THE STELMACH DISASTER OF THE WEEK: CONTAMINATION, TURF WARS AND A SCREWED UP HEALTH CARE SYSTEM

Premier Stelmach has an impressive resume of public service. Beginning in 1986 and continuing to December of 2006, it was always onward and upward. His first step was to win a seat on the County of Lamont Council in 1986. The next year he was appointed Reeve, a post that he held for the next 7 years. He was elected to the Legislature in 1993 as the member for Vegreville-Viking.

Happily for Stelmach, his election to the legislature coincided with Ralph Klein's first election as Premier. He certainly caught Ralph's eye, for his rise to government prominence was as fast as it was impressive. He began by becoming Chair of the Alberta Agriculture Research Institute. He continued with getting the posts of Deputy Whip and Government Caucus Whip in short order. In 1997 he was appointed Minister of Agriculture. He served in that post until his next appointment as Minister of Infrastructure in 1999 which he held until 2001. From 2001 to 2004 he was Minister of Transportation, and from 2004 to 2006 he served as Minister of International and Intergovernmental Affairs. Add to this impressive list 5 years of service on the government's important Agenda and Priorities Committee. So for 13 years, right up to the time the Tories turfed Ralph, Ed Stelmach and Ralph Klein were shoulder-to-shoulder all the way.

Oh yes, I almost forgot. The Premier had plenty of health care experience along the way. While Reeve of the Municipal Council he served as Regional Representative on the Alberta Health Unit Association. His health care record included 7 years on the Board of the Lamont Health Care Center. He was a member of the boards of the Archer Memorial Hospital and the Lamont Auxiliary Hospital and Nursing Home. And in the Legislature he served on the Standing Policy Committee on Health Restructuring. The Premier was very much an integral part of the Klein years and so deserves an important share of the credit, or otherwise, of the initiatives taken during that time. And that includes the government's actions in health care.

Which brings me to the new Stelmach disaster of the week. Back in March of this year it was reported that Health officials began a review of patient records of the St. Joseph's General Hospital in Vegreville. Vegreville happens to be the Premier's riding. The review came in the wake of a methicillin resistant staphulococcus aureus (MRSA) superbug outbreak in January. 7 patients in the 25-bed hospital had contacted the bug. An investigation revealed that hospital equipment at St. Joseph's wasn't properly sterilized. In fact, the East Central Health Region's medical health officer ordered the hospital to halt all admissions and close its sterilization room. Letters were going to be sent out to all patients treated with surgery and emergency room procedures, since they all had been exposed to the inadequately sterilized equipment. The letters would advise them of the cheerful news that they should get tested for HIV as well as hepatitis B and C. This was no small job. The hospital's emergency room alone sees 14,000 people a year.

Health Minister David Hancock immediately ordered the Alberta Health Quality Council to look into the matter and to report their findings back to him.
Those findings were publicly released last week and thus became the Stelmach Disaster of the Week for the week of July 22.

The Health Quality Council pulled no punches. Its scathing 100 recommendation report released Wednesday said bluntly that it was 'vague legislation' and a 'widespread patient safety culture' that led to the improper sterilization of surgical equipment which caused the spread of the superbug.

The 'root cause' of the problem, according to the report, was due to faulty provincial legislation. In the Council's view, the legislation gave both the faith-based hospital and the East Central Health Region jurisdiction over standards of infection control.

Here is a sampling of some what Head of the Council Dr. John Cowell and the Health Quality Council had to say about the problems at St. Joseph's hospital:

" . . . You have the problem of two bosses and no bosses. . . . "

" . . . Move down the food chain to the individuals trying to do their jobs who don't know, at the end of the day, who they are getting their direction from. This led to ambiguity, a lack of clarity and thus allowed unsafe practices to continue. . ."

". . . there were severely strained relationships between the Region and St Joseph's that failed to ensure that best practices in sterilization and infection prevention control were followed in St. Joseph's despite knowledge the practices did not meet standards."

" . . . There seemed to be much more focus on turf and not enough on patient safety . . ."

Among its 100 recommendations, The Health Council proposed that the government should review provincial legislation to ensure one entity has final authority over hospital health and safety issues. It warned that if nothing was done, similar problems would happen again. It also recommended that the government "define and create a cuture of safety" among staff, managers and administrators.

Health Minister Hancock had to pick up the pieces. He appointed two administrators to oversee the East Central Region's operations to replace the Board. He admitted that the relationship between St. Joseph's hospital and the Region were unworkable. And he vowed to get a handle on the situation.

This whole sorry mess happened as a result of the health restructuring that created the new system of Health Regions. Ed Stelmach, who had served on health boards prior to becoming an MLA, served on the very important government committee on health restructuring. For those reasons alone, he deserves part of the blame for the fiasco.

But, even more devastating, it happened not only on Stelmach's watch as Premier, it took place right under his nose in the largest town in his riding. Given the importance of health care, it is also very likely that the Premier was largely involved in making the appointments to the board of the East Central Health Region, which board had failed so miserably in overseeing its relationship to the hospital.

And that is last week's Stelmach's 'Disaster of the Week.'