8/27/08

Pick equality over duality

 

Every New Brunswicker, regardless of gender, race, religion, language, or place of residence, has a right to timely, effective health care.

Universality is the first test health care must meet in Canada - and in a province this size, the only way to guarantee equal access for all citizens is to have all hospitals managed by a single administrative body.

Public policy should be determined by sound, underlying principles - and the principles on which the health system should be based are easy to grasp.

Health care needs to be universal; it needs to be apolitical; and it needs to be sustainable.

In reducing the number of regional health authorities from eight to two, Mr. Murphy was aiming for 'universal' and 'sustainable', but he missed the mark at 'apolitical'.

One health authority would be better than two. Even three health authorities would be better than two, because creating two health authorities in this province risks touching off a political battle between French and English - a lesson the Graham government is learning the painful way.

Mr. Murphy chose to create two health authorities in an effort to avoid a lawsuit over constitutionality. It seems a legal challenge is now brewing anyway. Wouldn't it be easier to go to court to defend one bilingual health authority that serves the entire province, rather than two geographic health regions, one of which is predominantly francophone and the other predominantly anglophone?

The core principle underlying Mr. Murphy's plan seems to be balancing political interests - creating separate districts for francophones and anglophones, and headquartering health services in four parts of the province, for example. But the trouble with such attempts at fair political coverage is that "fair" is always a judgment call, open to contention and dispute. That's less of an issue when public services are centralized.

The least-political location for a single health authority would be Fredericton. Health administrators working out of the capital would be closer to the legislature, which is the source of their funding, while the minister and his staff would be closer to those in charge of implementing provincial health policy. This arrangement would be less vulnerable to allegations of political favouritism. It would also ensure better communication between health care administrators and legislators - an important consideration in a province trying to revolutionize public health care.

Mr. Murphy's two-region model is not viewed as universal, because it contributes to a sense of rivalry. The political pressure to duplicate hospital facilities and services is already increasing. By aligning regional rivalries with language politics, he has set the stage for an escalation of political lobbying which, in all likelihood, will be waged right up to the Supreme Court.

Those arguing for greater duality have engaged former Supreme Court justice Michel Bastarache to help make their case. It seems the government is in for a rough ride.

This is the outcome we anticipated - and the reason we called for the minister's resignation. You can't play politics with health care and expect universality to surviv




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Jean-Louis Kayitenkore
Procurement Consultant
Gsm: +250-08470205
Home: +250-55104140
P.O. Box 3867
Kigali-Rwanda
East Africa
Blog: http://www.cepgl.blogspot.com
Skype ID : Kayisa66

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