"Review" shouldn't mean loss of services

The Report: July / August 2002 vol.23 num.3

by CINDY STEWART

ince the provincial government began its overhaul of our health care system, health care unions and advocacy groups have been anticipating a massive privatization of services.

When the government introduced legislation allowing for contracting out of health care services, HSA worked to protect a number of services our members deliver. While Ministry of Health officials, including Minister Colin Hansen, professed to understand our concerns, in the end only a few services were protected from the legislation that allows contracting out and privatization. We were particularly concerned about the future of laboratory services, as this is an area where the private sector has lobbied heavily and consistently to expand at the expense of the public sector.

There were early indications that the government viewed lab reform as a necessary element in meeting their fiscal targets in the health budget. Our meetings with the new Health Authority CEOs confirmed that they were anticipating an overhaul of medical laboratory services.

HSA has long advocated the need for a thorough review of the system and in anticipation of pending changes, we held a very productive and informative consultation session with members in Victoria. It turned out the consultation was not a moment too soon, as we received information on extremely short notice from the government that the review was going ahead. We were given 10 days to produce a submission.

Our decision to participate in the governments review process was made with a healthy dose of skepticism. I do not have a lot of confidence the government is going to look at lab restructuring objectively, given its obvious bias to privatize public services. However, since we have advocated for a review, and since this is the only process we could see developing, we made a decision to participate and ensure HSA members interests were forcefully represented and on the record.

My skepticism hasnt faded. The process in the June 13 and 14 consultation meeting was disappointing. A -change management" consulting group from Ontario, THiiNC, was contracted to facilitate the consultation. The group is the same consulting firm that managed a similar process in Ontario and has also worked in Alberta.

Ron Ohmart (HSA Executive Director of Labour Relations) and I attended on behalf of HSA and we found the level of support articulated for the role of the public sector by many of the participants encouraging. There was a consistent message delivered that lab reform should be about delivering the best services cost-efficiently to the most patients, and that the public system is well positioned to do that.

Heather Autio, past president of the BCSLS (British Columbia Society of Laboratory Science), did an excellent job of reminding all the participants that the bottom line is our responsibility to deliver meaningful services that contribute to the health of British Columbians. She emphasized that any change must be in the context that the system exists, first and foremost, for the patient.

In HSAs submission, we advocated three areas that must be considered to achieve an integrated, cost-effective and modernized system:

1. Changes to service delivery must be based on evidence, rather than on self-interest, emotion or ideology;
2. The funding mechanism for laboratory services must change from fee-for-service to global funding; and
3. Funding must be devolved to the regions.

These principles, combined with a commitment to consult with the people who deliver the services, must be the cornerstones of decision-making related to lab reform.

I anticipate the follow-up and reform will be upon us in the very near future. We will be watching closely to ensure your interests continue to be represented in this period of change, and will update members as changes are introduced.

HSAs complete submission, and addendum related to labour relations issues, can be viewed by clicking on the links below.

HSA Submission to the Provincial Lab Review
(PDF file - 164 KB - requires Adobe Acrobat)