Inquiry finds queue-jumping occurred in Alberta, recommends changes

EDMONTON – An inquiry has found that queue-jumping has occurred in Alberta’s health-care system and an environment exists in which it could happen again.

Justice John Vertes says there was no basis to claims that queue-jumping was widespread and politicians were moving people to the front of the line. But there were instances where people got faster care.

Vertes, a retired member of the Northwest Territories Supreme Court, said policies need to be tightened to stop that.

“The claim that it was not uncommon for senior executives to receive requests for expedited care proved to be unfounded,” Vertes wrote in his report released Wednesday.

“However … the inquiry did in fact learn of incidents of improper preferential access and also identified several systemic issues that could foster an environment conducive to such improper access.”

Vertes made 12 recommendations to help prevent abuses in the province’s $16-billion health-care system. Those recommendations included reducing wait times, which he said were at the heart of the problem.

He suggested that the definition of queue-jumping and prohibitions against it be strengthened. He also said it should be mandatory to report instances when patients are being pushed to the front of the line and added that whistleblowers should be protected.

As well, Vertes said doctors should never give priority under the guise of “professional courtesy” to other medical staff unless there is an emergency or compelling reason.

Another recommendation was for a health advocate to advise patients and help them resolve complaints.

The inquiry was called by Premier Alison Redford in response to a report by the Alberta Health Quality Council which found a variety of problems involving patient wait times and administrative confusion.

There was also controversy around comments made by former head of Alberta Health Services, Stephen Duckett, who claimed that preferential access to care was a common practice when he took over and politicians had fixers who could get valued constituents faster treatment.

Raj Sherman, an emergency room doctor and now Alberta Liberal leader, made similar allegations, and added that doctors were intimidated into going along.

The inquiry found little evidence of widespread abuse. It did, however, find problems concerning the Forzani and MacPhail Colon Cancer Screening Centre, a public facility on the University of Calgary campus.

Witnesses testified that the centre gave preferential treatment to patients from the Helios Wellness Centre, a private clinic, also on university grounds, which charges members $10,000 a year for health services. Testimony suggested that between 2008 and 2012, Helios patients were treated within weeks or months — well ahead of the three-year wait other patients endured.

Vertes found those concerns well-grounded.

“For a significant period of time, some patients … received improper preferential access to CCSC screening colonoscopies,” he wrote.

“There was no medical or ethical justification for this preferential treatment.”

The University of Calgary said in a statement it would not immediately comment on the findings.

Staff who worked at the screening clinic testified that the booking system was in such disarray that referrals from Helios were being slotted in randomly.

Vertes addressed that issue by recommending that a standardized referral and booking system be developed.

Vertes also found that a special clinic set up to administer the H1N1 vaccine to members of the Calgary Flames NHL hockey team amid fears of a pandemic in 2009 was improper.

Health Minister Fred Horne accepted the recommendations.

“Although Justice Vertes did find a few instances of improper preferential access, he was very clear that there was no evidence to support the idea that this was a widespread problem,” he said.

He suggested that Duckett and Sherman had needlessly damaged public faith.

“The damage that is done is that it undermines the confidence of people who use the system — us — and it also undermines the position and the confidence that front-line workers have that their system is strong.”

Horne said a standardized referral system and health advocate are already in the works. The advocate’s position is part of the new Health Act, which has been passed in the legislature, but not yet proclaimed into law.

A separate inquiry has been called into the activities of Helios and the screening clinic. Horne said it is expected to report soon.

Opposition Wildrose Leader Danielle Smith applauded Vertes’s recommendations on whistleblower protection for doctors. But she chastised the Redford government for not delivering the inquiry that it had promised.

“This wasn’t the inquiry that we were asking for. Nor is it the inquiry that the premier initially promised. We wanted to see an inquiry that also went into the issue of bullying and intimidation (of doctors).”

She praised Vertes for pointing out that long waiting lists contributed to the problem of queue jumping in the first place.

New Democrat health critic Dave Eggen said the government cut the inquiry short just as it was getting interesting.

“While we ended up with some good recommendations, I think that the inquiry itself could have made more compelling evidence if it was not stopped by the PCs when it was.”

Dr. Michael Giuffre, Alberta Medical Association president, said he is “generally pleased” with the report.

“I think the Alberta Medical Association would endorse the 12 recommendations that we saw,” said Giuffre, who was attending the Canadian Medical Association annual convention in Calgary.

Giuffre said concerns about queue-jumping would fade away if lengthy wait lists were dealt with.

“People should be optimistic that we are actually trying to improve efficiencies and improve access.”

— With files from Bill Graveland in Calgary.

Note to readers: This is a corrected story. An earlier version said there were seven recommendations

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