Major screw-up

I just love living in BC. Besides all the obvious feel-good things we constantly hear trumpeted by the “Beautiful BC” people in the Ministry of Tourism, there is a constant cornucopia of yummy political gaffes regularly served up by health bureaucrats and politicians.

The health minister’s most recent foray into doctor-controlling legislation recently hit the floor (and it seems the fan) as a nasty bit of paper called Bill 92. The minister wanted this legislation galloped as quickly through discussion period as possible so it could be proclaimed in law. Bill 92 appeared to be a move to shore up the government’s resolve to ensure that doctors will not be able to stare down government-appointed negotiators in the future, as we so effectively did in our last round of negotiations. Apparently, the wounds suffered by the top-of-the-totem-pole politicos in Victoria during our last acrimonious negotiations were so egregious that their psyches are still dangerously fragile. Bill 92, on at least one level, was apparently designed to send a message before our next round of negotiations begins in earnest (“don’t bother threatening to de-list because we’ll make sure you can’t”).

However, it seems that no one in the knee-jerk group actually thought about what kind of ripple effect this bill could have on the provision of public medical services, as well as the intended target of private medical and surgical providers. Once it became clear that Bill 92 would have far-reaching implications not only for private service providers and facilities, but more importantly for large segments of our tax-paying, voting population, they decided to send the legislation back to committee for semantic clarification before proclamation. It is likely that some of the backroom decision making may have also been affected by the news that there were a number of strong government supporters and contributors who were considering initiating a recall petition for the health minister unless the government sent the bill back to committee.

At any rate I’m sure all of you have read Dr John Turner’s articulate President’s Bulletin (24 November 2003), so it makes little sense for me to further describe the elements of Bill 92. However, if you haven’t read it, find it and read it!

The BC government’s stated reasoning behind the need to proclaim Bill 92 is that the amendment was necessary in order to ensure that federal transfer payments would not be compromised by BC’s “softness” concerning private medical services. However, there is more than meets the eye to every political story, and this one is no exception. It seems that our health minister was one of the front-runners for the chair of the Romanow-inspired Health Council of Canada. This position would have been an important political (read: economic) one in all future federal-provincial health interactions, and likely was one of the original drivers behind this legislative weather balloon. 

It seems so obvious now: which province in Canada has the largest and most successful group of private medical practitioners and fosters a political climate wherein the government could pass extremely restrictive legislation essentially without debate? I’m sure Ottawa and the provinces were watching with great interest as this played out, because if the government was successful here you can bet your next CMPA rebate that the rest of the provinces would have soon followed with similar legislation. 

However, as we all know our premier recently announced that Bill 92 “will never see the light of day.” This interesting about-face came within a day or so of the federal government’s announcement that the chair of the Health Council of Canada was someone other than our health minister. If my memory serves me correctly the federal government’s announcement was predated by a day or so by the BC government’s announcement that Bill 92 would be sent to legislative committee before proclamation. Now I’m not usually terribly paranoid, but doesn’t that all seem strangely coincidental? This whole mess once again points out how undemocratic the legislative process can be when there is no effective opposition. This government almost passed a terrible piece of legislation and the brakes were put on only when the public, the press, and the profession managed to get the ear of the right people in Victoria. I have to give our premier his due. He made the right call on this one, but I wonder how he’s viewing his health minister and the minister’s top advisers at this point. The words “major screw-up” come to mind; I wonder if he’s used them in any recent discussions with his minister and his deputies?

—JAW

James A. Wilson, MD. Major screw-up. BCMJ, Vol. 46, No. 1, January, February, 2004, Page(s) 4-6 - Editorials.



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