Autumn Morning

FTLComm - Tisdale - Thursday, September 19, 2002

With the wind expected to rise even above the stiff breeze at 7:30 this morning it seemed like a good idea to scoot around and get some pictures of the fall colours before they all moved on to Manitoba.

The odd thing, and I suppose it really isn't all that odd, is that while I was moving around the nearly deserted streets of this quiet town, the car radio was chronicling the consequences of the strike of health care professionals including ambulance drivers, pharmacists and a host of others who began a job action yesterday afternoon.

Should there not be harmony and peace amidst such glorious beauty? The sun flashing through the trees and diving down street after street turning on the colour of the leaves, those still green and those who have burst into fall flames.

But this is reality the camera recorded the scene while my mind and awareness take in the strange situation where we have an enormously difficult situation developing.

So often we miss the scenes that come before us because of what our emotions do to our awareness. But we often also see things and point our cameras in different directions when we are trying to understand those things so hard to grasp.

The health care management system is designed to fail, structurally it is completely unworkable. One fellow this morning reported that this strike was completely avoidable(Regina health district head in intereview on CBC radio) after the settlement of other health care workers, wasn't it obvious their coworkers would expect similar and fair treatment? Yet, Louise Simard and her organisation, which in itself has no real function other than to mess things up, decided not to negotiate with these valuable people. The consequences are totally unacceptable. People who have waited ridiculously long periods of time for treatment are now delayed even more, and with them, those who are waiting in line behind them. Their pain and suffering, and for some their death, is now the responsibility of Louise Simard and the SAHO, who the courts decided had negotiated in bad faith and it is clear to all, caused this strike deliberately.

These leaves will be blown from the limbs of trees as the wind rises today, that is a natural consequence, it just happens, but we have developed a medical system that can ease pain, augment life and provide better lives for our friends, neighbours and relatives.

Once upon a time, in 1962 the people of this province, through their government brought forth a system whereby the cost of health care was to be shared by all. There were those who did not like this idea of sharing and began an ideological struggle to restore what they believe is the natural order of things, those with money get help, those without money should rightly be blown from their limbs.

Once upon a time, hospitals were managed by powerful nurses called matrons. They run the places, supervised the help, seen that there was supplies, worked to see that there were doctors and paid the bills. But, some how this practical and working system was undermined. Management was moved from health practitioners to university trained accountants. The universities that trained them, in their business schools, are ideologically opposed to the idea that we should all share in the cost of medical care. They believe, yes believe, for it is a matter of religious economic faith, that only those who can afford it, should be afforded medical treatment.

In time, this class of management came to control the system and they set about successfully to destroy the system, which they work for and their method is remarkably efficient. They diffused administration so that no one, really is in charge, for a decision to be made, there must be a meeting, supervisors of supervisors must be consulted and decisions deffered In time this structure of non-decision makers has grown to the extent they are an army. Each are paid according to their university business trained education and their job is to prevent the system from working.

Our hospitals were once run by the front line workers, supervised by a local hospital board and the system paid for by billing the medical care insurance program for the work done. Efficient and locally controlled. But once hospitals began hiring managerial staff the system began to collapse and here is what is really amazing. Instead of recognising the error, politicians who do not stay in office long enough to learn from mistakes, merely increased the number of these nonfunctioning managers. When the weigh of economics cut in, the government dispensed with the local hospital boards and created district health boards with managerial staff. This was even more unsuccessful and of course you know the response. When something is unsuccessful the pattern of the past was repeated. The districts were dispensed with and even more remote Regions, twelve of them have been established.

The failure rate of this structure is complete. Publicly funded medical care is doomed, managed out of existence. You and I will not allow our friends and relatives to go untreated when we know treatment methods can make their lives better and longer.

The diffuse ineffectual administration is backed up by an even more diffused and even less effective front organisation called SAHO with is boss Louise Simard. Failure is not the consequence, failure is the plan.

The wind blew a lot of leaves off today and as more of them turn gold, brown and red, more will let go and drift to the ground to decompose and continue the cycle of life. Nature is harsh, it is brutal and it acts on plants without remorse. But we humans are a well developed social animal, capable of making conscious choices, capable of resisting and handling many of nature's violence, and we have been steadily, although still very primitively, improving our science. We can do better and will go on to do much better, but at the core of human life is the fact that we work together. Like bees and ants, buffalo and musk oxe, we are social animals.

Accountants and bookkeepers can do a fine job of looking after money, but when it comes to looking after the sick and injured, the person making the decisions and running the show should be a nurse and a doctor, not a janitor. Oh, janitors do fine job of cleaning things, but right now they are the only people in charge and have no say about how work should be done. It's just that, with the decision making so totally confused, its the last person in the string of people, who must decide what happens.

Some years ago education was disturbed to discover that the two most powerful people in a school were the secretary and the janitor. Everyone of us who has served a day as a principal knows this to be true and we learned never to cross either of these people if we want our school to run well.

In a modern Saskatchewan hospital there is no equivalent of a principal, the people who give care are people working twelve hour shifts, four days straight and forced to just "do their job". In effect that means getting through each ninety-six hour cycle, tired robots. The unmanaged doctors are overworked, considered by everyone as high paid magicians who give their patients their complete attention for 27.5 seconds and then write a prescription, "next."

As a kid I remember wondering why the things that grew on trees each spring and fell off each fall were give a verb for a name. Is it because they do if fact, each and every year, leave. If this is perhaps true, than is that why a person waiting for "elective surgery" or sitting in a "waiting room" in a doctor's office is referred to also with a name that is also a verb? It would be perfectly appropriate to call those managers in the Regional health offices and those whom they supervise as "obstructionist" or perhaps an anagram of some kind would be better as the CCM (chaos and confusion makers).

Now that leads to an interesting concept, imagine a bicycle factory, or better yet, several bicycle factories where the workers come in and do twelve hours shifts for four days straight. The ordering of parts, training of new staff and paint colours are controlled by a manager who has broken down the tasks so that some staff look after spooks, another seats, and another pedals, while another manager is in charge of nuts, chrome handle bars and reflectors. No one person is allowed to interfere with the director of design and his assistants, who also look after employee relations and marketing in small towns. Marketing in large towns is handled by the director of waste management, who with his assistants, covers paint selection and safety testing. Each part of the factory's functions and operation is dispersed through a range of supervising directors and assistants, so that there is approximately one person in administration for every person building bicycles during a single shift.

The province's health care system is being mismanaged as this bicycle shop would be, but add to this one last little twist and you will see that I have barely scratched the surface in uncovering the problem. What if that set of bicycle factories and its whole financial structure was paid for by taxation and no connection was ever made between sales, production and raw materials. Without the factory's output being related to the demand, the administration when faced with complaints from tax payers and politicians cut costs by reducing staff. The managers, increased pressure on the workers to produce more and more bicycles, forced them to work overtime and reduced their wages. When morale declined, they increased the number of supervisors and when the workers went on strike they were forced back to work by government legislation.

When you think it through, you realise that design failure is far worse a problem then insufficient funding. Take millions of dollars out of the support funds to pay for meetings, travel expenses for supervisors and failure to reach timely decisions, add to that wasted funds on payments to American weapons companies to create simple administration software, overpriced by perhaps as much as 900%, then reduce staff efficiency by overworking them, create staff shortages with lower pay then other places so that many skilled people move on, creating increased staff shortages and increased reduction in morale. Then to just really screw things up, when it is discovered that the newly created thirty-two health districts are a total failure, dissolve them and replace them with twelve even larger even less immediate management groups..

The provincial health administration organisation, (SAHO) with each member of its staff being paid handsomely, and it matters not to them, that they are failures. They blame the health care professionals for not accepting unacceptable wage offers and break for lunch. Louise Simard and her staff have nothing whatever to worry about, unless of course they get sick and that will mean a trip to Winnipeg or Calgary for treatment, but the odds are, they will be fine.

Ultimately, you are going to get so upset with this catastrophe, you will accept the capitalisation of medical care, you will do so gladly and the professors at the business collages across this land will smile secretly and say "yes." (The Fraiser Institute a right wing free enterprise outfit in B.C. got in on the not so secret cheering today, as they pointed out that Saskatchewan waiting lists are the longest in Canada.)

Do you feel the colder nights, notice that the days are getting shorter. You want to keep on living in Saskatchewan you had better suck it up, be tough accept that you are about to be sent from your perch and hurled to the ground, death is inevitable. If you can afford a good HMO plan you should be okay, if you are a member of the working poor, have low wages, or a large family, remember we all have to die sometime, for you, that will just be a little earlier.

Have a nice fall day.

Timothy W. Shire



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Editor : Timothy W. Shire
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