Has the NDP found its governing groove?
Have Darrell Dexter’s New Democrats finally, belatedly discovered their governing groove?
When Nova Scotia’s first democratic socialist government arrived at the governing starting gate in June 2009, they were already saddled with an embarrassment of their own making—how to renege, almost yesterday, on virtually every promise they’d made to get elected: a balanced budget, no new taxes, no program cuts, 24-hour ER services, a chicken in every pot…
Without passing Go, they stumbled into the grubby MLA expenses scandal. While that mess was not solely of their own making, they bumbled its handling, miscalculating the seismic depths of public outrage and squandering what remained of public goodwill.
For much of the rest of its first year-and-a-half in office, Dexter’s NDP has seemed unable to gain control of its own agenda.
Until recently.
Take last week, for example. Dexter began by piggybacking on a federal commitment of $20 million for tidal power projects to tout what he calls the province’s coming role as “a world leader” in clean energy. By the end of the week, he’d inked a tentative $6.2-billion deal with Newfoundland to bring hydro power from the Lower Churchill River to the Maritimes and the U.S..
Meanwhile, his ministers were introducing far less flashy but crowd-pleasing measures to protect used car buyers from lemons and cyclists from drivers, and to belatedly hand the auditor general the power he needs to muck about in government-business dealings.
Dexter’s government even appears to have grabbed the “big decision” ball. This fall, it said yes to a controversial new convention centre, no to oil and gas exploration on George’s Bank, no to online gambling, and yes to funding Lucentis to treat macular degeneration, the leading cause of blindness in people over 50.
Health Minister Maureen MacDonald, who also recently struck a deal to cut costs for generic versions of the anti-cholesterol drug Lipitor, framed her own announcement as “an important first step” in getting fairer drug prices for Nova Scotians.
As if there might actually be a plan…
Darrell Dexter’s NDP is still a long way from proving it deserves a second mandate, but it has finally begun the climb back to where it began.
Copyright 2010 Stephen Kimber
Pay for performance? What a concept
Ontario Premier Dalton McGuinty is proposing legislation—delightfully entitled the “Excellent Care for All” bill—to connect the salaries and bonuses of provincial hospital chief executive officers with their on-the-job performance.
We’re not talking here simply about how well the CEOs manage to shave operating room costs or slash vital support jobs to meet too-small budgets, but what they do to improve the quality of patient care. Has the hospital reduced the rates of infection among patients from one year to the next, for example? Has it reduced the number of patients who are discharged, only to be re-admitted? And what about the number of medical errors? Up? Down? As patient care goes, so goes executive compensation.
McGuinty thinks this is such a good idea he’s considering applying it to the CEOs of every Ontario crown corporation and agency.
Why not do the same in Nova Scotia? And why stop with the public sector? What if we applied more than just bottom-line calculations to private sector compensation?
Last month, Emera, which owns our electrical power utility, announced its CEO, Chris Huskilson, had earned more that twice as much in bonuses and stock options—a nudge above $1.5 million—as he took home in salary, which in 2009 amounted to a paltry $649,038. Rob Bennett, the president of Emera’s Nova Scotia Power subsidiary, received more than twice his $336,692 salary in benefits.
The company’s management circular attributed the executives’ good fortune—both men did even better in 2009 than in 2008—to Emera’s showing in the stock market.
But what if those bonuses had been based on other factors? Customer satisfaction, for example? Electricity rate increases not requested? How about the number of times power outages were not blamed on salty fog? Better, the number of outages that didn’t happen, or the speed with which power was restored when they did?
Those are all also signs—perhaps more telling in the long term—of a well run company. Why not recognize them when doling out bonuses?
Or how about Eastlink, one of the companies that got federal and provincial funding but failed to meet its deadline—“the project completion date has moved,” in corporate-speak—to supply broadband Internet service to all rural Nova Scotians? Why not reduce its CEO’s compensation package for each day it fails to complete? In 2010, that’s 126 days… and counting.
Dalton McGuinty is on to something here. There are other important measuring sticks for success beyond the bottom line. Time to factor them in too.
Copyright 2010 Stephen Kimber
IWK book to launch October 8
Th
e IWK Health Centre and Nimbus Publishing
are celebrating the launch of
IWK: A Century of Caring for Families
a new book by Stephen Kimber
Where:
The Gallery of the
Richard B. Goldbloom Pavilion,
IWK Health Centre
5850/5980 University Ave.
When: Thursday, October 8, 11:00am
Copyright 2009 Stephen Kimber
Scotia Surgery deal cosmetic
This week’s revelation that our on-its-way-out-turn-on-the-taps Tory government renewed a controversial contract with Scotia Surgery in early June—just six days before voters shoved it onto the political trash heap—was… well, interesting. But not surprising.
More intriguing—and perhaps more telling—was Health Minister Maureen MacDonald’s shrug response. “They’re entitled to sign contracts right up to the day they’re no longer the government,” she blandly told reporters this week, adding with Zen-like detachment: “Things that have already happened, I have to learn to accept and move on, and focus on what it is I need to do.”
You could almost smell the relief in her words.
In March 2008, then-Conservative Health Minister Chris d’Entremont announced a one-year, $1-million “demonstration” project to reduce then-18-24 month wait times for orthopedic surgery. Under the arrangement, privately-owned Scotia Surgery was to perform more than 500 minor procedures at its Dartmouth clinic in order to free time and space in Capital Health operating rooms for more complex cases like hip and knee replacements.
Harrumphed then-Opposition leader Darrell Dexter: “This is being billed as innovative reform, but in fact there's nothing new and nothing innovative about this whatsoever.” He called it “a million-dollar quick-fix… taking money out of the public system and putting it into a private facility,” and added: “This is really about the larger question of public policy, and is it the direction that we want health care in this province to go in?”
Pre-Premier Dexter was right.
But the problem for Now-Premier Dexter is that—at least as quick fix—this one appears to be working.
For starters, Scotia Surgery, unlike many private clinics, operates in concert with the public system. No one gets to jump the queue simply because they can afford to pay. And the clinic’s patients, concedes NDP Health Minister MacDonald, are satisfied with the service.
Given those realities, it would have been tricky for the new NDP government to have simply canceled the contract after they took office in June. The Tories took them off that hook.
But Dexter’s larger questions remains: Will this quick-fix work for the long term? What are the pluses—and minuses—of using private clinics to deliver public services? And is this really the direction in which we want public health care system to go?
Before Scotia Surgery’s oh-so-convenient contract extension comes up for renewal seven months from now, our new government will need to answer those questions.
Copyright 2009 Stephen Kimber
Health care right to strike (Oct 18, 2007)
Parent’s disappointment is disingenuous
So poor, put-upon Labour Minister Mark Parent is “disappointed” in Nova Scotia’s health care union leaders for refusing to meet with him face-to-face, man-to-man, cabinet-minister-to-lowly peon so he could lay before their wondering eyes the glorious, gory details of exactly how his government intends to take away their members’ right to strike.
By the minister’s own reckoning, Monday’s non-meeting with union leaders marked the sixth different non-occasion since June 18 to which he’s generously invited union leaders to come on down and converse over canapés on whether they would prefer to be hanged, drawn and quartered, or simply put out of their misery with a sudden, heart-stopping burst of electrical current. It was also, the minister allowed more in sorrow than anger, the sixth separate time the unions had ungraciously, unaccountably said no thanks.
Which is why Mark Parent, like the parent of a too-puzzling-for-words teenager, is just s-o-o-o disappointed. “When you sit down together and talk, some interesting things can happen,” he lamented. All he ever wanted, he added — cue the violins — was for the unions “to consult with me [on how] to make the collective bargaining process work better, and that’s really what we’re offering.”
Uh, not really.
If that’s actually what Parent and the MacDonald government had in mind in the aftermath of last April’s 16-hour mini-strike at the IWK Health Centre, all they had to do was open a public dialogue, not only with the unions and the representatives of the province’s health care employers but also with the rest of us.
If the government had framed the question as — let’s say, for the sake of argument — “Is there a better way to deal with labour disputes in the critical health care sector?” then the unions might very well have been keen and active participants in that discussion. And, out of that discussion, what the minister calls “interesting things” might actually have happened.
Because the discussion then would have actually been a discussion.
Instead, the government began with a narrow and non-negotiable premise: We are eliminating your right to strike; how do you think the dirty deed should best be accomplished?
Despite the many and very real crises the province’s health care system faces — too long wait times for all manner of tests and procedures, shuttered emergency rooms, lack of family physicians in rural communities, spiraling out of control costs — the government has done its level best to make the non-issue of health care workers’ right to strike the sole centerpiece of its fall legislative agenda.
Why?
Not because of Premier Rodney MacDonald’s much ballyhooed “concern for patient health and safety,” or because labour disruptions in health care are such a pressing issue for Nova Scotians — the IWK strike was the first since 1981, and it lasted less than a day — but because this government sees attacking health care workers’ right to strike as a potential vote-getting diversion from its own many and well documented failures to come to grips with the real health care problems we face.
Will it work?
It will if Rodney MacDonald’s government can frame the question as narrowly as a recent Bristol Omnifacts Research poll for the Daily News, which essentially asked respondents if they thought strikes are the best way to deal with labour disputes in the health care sector: “Using a scale of 1 to 10,” the pollsters asked, “how acceptable do you consider [strikes] as a means of resolving labour disputes in health care?”
Duh?
Ask a dumb question; you get the answer you were looking for.
The MacDonald government’s hail-Mary hope of winning the next election is now based on making Nova Scotians believe that that is the question, and the only health care question worth asking. If they can engineer their own defeat by pressing ahead with legislation the opposition parties have promised to vote against and then successfully cast their opponents as pro-strike, anti-health care, they might just be able to pull it off.
But I’m guessing Nova Scotians are smarter than that.
Stephen Kimber is the Rogers Communications Chair in Journalism at the University of King's College. His column, Kimber's Nova Scotia, appears in The Sunday Daily News.
Copyright 2007 Stephen Kimber
Michael Goodyear’s ordeal continues (Oct 4, 2007)
Five years of ‘stress, isolation and poverty’
Dr. Michael Goodyear marked an anniversary this week. He didn’t celebrate.
Five years ago on Tuesday — Oct. 2, 2002 — Goodyear, a respected medical oncologist and ethics researcher, received a letter from his bosses at the Capital District Health Authority.
As the result of ongoing personality clashes with his division head over Goodyear’s “communication… availability and judgment,” the chief of medicine, Dr. Elizabeth Anne Cowden, informed the doctor she was varying his hospital privileges.
The problem is that you can’t simply vary a doctor’s hospital privileges — which are critical to his ability to do his job — because he doesn’t get along with his boss. You have to prove he poses a real threat to his patients’ safety.
The CDHA hasn’t — and it’s had five years to make its case.
The District Medical Advisory Committee spent three months investigating the allegations against Goodyear, and found no substance to them. A complaint was also lodged with the doctors’ governing body, the Nova Scotia College of Physicians and Surgeons. It too was unable to substantiate the allegations, and eventually withdrew its complaint.
Despite that, the Capital District Health Authority — which, by its own rules, should have dealt with Goodyear’s case within a month after the initial emergency variance — has dragged its feet, all the while refusing to restore his privileges.
Worse, it appears — on the face of it — to have done its best to consign him to languish in a kind of extended exile. According to a complaint Goodyear lodged this summer with the province’s human rights commission, the CDHA has restricted him from “clinical practice, research, teaching, administrative duties and publication and presentation of my work.” It stripped him of his position as the authority’s research ethics chair — despite the objections of other members of the committee and several former chairs — and locked him out of his office. He was eventually forced to declare bankruptcy.
“Five years (and still counting) is a significant time taken out of one's life at a time when one is supposed to be at one's most productive and thinking about planning for retirement,” Goodyear mused in an email this week. “Five years,” he added, “is a long time to spend under continuous stress, professional and social isolation and poverty.
The only recent development in his case is that the CDHA’s board has finally agreed to assume jurisdiction of the case from the hospital’s privileges review committee, which hadn’t managed to come to a conclusion in five years of sort-of trying.
While that should be good news, Goodyear notes, “the two bodies are now, as expected, arguing about the terms of such a transfer [of jurisdiction], and this is continuing to occupy the now even larger list of law firms engaged in the process.”
Ah, yes, the lawyers — the only ones who actually benefit from this protracted affair.
And not just this one.
We know through freedom of information requests that the CDHA has already spent more than a million dollars on outside lawyers to fight a similar — and similarly ongoing, not to mention similarly frivolous — case involving pioneering heart researcher Dr. Gabrielle Horne.
The Horne case started at almost exactly the same time and involved the same non-issue of personality differences with her bosses. Last September, the authority’s board finally ruled that it had had no authority to vary Horne’s privileges but it did so in such a reluctant, roundabout way that Horne is now suing the health authority.
Which means the case will cost taxpayers — and Nova Scotia’s underfinanced health system — even more than it already has.
We can only guess that the CDHA has spent at least as much on outside lawyers in Goodyear’s case — and will continue to run the clock until it runs out of legal options.
Or until the premier and his minister of health insist the authority stop wasting our money on lawyers to cover its collective ass and spend it on providing health care instead.
Are you listening, Rodney? Chris?
***
In last week’s column, I quoted Jayati Vora, a former student in Columbia’s School of Public and International Affairs who’d written an article for The Nation about Iranian President Mahmoud Ahmadinejad’s recent speech at the university. I described Vora as a he. Well, “he” is, in fact, a she. My apologies.Stephen Kimber is the Rogers Communications Chair in Journalism at the University of King's College. His column, Kimber's Nova Scotia, appears in The Sunday Daily News.
More text goes here.
Copyright 2007 Stephen Kimber
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About
STEPHEN KIMBER, the Rogers Communications Chair in Journalism at the University of King's College in Halifax, is an award-winning writer, editor and broadcaster. He is the author of one novel -- Reparations -- and eight non-fiction books.