An Alberta inquiry has determined that some citizens – including members of the Calgary Flames and some patients at a private centre, which made a Christmastime wine delivery to a public colonoscopy clinic – jumped the health-care queue, and that the provincial system suffers from systemic problems that could allow improper access to continue.
John Vertes, the inquiry's commissioner, said in a report released Wednesday that there are "myriad opportunities" for patients to receive preferential access to health care, although the belief that it was common for senior executives to skip to the front of the line proved untrue.
Mr. Vertes, a retired member of the Northwest Territories Supreme Court, also said MLAs did not use their position to improve the care for their family or friends, though there were cases when elected officials properly advocated on behalf of their constituents.
Preferential treatment is possible, Mr. Vertes said in his report, because of the multiple ways patients can gain access to Alberta's $16-billion health-care system and the discretion physicians and others exercise over wait lists.
The report gives an official voice to what many Canadians have long suspected – that influence can deliver priority care in the public system. Mr. Vertes determined that abuses were limited in Alberta, but he provided recommendations that he expects could stem queue-jumping.
Wait lists are politically touchy across Canada and while the problems the inquiry uncovered are specific to Alberta, the solutions could be applied nationwide.
"The inquiry did in fact learn of incidents of improper preferential access and also identified several systemic issues that could foster and environment conducive to such improper access," Mr. Vertes wrote.
However, the inquiry did not find "specific evidence that anyone had been medically harmed" as a result of queue-jumping.
Mr. Vertes highlighted the way the Calgary Flames were treated during the H1N1 flu pandemic in October, 2009. The team, along with those associated with the National Hockey League club, received shots at a private facility, avoiding long lineups at Calgary's four public vaccination locations.
"This episode is a clear-cut case of improper preferential access," Mr. Vertes said. "This problem might never have arisen if AHS [Albert Health Services] had a policy on dealing with requests for special accommodations."
The inquiry also found that some patients from the Helios Wellness Centre, where an adult membership costs $10,000 for an individual or $15,000 for a couple, received preferential treatment at the Colon Cancer Screening Centre, also known as the Forzani & MacPhail Clinic.
Helios's management team sent the cancer centre wine at Christmastime in 2010, prompting concern from a doctor at the clinic, as well as from a director at Foothills Hospital. The queue-jumping patients came from Ronald Bridges, a gastroenterologist and senior associate dean at the University of Calgary's medical school. He was key in establishing the Colon Cancer Screening Centre and had previously served as a director.
Helios donated $200,000 or more annually to fund medical scholarships and other activities at the University of Calgary, the inquiry heard.
Mr. Vertes recommended that the province strengthen queue-jumping legislation; expand protection for whistleblowers; reduce wait times; clarify the scope of so-called professional courtesy, when physicians give priority requests for care by other physicians, health-care workers and their families; develop wait-list management strategies; standardize referral procedures and booking systems; consider creating a Health Advocate, an independent office to advocate for patients and help to resolve complaints; develop a policy on courtesy calls, where VIPs such as politicians, health board members and athletes are treated; develop rules on special accommodation during pandemics; come up with policies on how patients using private facilities access the public system; strengthen triage systems; and develop a policy on preferential access, describing which forms of preferential treatment are improper.
With a report from The Canadian Press