23 September 2009

The Kings of Cuts

There’s something about Paul Oram that just seems so familiar.

Maybe it’s his similarities to the equally-perfectly coifed predecessor, Lloyd Matthews.

Yes the father of the Premier’s Chief Publicist occupied the health minister’s office until early 1997 when he was hastily shuffled out.  There was a massive revolt against the way government was handling health care. 

Take a second and read the old news releases from those days though, and you’ll find more than a few things that seem oddly familiar.  Stuff like reviewing health care in central Newfoundland with an eye to what could get “improved”:

Health Minister Lloyd Matthews will take the next 6-8 weeks to fully evaluate and consider the recommendations of the report into health services in Central Newfoundland. KPMG Management Consultants recently presented the final report to the minister following four months of consultation with individuals and organizations throughout the region.

"This review is a comprehensive analysis of current and future health needs for the entire Central Newfoundland region," said Mr. Matthews. "The report looks at the network of primary, secondary, chronic and community based care, and makes recommendations on how these services can be better organized and coordinated to meet existing health needs and to reflect the emerging health needs of residents in the region."

The minister stated he would now be presenting this report to Cabinet for consideration. "Once government has had an opportunity to consider the full report, I will be able to provide further details on health services contained in the report, as well as outline future directions for health services in Central Newfoundland," said Matthews.

The minister thanked all individuals who made presentations or submissions to the consultants during the period of review, for their interest in health service delivery.

Matthews released the review in March, 1997, after announcing it had been received in early January.  The project started the previous June.   It recommended a number of things, including renovations to North Haven Manor in Lewisporte to ensure it could provide service out to 2005.

There are a lot of things in Matthews’ ministerial past that seem oddly familiar to the current generation, as well as a few surprising differences.

Matthews didn’t have much money to play with either as minister or as a member of cabinet generally.  Paul Oram and his cabinet colleagues  - by stark contrast - have access to more cash than any cabinet in the province’s history.

Oram talks about health care cuts.

Matthews’ review of health care in central Newfoundland could note that since the creation of new health care boards (re-organized out of existence by Oram’s clan), day surgery had increased by 70% in Gander. Note, for example, the reference to demographic projections for 2005.

There’s a sense of planning and organization to the whole thing.  The re-organization started with a view to changing how health care money was spent so more could be pushed toward front-line service.   It may not have worked out exactly as intended, but there was a long-range goal based on the knowledge that by 2005ish, the population would be pretty much where it actually turned out to be.  That brought with it certain predictable consequences and government worked to organize a system that could provide needed care within the budget likely to exist.

Sometimes, the differences are startling.  Back in the 1990s, the health minister could commission a report, get it and then release it within six weeks.  When was the last time Oram and his colleagues managed to get a report on the street within six months of getting it in hand? 

Compare as well, Matthews’ language to that used in the past 48 hours or so.  The emphasis on changes in the 1990s was ensuring that the government could continue to meet health care needs despite limited funds and what was anticipated to be skyrocketing demand. 

There’s a decidedly less positive sound to the way Oram put it:

“Our government faces a difficult decision to make regarding the types of services we can offer in the long-term, how much we can continue to invest as a province and identifying how we can improve the quality in our programs and services across the province.”

Still through it all there are some common threads, ones that transcend the superficial nonsense Oram got on with the other day by referring to cuts in the 1990s. 

He might do well to check with some of his predecessors, people who had a real hard time running the department but who managed to get through it with their reputation intact.  Roger Grimes would likely give him a good pile of advice. So too would Herb Kitchen or Julie Bettney.   Lloyd Matthews wouldn’t:  if memory serves, he got into political hot water largely due to the way he presented himself publicly.

How Oram handles himself might determine who really gets remembers as being the Kings of Cuts: Danny Williams and his crew or the guy Danny used to call the King of Cuts.