The eHealth scandals unfolding in both B.C. and Ontario can be tied by one theme: Governments can get into a "bagful of trouble" when they rush to embrace technology they don't really understand.
This week, the Ontario eHealth debacle continued to spread when the Auditor-General tied Premier Dalton McGuinty to the appointment of top officials who have resigned over untendered consulting contracts.
In British Columbia, detailed allegations of breach of trust, influence-peddling and fraud involving B.C.'s share of the federal-provincial initiative were revealed in an RCMP search warrant that names a senior government official, now retired, who headed the program. No charges have been laid.
When B.C.'s new Health Minister Kevin Falcon - a vocal proponent of public-private partnerships - was briefed on eHealth earlier this year, his first reaction was: "Why don't we just outsource it?"
The answer was, it would cost B.C. a bundle.
B.C. so far has spent $185-million developing new technologies under the flag of the Health Canada Infoway. The objective is to create a national network of electronic medical records and other, related technology to improve health-care information systems.
If the province hopes to collect its share of the federal contributions, worth almost $140-million to date, it has to play by Ottawa's rules, Mr. Falcon said. "That is being driven in a manner that says it is going to be designed by government."
But without the in-house expertise to develop new technology, the provinces have relied upon contractors in a specialized field.
And that, Mr. Falcon said, is a dangerous proposition.
"As long as I've been in government, my biggest concern has always been technology investments," Mr. Falcon said this week. "That's the area that can always get large organizations - both in the private sector and in government - in a bagful of trouble if they are not very, very careful."
He was responding to the release of the RCMP's 99-page search warrant outlining a litany of allegations related to eHealth contracts in B.C. But ongoing investigations by the comptroller-general and the Auditor-General in B.C. have already led to tighter controls on how contracts are awarded.
The B.C. Liberal government was an early advocate of contracting out its back-shop administration services, such as management of the provincial Medical Services Plan.
Mr. Falcon's government "took it on the chin" politically for outsourcing government jobs, he acknowledged in an interview yesterday. But that approach, he said, would help avoid the kind of scandals that now envelops eHealth. "The reason why we've been doing that is to get away from exactly this kind of situation, when government tries to design and build these systems on our own."
Kirsten Tisdale headed B.C.'s Alternative Service Delivery team that negotiated $2-billion worth of service contracts. She also served for a time on the board of Health Canada Infoway. Now back in the private sector, Ms. Tisdale knows where the weak spots are.
Ms. Tisdale said the vision of a national electronic health-record system is worthwhile, but no government in Canada can claim to have the expertise to put it together.
"This is highly sophisticated technology. A government would never have on staff that kind of deep expertise. ... That expertise sits in the private sector and also what sits in the private sector, quite candidly, is a lot of capital."
Where trouble develops, she said, is when government fails to bring its top talent to the table to negotiate good contracts.
"Where government sometimes falls down is where it doesn't invest in the governance, it doesn't invest in that level of talent."Report Typo/Error