Wednesday, April 6, 2016

Health Care Ombudsman; Good Idea?

Today in an act of political opportunism, Manitoba Premier Greg Selinger announced that if re-elected their government would introduce an office of the patient advocate...or a health care ombudsman.  A stand alone body that would report to the Provincial Ombudsman.

This was the typical politically expedient response to a tragedy that took place in a Winnipeg ER. Something that happened months ago but is only being addressed now because it became an inconvenient news story.  A tragedy that would never have been prevented by a health care ombudsman.

A health care ombudsman is something i've done a lot of thinking about.  I've also asked several physicians what they think about the idea.  The responses have been interesting.  Most physicians I talk to expressed that they would rather prevent harm, to patients, than have an office that only steps in after the fact.  It seems more reactive than proactive.

I do think the idea does has some merit.  Having a body that operates at arm's length of the health authorities, and the government they report to, is not a terrible idea. The issue is how the office is setup and what authority it would have.  I am very skeptical that this office would have the authority it would need to be effective.  Following the Phoenix Sinclair Inquiry Justice Ted Hughes recommended increased powers for the office of the Children's Advocate.  This issue has been studied to death by the current NDP government and nothing has come from it.  On this issue and many other issues this NDP government has suffered from paralysis by analysis.  I have a hard time believing this NDP government is capable (or even genuine) about its intent to create an effective Health Care Ombudsman.

Although I believe a health care advocate may be a good idea I don't believe it to be a priority.  Many issues in health care are well known.  Lack of patient and personal care home beds are an obvious issue.  Doctor shortages are another issue that is causing havoc in rural ERs.  There are hundreds of vacant nursing positions.  Everyone knows the issues.  It isn't difficult.

When it comes to listening to patients concerns, these issues are also well known.  The vast majority of complaints that come from patients and patient families surround communication issues.  As one physician told me..."we're just not patient centred."

Some may argue that a health care ombudsman could facilitate better communication with families and provide improved and more timely responses to family concerns.  That could be true, but it would only take place after the relationship between patient and the health care system have already been irreparably harmed.  Shouldn't we be trying to improve communication and solve issues before having to bring in a third party.

The current NDP government has touted the success of their Critical Incident Reporting legislation.  Is the promise to create an new office to investigate critical incidents an admission that the CI reporting process is broken?  Are we now just layering another half baked bureaucratic investigative body on top of an existing dysfunctional system.

It is interesting that the Premier chose to call this the office of the "Patient Advocate"  I am a patient advocate.  Not a pencil pushing bureaucrat.  I know a little more about this than he does.  I have absolutely fabulous members of the health care system who effectively advocate on our behalf when we have issues in the health care system.  We have an effective relationship.  It's time to start building productive relationships with patients in health care. We are equal partners.  We have a mutually beneficial relationship.  That is not true for most.  The way many patients are treated in health care it seems like they are in an abusive relationship.

If you sense a great deal of frustration in this blog post; that would be accurate.  We need to start taking action on health care issues and stop creating bureaucratic empires.  It just seems that we have become totally infatuated with trying to hide the failings of our health care system and forgot about dealing with real life patients.  There are people in our hospitals in Winnipeg right now.  Treat them!

My honest opinion is that creating a health care ombudsman simply sounds like an attempt to avoid dealing with the real problems in health care.

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