Patients wait too long in emergency rooms and doctors dare not advocate for patients if they want to keep their jobs, according to a report on Alberta's healthcare system.
The Alberta Health Quality Council panel, which authored the report, said it has found widespread instances of physicians experiencing intimidation and muzzling when advocating for patients, evidence of a culture of fear and alienation across the province.
The panel said the provincial government doesn't need a full-scale inquiry into doctor intimidation and should instead spend that money on combatting the problem.
It issued 21 recommendations, including creating a task force to develop clear lines of authority in Alberta Health Services (AHS) and halting further restructuring in the health system until a clear plan is in place that allows physicians to advocate.
The report says the province has tried to change too much too quickly in the health-care system over the past four years. It accuses politicians of meddling and says doctors have been cut out of the important decisions over how the system is run.
"Doctors are saying to us that they're worn out. In fact, we were quite alarmed to learn that many have just disengaged," Dr. John Cowell said at a news conference Wednesday where the report's results were unveiled.
"They're simply not going to get involved anymore."
Freeing up hospital beds
To deal with the wait-times problem, the report recommends "dedicating critical resources" to free up hospital beds. Too many patients are in emergency beds, the panel found, when they should be in palliative care or long-term care.
The report comes a year after CBC News first broke the story of Alberta Health Services punishing doctors by withholding hospital privileges and cancelling contracts for advocating on behalf of their patients.
Premier Alison Redford had promised to call an independent inquiry based on the recommendations of the council. Health Minister Fred Horne said Wednesday the inquiry would go ahead despite the panel's recommendation not to establish one.
Horne said the terms of reference for the inquiry have yet to be established, but that could change as early as next week.
Liberal, NDP reaction
Opposition parties have been clamouring for a full inquiry. Liberal critic David Swann, a medical doctor, said Wednesday that it's the only way to root out the problem.
"Hold these people's feet to the fire. Get the people who have been making bad decisions, continue to make bad decisions, continue to intimidate people in the health system — get them out," he said.
NDP Leader Brian Mason said it's not surprising Cowell's panel failed to pin down the problems at the political level.
"This body is a creation, a creature, of the provincial government. And they will not — and do not — have the capacity to lay the blame for this culture at the foot of their masters," Mason said.
The Stelmach government called for the investigation in the face of growing public pressure about wait times and opposition claims in the legislature. At the time, MLA Raj Sherman, now leader of the Alberta Liberal Party, claimed 250 lung cancer patients died while waiting for surgery in the early part of the last decade.
However, Tuesday's report said that allegation was unfounded. Mortality rates for Edmonton and Calgary were the same and comparable to national averages.
The report also found that University of Alberta Hospital Emergency Department physician concerns about patients waiting unacceptably long times for ED services in 2008, including waiting for a hospital bed, were justified. While patients' safety margins were compromised, the panel said, no deaths could be attributed to excessive wait times in the hospital.
As Cowell put it: "We have ample evidence that people suffered."