Working for a more open and accountable health care system

Frances Raglan was admitted to Riverview Health Centre on October 8, 2001. She and her family were told it was for a short-term stay to treat an ankle ulcer and that she would soon be going home on home care. Unknown to Mrs. Raglan or her family, the chart had an order "Reassure the patient/resident/signfiicant other(s) that all comfort measures will be continued to ensure a dignified death." She died in the Riverview Health Centre 18 days later.

The Protection for Persons in Care Office carried out an investigation and reported their findings on January 16, 2002. For three years, Frances Raglan's family had to fight before getting access to the report to see what it said. They asked for help from Manitoba's Ombudsman Barry Tucket. At one point he was so frustrated in his efforts that he told them that the system failed Frances Raglan at both ends and he was mad about the delays.

In order to improve our health care system we need to be more open. People want to know details of their care and their relative's care. We need to be able to learn from mistakes, and this means recognizing they have happened, and acknowledging and apologizing for errors. It also means that circumstances where errors occur need to be looked at carefully and recommendations for improvement made and implemented.

The Protection for Persons in Care Office report contains 8 recommendations. One of these emphasized that "the nursing care plan reflect the current health status of the patient", clearly recognizing that a patient admitted for short term care for an ulcer should not have a care plan which emphasizes dealing with a dignified death.

Yesterday, in question period, I asked the Minister of Health to provide a letter to the Raglan family with details of the extent to which each of the recommendations have been implemented. Familes who have experienced difficulties with the health care system want to know that something has been done to prevent future similar problems. Information on the implementation of recommendations can demonstrate that improvements have been made.

Having a more open health care system is not easy. As a doctor, I know because I have had experience as a caregiver. But my experience as a physician provided lessons which taught me that there are big advantages in being open with patients and their families. Patients and their familes and friends are an important part of the network of care which is so important to achieving the best care possible.

[Follow up: As a result of the efforts of Frances Raglan and our persistence in putting forward a bill to provide for 24 hour access to medical records for those in hospital or personal care homes, legislation to this effect was finally passed in 2008].

We also need a more accountable health care system. Three years ago, November 28, 2002 Roy Romanow in his Commissions Report on the Future of Health Care in Canada recommended that Accountability become a major principle for the operation of our medicare system in Canada. I agree. Indeed, in 2003, in 2004 and today, I introduced legislation which would have required that health services delivered in Manitoba under The Health Services Act and The Health Services Insurance Act comply with the fundamental principle of accountability. The bills I introduced in 2003 and 2004 were not supported by either the NDP or the Conservatives in Manitoba. I am trying again this year in introducing Bill 203 which will provide for accountability as a major principle in the delivery of health care in Manitoba. I welcome your comments.