Monday, November 01, 2010

Bill 17: De-democratizing healthcare

My time lately has been consumed by two grad courses, an active full-time job and home and family commitments. But one emergent and urgent issue has forced me to tend to my oft-neglected blog. (Yes, Minister Zwozdesky, I do consider healthcare to be urgent.)

If I was at all surprised about the contents of Bill 17, the new Alberta Health Act, it was in how accurate my predictions for it were. While it is being positioned by government as sticking up for Albertans through a "health charter", "health advocate" and improved "public input," it is actually much more about removing power from Albertans and placing it at the cabinet table. Let's look at those three concepts and how Bill 17 is positioned to improve the power of cabinet.

Section 2 of the bill calls on the Minister to "establish a Health Charter to guide the actions of regional health authorities, provincial health boards, operators, health providers, professional colleges, Albertans, and any other persons specified in the regulations." Sounds great. Let's develop a document that outlines the rights of patients and responsibilities of the players in the system. While it is called a charter to make us think that it has some sort of higher power status like the Canadian Charter of Rights and Freedoms (part of our constitution), Bill 17 allows it to be changed by the whim of Cabinet. Section 12(c) allows the Cabinet to make regulations "respecting the establishment and review of the Health Charter." This means that your sacred Health Charter can be changed by an "Order in Council" at a roughly bi-weekly private meeting.

"Relax," you say, "the Health Charter will be enforced by the Health Advocate." But section 6(1) of the act ensures that the Advocate reports to the Minister of Health as opposed to the legislature and section 12(f) allows the Cabinet to "make regulations respecting the powers and duties of the Health Advocate." So, while the position of the Health Advocate may be valuable within itself, he or she will be under the strict control of Cabinet.

This type of act is considered enabling legislation, because it lacks restrictive clauses and enables the Cabinet and Health Minister to govern the system by regulation. Section 12 contains 11 areas for which Cabinet can enact regulations. Section 13 allows the Minister of Health to make regulations "respecting the designation of other persons as health providers" and "respecting the roles and responsibilities of (regional health authorities, provincial health boards and professional colleges)." Previously, making changes to the roles and responsibilities of regional health authorities, provincial health boards and professional colleges would mean changing legislation and having those changes approved by the democratically elected legislative assembly. With Bill 17, those changes can be made at the whim of the Minister of Health (no need to worry any longer about the pesky College of Physicians and Surgeons).

Perhaps we need not worry, perhaps we should trust the discretion of Cabinet and the Minister of Health (you do know that Ron Liepert could be reappointed as Health Minister, right?). After all, Bill 17 assures us that regulations can only be made if "the Minister has published a notice of the proposed regulation on the public website" and a "time period during which members of the public and stakeholders may submit comments, has expired" and that time period "must not end until at least 30 days after the Minister gives notice." BUT, Bill 17 also says the Minister has to pass on to Cabinet the changes which he or she considers appropriate. It also says that Cabinet may or may not make changes to the regulation, whether or not such changes are referred to in the Minister's report. Furthermore, the time period for submission of comments can be changed if in the Minister's opinion, "the urgency of the situation requires it, the proposed regulation clarifies the intent, or the proposed regulation is of a minor or technical nature." Oh and by the way, "no regulation made (by Cabinet or the Minister) is invalid as a result of non-compliance" with the Public Input section of the Act.

In the off chance that this argument is too wordy or technical, what all of this means is that the Minister has to seek Public Input, unless he doesn't want to, and Cabinet has to change regulations after listening to the Public Input, unless they don't want to.

The big intent behind Bill 17 is to remove governance of our health care system from the control of our democratically elected legislative assembly and place it neatly under the thumb of Cabinet - and done all in the name of seeking Public Input and protecting patients.

No Thanks!

Call your MLA today and demand they return democracy to our healthcare system.


Esmé Comfort said...

Yes, you are right to sound the alarm. The government can and will do what it sees fit regardless of anything either the people or the opposition says. Nothing here but trouble.

Feynman and Coulter's Love Child said...

Just file this one under "careful what you wish for." Or did I miss you at the privatize healthcare discussion forums?