 drafts and ended up pretty much as Simons submitted it in September, 2003, Morley reports.
But not entirely. Recommendations on ways the ministry could improve were gradually eased out of the report.
The ministry view was that the report should only look at whether people followed existing policy, not whether those policies were adequate to protect children. (Simons’ initial draft said that homes where children were to be placed under the new “Kith and Kin” agreements should be evaluated as thoroughly as any other placement; the ministry resisted including the recommendation.)
It’s an unreasonably narrow mandate, one more likely to find individual scapegoats than systemic problems. That’s especially worrying in the light of the lack of any other timely, effective review.
Through this long process the ministry had other priorities than learning from a child’s death. The government had launched a massive shift to regionalization, then pulled back. It had announced a 23-per-cent budget cut, then reduced that to 11 per cent. Coping with budget cuts consumed managers.
“The issue of how to manage the budget cuts took priority for senior managers, particularly starting in the summer of 2003,” Morley reports. “The regular monitoring information received by the executive was focused on this issue, not on such issues as whether the director’s cases were reviews were being completed.”
Managers failed. They let things slide, communicated badly and didn’t do their jobs. The people in charge didn’t get the review done.
But they failed in part because the government’s policies - including a damaging budget cut - left them unable to do the job.
Footnote: Minister Stan Hagen’s written response tried to shift the blame on to Simons. But he did not address the impact of budget cuts, or the management failures. Morley didn’t address the role of her office in not responding to the fact that the report was so long overdue.