Quality of care suffers with bottom-line management

The Report: December 2003 vol.24 num.6


n November 3, the Fraser Health Authority announced that St. Marys Hospital in New Westminster will be closing. Well, actually, not exactly. The Fraser Health Authority said it will no longer purchase services from the hospital and that the future of St. Marys will be decided by the Saint Marys Board and the Sisters of Charity of Providence, the owners of the hospital. But without support from the public health care system, the future of St. Marys really is up in the air.

This isnt the first time the community, patients and staff have heard that news. Nonetheless, the announcement hit everybody involved with St. Marys hard, as they believed an agreement had been made with the Fraser Health Authority to allow St. Marys to continue to serve New Westminster and the surrounding community. While the hospital, the Fraser Health Authority, and the Ministry of Health Services will no doubt continue to point fingers about whos responsible, my worry is that amidst all the finger pointing, the fate of the health services St. Marys offered to the community will be ignored.

HSA has been working to ensure members are protected as much as possible as programs are moved out of St. Marys. We have reached an agreement with the Fraser Health Authority that gives members who work at St. Marys enhanced collective agreement rights to stay with the programs they work in when those programs move to other facilities.

But the question remains whether in the financial crunch, those programs will survive the move intact.

The mammography clinic at the New Westminster Hospital is known as one of the best in the province. What will happen to the state-of-the-art equipment and the health science professionals who deliver that superior service? The surgical eye clinic, to which patients from around the region are referred, will close. Where will that service move to and will the people who make it such a successful element of St. Marys go with it? The palliative care unit, which has provided such service to the community is closing. Where will it go? Where will the compassionate staff ... who make the lives of the dying and their families so much more manageable ... go?

These are questions the community, patients and staff have a right to ask.

-Cost pressures" have been the driving force behind health care planning since the Liberal government was elected. Increasingly, were seeing the bottom line dictate decision-making. Whether its a move to program management, a decision to delist services from the Medical Services Plan, or a directive to close a hospital, the priorities are clear: financial considerations trump quality of care.

Health Services Minister Colin Hansen keeps telling British Columbians that he is making those decisions with the best interests of patients and a healthy health care system in mind. The evidence from our members work places does not support this assertion. I heard from members across the province in the recent Regional Meetings that bottom line thinking is permeating your workplaces and having an effect on every aspect of the work you do. A growing trend to hire managers with a business background, rather than a health care background, means decisions in health are being dominated by discussion of cost -pressures" and cost cutting, rather than quality care. This may appear to make sound financial sense, but in a health care setting, a strong understanding of the full range of implications on the system and the delivery of services is essential. If patient care is negatively affected by a cost costing initiative, it is not going to result in savings in the long run ... quite the contrary.

In the case of St. Mary's, from the Minister of Health Services down to the Fraser Health Authority and New Westminster MLA Joyce Murray, the responsibility is to the patients and the community that count on services being there when they need them. The community has the right and the responsibility to hold all these decision-makers accountable for their actions.

Cindy Stewart has served as HSAs President since 1993.