If the provincial government can actually get control on its spending and head down the road to management reform along the lines that Eastern Health’s Vicki Kaminski talked about on Tuesday, then they are headed down the right road.
Kaminski described the results of a review of EH’s operations that showed the regional health authority ranked dead last in efficiency. EH was costing taxpayers more than anywhere else in the country to deliver a range of services. The review didn’t look at the quality of the health care involved but on the cost of delivering care and all the supports to EH’s core function.
Likely most people have been gobsmacked by reports that Eastern Health operated Tim Horton’s franchise that lost money. As bizarre as the idea is, it’s a potent symbol of the fundamental management problem at the province’s largest health authority.
We do not have a bottomless trough of money available to us.
That’s always been true. Until very recently, it was one of the guiding principles of the provincial government. The management problems Kaminski described could only grow in the kind of political environment in which people could act like money was no object.
The kind of mess Kaminski described could only happen in a place where public spending is about nothing except patronage, pork, and paternalism. That situation is made all the worse by a political party that has lived by the philosophy that everything reduces down to the amount of money it spends.
That’s the world we have all been living in since 2003.
The problem isn’t confined to Eastern Health and it is not confined to the health care sector alone. Take a look at the chronic, massive cost over-runs and project delays in the province’s capital works program. That’s just the tip of what might turn out to be a very large iceberg.
Recognising you have a problem, as the provincial government indirectly acknowledged on Tuesday, is the first step in fixing it. Sorting out a decade of such such fundamental mismanagement as Tuesday announcement revealed will take a lot more than handing a hospital’s Tim Horton’s franchise to the private sector.
Just as the problem started with a Premier’s attitude, so too will politicians on the government side today have to change their attitudes and behaviour to fix the mess the Old Man left them with. For starters, they can get rid of the Old Man’s obsession with connecting everything to how much money government spends. That’s evidently going to be hard. In Tuesday night’s budget debate, the Premier and her caucus mates all droned on and on about how much they were spending.
They will also have to restore the public oversight and accountability offices they have busily dismantled since 2003. They need to put the House of Assembly back in order by extending its sitting days and reforming its committees. Chief among them should be a revitalized public accounts committee in which the government members actually lead the charge to root out inefficient and ineffective spending. The new Auditor General will have a key role to play. First, though, he will have to restore the credibility of an office that, over the past decade, too often reeked of ineptness, ego and partisanship.
If the current provincial government can actually get control of its spending, then they will be on the right road. It will be a hard road but the rewards are immense. Tuesday’s news was a decent start.