07 November 2008

What's Missing in Health Care

The following article, originally written for the Campbell River Courier-Islander, was reprinted yesterday in the Victoria Times-Colonist. While it targets the Vancouver Island Health Authority, the message is applicable to communities across Canada.

It has been a long time since I've read something by a newspaper writer which so eloquently and truthfully makes this vital point: communities MUST be empowered, and with the necessary resources, to set their own destinies, determine their own needs and provide their own solutions.

One really has to question the usefulness and economic sense behind the Vancouver Island Health Authority. At a local level we know how to run our hospital. We know what it needs. We know its intricacies, we know its strengths and we know its weaknesses. And we know how to fix it.

VIHA apparently does not.

To try to manage such a vital community commodity from long distance is a recipe for disaster.

Too often this management becomes a numbers game. Too often decisions are made to align certain equations, equations handed down by the powers that be -- equations that have no practical purpose and no relation to reality.

But on a local level, if we were to manage, we would be looking at the spreadsheet of humanity.

Yes, we would see the numbers, we would work the equations.

But we would also see the faces. We would see the smiles and we would see the tears. We would join in the celebrations and would comfort each other in the sorrow.

We would listen to the doctors and nurses and the staff and we would find in them the truth and the vigour with which to remedy problems. We would listen to the patients and we would ensure that their health care is more than just numbers.

We would care and we would tell the truth. We would not, could not, do anything less because we would be accountable. We would live here and carry that accountability to the grocery store, to the church, to the pub, to the arena. We could not get on our high horse and ride it back to Victoria, there to delay and waylay vital health services that are desperately needed.

We would be born here and die here.

We would be the hospital and the hospital would be us. We would understand that our community's well being is bound tightly to a health-care system that combines passion, intelligence and understanding.

The same message is applicable most issues which affect people in communities: health, poverty, infrastructure, employment, housing .... We who live, work, and play in our communities know best what our collective aspirations, strengths and needs are and how best to achieve them.

We need, desperately, a fundamental change in how Canada's people are governed.

Presently, virtually all money collected from citizens in their communities flows to the topmost levels of government, while all power flows down from the federal government, through the provinces, on to regional governments and last to communities.

The whole system is ass backwards. It works well to preserve the old boys club, certainly here on Vancouver Island.

We need to invert the pyramid.

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