The Thunder Bay Regional Hospital Board !
An important Health System Link: The Hospital Board System. On June 20 th, 2001, I attended my first annual hospital meeting for the Thunder Bay Regional Hospital held at the Airlane Hotel, and came away with some questions about the whole system of electing board members.
The meeting chaired very quickly and smoothly, except for only one question being asked. At the beginning of the meeting a glossy Annual report was distributed, report that contained departmental reports. A motion was passed "that the reading of the annual reports be waived," as was done last year; is this accountability ?
The only question concerned the Thunder Bay Regionals budet of some $ 126. million dollars, and originated from Buzz the truck driver. The income statement included a lump sump figure for wages of some $ 71 million dollars. This figure failed to itemize, within various normally accepted groupings, commonly identified costs such as management labor costs verses labor costs. A more useful income statement would disclose how and where the Thunder Bay Regional spends its labor resources across departments. A relative comparison of wages to health care workers, relative to management expenses relative to provincial averages would be a good start.
In addition, the Auditors report did not include any mention of projected cost over runs, which appear to be a known fact throughout the city.
The Thunder Bay Regional while experiencing a shortage of doctors, a shortage of state of the art equipment, makes a poor example of priority funding by its multi page glossy annual report. The report had more than half of its pages as a monument to some of its high level staff, most all of which earned over $ 100,000.00 a year. This type of layout would have been appropriate for Mr. Ford, or Mr. Trump but not for our local not-for profit hospital given its limited resources. Mind you, if any full color page picture of staff was justified it was the one dedicated to the great many volunteers who contributed some 34,000 volunteer hours to the hospital.
My greatest concern about the annual meeting and the election of officers for the board deals with the issues of accountability and fair representation of the general community. This hospital board is suppose to represent the regional nature of this hospital, where ½ of the people it serves lie outside the city of Thunder Bay. With a regional client base of some 260,000 people and with an annual budget of some $ 126 Million dollars, the number of people who attended this annual meeting was approximately 80 people. And this number included management staff and their spouses, doctors and their spouses. This should sound an alarm as to the level of integrity within the current system being used to elect members to the hospital board.
Recently, the resignation by a former board member was in part based on the statement that the board was very closed and a "boys club." My observation would tend to substantiate that the current electoral system may allow this to develop. To vote any citizen of the area must have bought a corporate membership months prior to the meeting.
It is interesting to note that of the seven successful candidates elected to the board, all had been nominated from within the hospital system itself by the hospitals nomination committee. An effective hospital board should be comprised of every groupiing of health providers and health users. The focus on the past clients of the health services provides a critical key to formulating hospital policy and procedure from the most important perspective; the patient.
As a systems analyst I have suggested to the Minister of Health and the Premier that the election of board members for hospital boards be conducted during the municipal election, similar to the manner in which we elect members to the education board. This would at least give all the voting public of this area the abilibty to elect the hosptial board members, and give at least the impression that hospital board would be elected in a more democratic fashion. Compare the 70 to 80 people that voted for a hospital board to the number who elect and or vote for our city council, some 50,000.
I wish the board much success in their work, and sincerely hope that the community of Northern Ontario, support our hospital financially and morally, but if we are to create a world class hospital system, and if this is a hospital funded by the people, for the people, then perhaps we should allow the people of this region the ability to elect their hospital board representatives fairly and democratically; we are in Canada, eh ?
The Thunder Bay Regional Hospital Board Meeting 2002!
An important Health System Link: The Hospital Board System.
I attended my second meeting of the Hospital Board at the Italian Cultural Society and make the following observations. The group consisted of less than 50 people, and the majority were board members, their spouses, and hospital staff.
Unusual was the fact that the financial statements and the departmental reports were not mailed to the corporation members as in the past but were handed out at the door, minutes before the meeting. The financial statments reported a 2.8 million dollar deficit.
The chairman moved to not read the minutes of the reports, as he did last year and I challenged him. After some debate the chairman decided against the historic norm to have the department reports read individually.
I was disappointed to learn that Medical Advisory Committee made up of medical doctors of 12 different departments and several other medical staff, all of whom are not hospital salaried positions get to vote, while the lone Chief Nursing Officer, was given a non-voting position on this committee. It would seem to me that the hospital board deserves to give nurses a more fair representation on this committee and the quality control committee. Imagine having only one nurse on this committee and to insult them, they are non-voting.
The audited statements were passed without any questions, even though the hospital reported a shortfall, a deficit of some 2. 8 million dollars. No one questioned the increase of some 20% for medical staff renumeration .
As I asked questions of the group, one women behind me laughed, and ridiculed my questions. Basically the only ones asked that evening.
The board's chairman reported that we will have a beautiful hospital, and we should all be proud of that, but I was disappointed that questions about recruiting foreign doctors by one member was denied, and "we are not going to talk about that." What good is a hospital with the shortage of doctors that we are experiencing. Is not doctor recruitment a priority that should be addressed, examined and discussed.
The manner in which we elect hospital board members is still somewhat based on a system that does not give the general public an opportunity of electing its hospital leaders.
As a community, we should appreciate that many improvements have been made to health care services in the last few years, and if we are going to continue this road to creating a world class medical facility we must be man or woman enough to discuss all relevant issues to creating a more effective and efficient health hospital system in Thunder Bay.
© aesar J. B. Squitti
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