Vancouver Province

November 10, 2000

Because of a tainted blood transfusion, Sharon Singh’s liver packed it in and, as we all know, she didn’t get a new one because the system broke down and it was snatched away from her 30 minutes before it was to be implanted.

Who’s to blame?

The Liberal Health critic Colin Hansen said "When we can’t provide health care access to someone who has the opportunity for a life-saving liver then we really have our priorities warped. We can find money for advertising, subsidies for business, money for fast ferries but we can’t find money for critical care."

Unfair? Doesn’t shit happen, even in the best of hospital systems?

In fact, Mr Hanson is bang on. This government stands convicted of the grossest neglect.

It’s true that the NDP has thrown more money at the health care system and its equally true that the federal government starved it of resources. But this avails the government nothing. And to understand why, one must go back to basics.

Government’s only task is to prioritize the spending of public money. That means making choices which is what Treasury Board, health ministers and cabinets are all about. In a properly run government, every expenditure is anticipated, line by line. In the case of the health ministry the budgeting process is a full time job for many public servants.

When a government decides to build HOV lanes it performs a service the public using those highways want, often badly. When it sets as a priority the building of a super highway on Vancouver Island, it does so (incidentally shoring up government MLAs) knowing that the money must come from somewhere. When it gets involved in a half a billion more or less for a new untried ferry boat enterprise it knows, especially at a time the government is running on massive deficits, that something somewhere else has to give. When a government spends a couple of hundred million to bale out an industry it makes a choice. Governments would like to throw dust in the people’s eyes and mumble things about money coming from different allocations, blah, blah, blah but in fact, as the former auditor-general has taken great pains to point out, government money is government money.

But, having said all that, can one still blame the government, its premier and ministers for what is, after all, just one major screw-up?

The answer is a resounding YES!

That’s because the health minister must, within his budget, set his own priorities all the way from the trivial, which might be a grant to a private group, to where the action is. Where the action is in health care is in the emergency room and the intensive care unit (ICU). Those are two areas that simply cannot be compromised although, of course, they are. They are, because if we had a huge disaster in one of our major cities there is no way we could handle the carnage. But the point is, huge disasters aside, dramatic care is something every health minister, every finance minister, every treasury board member and every premier must know about. (As Health Minister in 1980 I was warned that the ICU in the Vancouver General Hospital was woefully under staffed and physically a mess. Not able to get the attention of the bureaucrats, with the Premier’s assistance I got members of Treasury Board to visit the unit and the money followed instantly. This wasn't a heroic health minister at work, this was a health minister doing his job. I could give you other similar examples from my predecessors, Bob McLelland and Dennis Cocke.)

To run a health ministry – and in fairness it’s run more by the minister of finance than the health minister – one must always be in touch with the front end. When you’re a government that stands for better social services and is elected, twice, in part for that reason there are no excuses for a Sharon Singh case. If there are ICU nurses necessary, you find them and pay them. If your ICU is such that you cannot handle what for it are routine operations, you fix it. After all, Sharon Singh’s operation was long planned for the moment a liver became available.

The blame for the system breaking down must be squarely laid on the doorstep of the cabinet room. That’s where the buck ends.