The Health Quality Council of Alberta has found widespread physician intimidation and an emergency room system under severe strain, but no suggestions that doctors were paid for their silence or that lung cancer patients died on a waiting list.
While the council found there was limited need for a public inquiry into the issues of doctor intimidation, Premier Alison Redford pledged Friday one would continue and would look into that issue as well as allegations of queue jumping that were raised last year.
“We are going to keep to my commitment,” she said. “There is not a doubt in my mind that we will have this inquiry up and running before the writ is dropped.”
Redford said that might not mean the public inquiry will be hearing evidence during the campaign. She said once she asks the council to conduct the inquiry how they do that and on what timetable is entirely out of her hands.
“It is no longer possible for me to dictate to the inquiry.”
The council’s long awaited report released Wednesday found the emergency room system is in deep distress and patients are suffering.
“Many emergency patients waited 10 to 20 times longer than the Canadian guidelines recommend, patients with time sensitive conditions waited long periods of time, which dramatically reduced margins of safety,” said Dr. John Cowell, the council’s CEO.
Cowell and the council conducted a review of emergency room care, including a thorough examination of nearly 700 patients who were treated at the University of Alberta emergency room.
In that review Cowell said one thing that shocked them was the treatment palliative patients received in emergency rooms in their final days.
“Some of our reviewers became quite emotional when they read this, when people had spent all of their lives only to come and to die while waiting in an emergency room.”
Cowell said the reason emergency rooms are struggling is because there are no acute care beds to treat them in. He said the solution is ready and apparent and recommended Alberta Health Services put the power in the hands of their staff.
“I would send a message to Alberta Health Services: trust your people, they actually do know what to do, enable them to get it done.”
Dan Hryciuk, an emergency room doctor at the Sturgeon hospital, said he had little to say on the report’s conclusions, but said the wait in the emergency room remains unchanged.
“We have not seen any improvement in our ability to move our admitted patients out,” he said. “It is the same as it always was.”
The council was also asked to look into questions about whether physicians felt intimidated when advocating for their patients. The response the council received from physicians in a survey sent out last year indicated many felt pressured to stay silent.
“It is extremely difficult to advocate due to undertones of intimidation and being told to stop being so outspoken,” wrote one respondent.
“I was never persecuted, but was certainly placated, censored and then ignored,” read another response.
Cowell said doctors often don’t know how to raise their concerns effectively.
“It is almost in the doctor’s DNA to advocate, but you are going to find we learned that there is precious little guidance on how to do that effectively.”
He also said the creation of Alberta Health Services’ super board blurred lines of responsibility and made it even harder for doctors to know where to take patient concerns.
“Time and again we heard that the creation of Alberta Health Services was disruptive to physicians.”
He said doctors were completely left out when the board was created.
“They have felt left out of the tent and not adequately consulted with.”
The one other aspect the council looked into was surgery times for lung cancer, after now Liberal leader Raj Sherman suggested doctors had been paid for their silence and Albertans had died waiting for surgery.
Sherman said there was a wait list of 1,200 people and 250 people had died waiting.
Cowell said that allegation was unfounded.
“I am completely satisfied, my team and I are completely satisfied that we got to the bottom of these allegations,” he said. “There is no list of 1,200 patients waiting for surgery … there is no evidence that 250 people died while waiting for surgery.”
Sherman welcomed the report’s finding on emergency care and physician intimidation, but said it didn’t have the resources to look thoroughly into the issue of cancer deaths.
He said he raised the issue because doctors he knows and trust brought up the concerns. He said many of those physicians did not feel comfortable talking to the council for their report.
“I know there are many doctors who were scared to even report to the inquiry,” he said. “The health quality council did not have the ability to subpoena witnesses and compel them to testify.”
Sherman said he was relieved to see the allegations around doctor intimidation have been vindicated, but he now wants to know who is applying the pressure.
“We need to know who in management and in politics is causing this and they need to be brought to account.”
The government gave the health quality council powers to conduct an inquiry with new legislation that was passed in the fall session of the legislature.
