An ongoing Alberta public inquiry is offering an unprecedented glimpse at a side of health care usually kept under close wraps: Patients whose influence, fame or money earns them special treatment in an over-taxed system.
After a slow start, the so-called queue-jumping hearings have elicited some revealing testimony from doctors, nurses and administrators, including disclosure that patients at a private clinic — some of them apparently major donors to the University of Calgary — were given expedited access to a public colonoscopy service.
In one case, a wealthy patron cancelled his fast-tracked colonoscopy appointment so he could attend the Calgary Stampede — and was still put back near the front of the line later, the commission heard.
“It’s absolutely unacceptable,” Dan Holinda, executive director of the Canadian Cancer Society, told Postmedia News about the revelations.
The inquiry, which had been poised to wrap up, has now scheduled an additional seven days of hearings this month.
Yet the kind of incidents being aired by the commission are hardly unique to Alberta, says one Montreal doctor who now runs a company that helps patients better navigate the system. Physicians everywhere are routinely asked to expedite care for relatives of colleagues, politicians, sports stars and other prominent citizens, said Dr. Jeff Brock, head of MedExtra.
He said he would get such calls frequently when working as an emergency physician in the past.
“In theory everyone’s equal, but we know everyone’s not equal,” he said. “It’s naive to think that Stephen Harper’s wife is going to be treated the same way as the woman on welfare.”
It is another question, though, whether such preferential treatment is merely distasteful, or actually hurting the people who urgently need medical help. Dr. Brock said it generally does not, and some observers question whether the inquiry itself has uncovered evidence of real harm to patients, helping justify its $10-million pricetag.
“Do you take out a bulldozer when you could use a hammer?” asked Tracey Bailey, former head of the University of Alberta’s Health Law Institute, about the process. “So far, we’ve heard a couple of really limited examples where perhaps people have been put in the lineup where they shouldn’t have been.”
The Health Services Preferential Access Inquiry, headed by John Vertes, a retired judge from the Northwest Territories, was called by the province’s Conservative government almost a year ago, partly in response to allegations about queue jumping leveled by a former head of Alberta Health Services.
That ex-CEO, Stephen Duckett, told the inquiry as its hearings got underway in Edmonton in December, however, that he actually had no direct knowledge of transgressions. Raj Sherman, an emergency physician and leader of the opposition Liberal party, said much the same thing.
Meanwhile, the mandate set out by the province may itself be hindering the commission’s work, suggested Juliet Guichon, a bioethicist at the University of Calgary. The official instructions indicate the inquiry should look not at past incidents, but at whether queue jumping is happening now, and fail to address allegations of widespread intimidation within the province’s health sector, noted Prof. Guichon.
The inquiry has not been without its revelations, though.
In Calgary, nurses who helped run overburdened, public vaccination clinics during 2010’s H1NI pandemic described how they had ushered friends and family into the clinics during breaks to get their shots rather than wait in line. They argued the vaccine — which had a short shelf life once prepared for injection — would have been wasted otherwise.
Two hospital administrators said they were regularly asked by superiors to check in with VIPs who had been admitted, though one said she never did visit the prominent patients’ bedsides.
Most eye-opening have been revelations about the Calgary colonoscopy clinic, which conducts high-tech colon cancer tests both on patients with worrisome symptoms, and apparently healthy people to screen for potential problems.
While most screening patients had to wait up to three years, clerks testified that clients of the private, fee-charging Helios Wellness Centre — located nearby on the U of C campus — got a scan in as little as a few weeks. The arrangement was set up to reward major donors to the university, one doctor told the inquiry.
There has been no evidence, however, that the private customers’ queue-jumping — as inappropriate as it would appear to be — actually meant patients who needed a scan quickly had to wait any longer.
And from that perspective, the inquiry has unearthed little evidence that is deeply concerning, said Dr. Danielle Martin, head of the group Canadian Doctors for Medicare. With the Alberta hearings poised to resume soon, she is convinced that queue-jumping is a relatively minor nuisance — and the sickest patients are almost always seen first.
“I don’t think it’s a major issue,” said Dr. Martin.
Original Article
Source: national post
Author: Jordan Press
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