Our first all-new episode of White Coat, Black Art
is on whistle blowers in health care. More precisely, the show is about why there are so few
people on my side of the gurney who are willing and courageous enough to blow the whistle. The death of Brian Sinclair, an aboriginal man who spent the last 34 hours of his life in the ER waiting room of a Winnipeg hospital, is an unfortunate case in point. We'll have much more to say about Sinclair's death in the weeks ahead. For now, I want to make the point that the circumstances of his demise demonstrate conclusively why health care won't get safer and more just without more insiders who are willing to speak up.
Brian Sinclair attended the Health Sciences Centre in Winnipeg for a urinary tract infection associated with a blocked catheter. He died in the ER waiting room on September 21, 2008, some 34 hours after he first wheeled himself into the department. A judicial inquest into the circumstances of Sinclair's death adjourned this week, and will resume in October.
The big news this week - and the connection to whistle blowing - came in the form of a confidential report into Sinclair's death conducted by the hospital's Critical Incident Review Committee. CBC News' I-Team
obtained details of the report. According to a story on CBC News
, authorities have not shared the report with the Sinclair family or the lawyer who represents the family.
The report cites comments from front-line hospital staff describing the waiting area of the ER (where Sinclair was found dead) as "a war zone." Another potentially pertinent observation is just how many bystanders came up to the nurses and security in the waiting room with concerns about Mr. Sinclair's well being, only to be turned away -- repeatedly.
Representatives of Winnipeg Regional Health Authority have cited provincial privacy laws as the reason for not making the report public and for not sharing the report's findings with the Sinclair family.
As you'll learn on this week's episode of WCBA, privacy laws are supposed to allow health care insiders to discuss bad outcomes and near misses freely and without fear of legal and professional repercussions. But in my opinion, from the standpoint of accountability, all too often, privacy concerns enable authorities to keep the matter quiet.
Beyond legal and regulatory requirements, there's a culture in medicine whereby my health care colleagues are all too ready to comply with the directive from on high to keep things that might embarrass a hospital quiet.
The impact of the ensuing lack of transparency is that the public has a false belief that in Canada, health care is a lot safer than it really is.
That we now know the main findings of the Critical Incident Committee report into Brian Sinclair's death can be attributed solely to the fact that a whistleblower stepped up to share all or part of it.
In the UK, it took a mega-scandal in which a pattern of widespread negligence lead to an estimated 1200 deaths at Stafford Hospital - which is run by the National Health Service or NHS. Read the report
here. The scandal led British Prime Minister David Cameron to apologize in the House of Commons last February. it also led the British government to appoint Sir Michael Richards (famed British cancer specialist) as that nation's first Chief Inspector of Hospitals (aka the 'whistle blower-in-chief')
with the power to inspect hospitals and fix the NHS.
I predict that Canada will one day have its own 'whistle blower-in-chief'. Still, if Canadians are waiting for the kind of tipping point that got the British public to encourage more whistle blowing, I think we're way past that.