NEED OF TRANSFORMATIONAL CHANGES IN SASKATCHEWAN:

Healthcare Reform and New Economic Policies, Part 1

By Mario deSantis, October 18, 1998

the authoritarian management approach is creating a "Big Brother" syndrome

open to ideas and that public input is not only welcome but that it is essential

late 70s when Mr. Hewitt Helmsing ....fired half of this agency's staff and developed an autocratic and most powerful organization centred on power, obedience

SAHO, through its member health districts and allied organizations, is such a powerful and intimidating organization that it is above the social accountability of the taxpayer money it manages

In our past article "Healthcare Reform and Authoritarian Management"⁽¹⁾ we showed how the authoritarian management approach is creating a "Big Brother" syndrome which is interfering with the democratic empowerment of District Health Boards, the affirmation of our individual rights to privacy^{(2) (3) (4) (5)} and the proper allocation of taxpayer dollars^{(6) (7)}. The present healthcare provincial policy of centralization⁽⁸⁾ and related management by fear^{(9) (10)} are not compatible with the democratic health reform envisioned by the Saskatchewan Vision for Health⁽¹¹⁾ and related legislation. Therefore, I was not surprised when the authors of the article "Health board policy wrong"⁽¹²⁾ warned all of us of the unprecedented
disrespect of the democratic principles by the Saskatoon District Health Board in absolving "...itself of the need to hold monthly public meetings by revamping its communications policy..." The authors of this article go on to say the following:

"...But instead of working to make its business more taxpayer friendly and democratic, the health board has decided the answer is to make itself less accountable and more distant from those it serves. Former board member Maurice Vellacott suggested last year that the board needs to bring its business out from behind closed doors... For an institution that is already saddled with an image problem-most people consider the health boards a convenient creation by the government to buffer itself from criticism over provincial health policy-the district health board is on the wrong track with its latest communications strategy... The only communications strategy the board needs is one that makes it clear that Saskatoon District Health is accountable, open to ideas and that public input is not only welcome but that it is essential. With its recent decision to reduce the number of public meetings, the board is moving ever further from that ideal..."

The above mentioned concerns of closed door meetings, fiscal responsibilities and democratic running of healthcare services are not unique to the Saskatoon health district; it is a matter of fact that these concerns are widespread across the province and they have come to the attention of the Provincial Auditor⁽¹³⁾ for sometime. We are not dealing with temporal concerns which are just happening now. These concerns are of a systemic nature, and they are consequences of the continuation of a centralized and authoritarian management⁽¹⁴⁾ directed and enforced by the Saskatchewan Association of Health Organizations (SAHO)⁽¹⁵⁾ through most of their member district health boards. These systemic concerns go back to the late 70s when Mr. Hewitt Helmsing⁽¹⁶⁾ became the CEO of the Saskatchewan Health-Care Association (SHA), fired half of this agency's staff and developed an autocratic and most powerful organization centred on power, obedience⁽¹⁷⁾, and closed door decision making policies. This was the time when health care leaders such as Mr. Harvey Fox, former CEO of the South Saskatchewan Hospital Centre, and Mr. Elmer Schwartz, former CEO of Saskatoon City Hospital, built personal empires at the expense of Saskatchewan taxpayers⁽¹⁸⁾. This was also the time when I wrote a paper⁽¹⁹⁾ on the application of queueing theory to properly staff the emergency rooms (ER) of Saskatchewan hospitals, without realizing that the cities of Saskatoon and Regina had already an over supply of acute care beds!

The Saskatchewan Association of Health Organizations plays a prominent policy role in the administration of provincial health services, yet nobody has been able to evaluate the integrity of the services provided by this organization. In the Spring of 1995, I had a meeting with Mr. Wayne Strelioff, Provincial Auditor, and at that time he stated that SAHO falls under his jurisdiction⁽²⁰⁾. We are in 1998 and there is no sign that SAHO will ever be audited by the Provincial Auditor. It appears that SAHO, through its member health districts and allied organizations, is such a powerful and intimidating organization ⁽²¹⁾ that it is above the social accountability of the taxpayer money it manages and above the law⁽²²⁾. Therefore, in the next articles I am going to evaluate the integrity of some services of this organization as they transpired through my own personal experiences.