Where oh where do the tax $ go? Oh where oh where can they be?

Have you, or someone you know had need of Medical and or Hospital services in recent years? If so, how would you rate the services and would you say they were satisfactory overall?

Having had considerable personal experience in this area over the course of some decades, I have come to believe that the following story from the CBC is indicative of many of the ills encompassed in the trough now known as Health Care in Canada.

http://www.cbc.ca/canada/story/2009/06/17/ehealth-ontario-mcguinty.html

A few highlights from yet, the latest scandal;

"Opposition parties continued their calls for Health Minister David Caplan's resignation due to his handling of the scandal, but McGuinty stood by his minister on Wednesday, saying he still has confidence in Caplan.

Meanwhile, the search continues to replace Sarah Kramer, who departed the agency more than a week ago after seven months as CEO and president. She received a severance package worth 10 months' salary, or about $317,000.

Kramer was lambasted for receiving a $114,000 bonus, more than double the amount allowed at the provincial agency. Hudson signed off on the bonus just four months after Kramer started.

Two reviews underway

The former CEO was also responsible for signing off on many of the untendered contracts during her first months at work. She defended the lack of a competitive bidding process, saying it was justified due to the urgency of the agency's work.

Under the old rules, provincial agencies were required to put contracts up for tender if they surpassed $100,000 unless they involve legal services, an urgent circumstance or a patented product unique to a single supplier.

EHealth expenses

Some of the consulting costs incurred at eHealth:

• A $2,700-a-day consultant charging for a $3.26 muffin and tea.
• A $300-an-hour consultant, charging for reading an article on electronic health records given to her by her husband, another consultant.
• Two consultants serving as vice-presidents and flown regularly from homes in Alberta.
• A $1,700-a-day executive assistant.
• Consultants charging to watch an eHealth episode on TVO's The Agenda and "debriefing" on the Toronto subway."

And that friends, is only the tip of the iceberg based on my experiences. Check the comments section for some enlightened views on the matter. I read a few and most have something of value to add to understanding the nature of the problems. None that I read pointed directly to the reality that the problems stem from the top down. Those in the most senior positions running amok in the world of privilege they create for themselves, and the attitude of subordinates that this generates.

No one can do anything without authorization from above, and authorization takes forever largely due to several factors. The most significant of which being a lack of real commitment and posturing. These people do not spend adequate time and effort following up on the effects of their policies and are either largely clueless as to the effects, or are busy trying to cover up the truths and making themselves unavailable. The one thing they have an abundance of though, is excuses.

Another glaring problem is the non unionized administrative people have come from a University environment where a half days effort on the ground is the norm and they continue this approach on the job. This mentality permeates the unionized workers thinking and work ethic. On the flip side, the unionized workers have a set of clear rules which determine such things as hours of work, rate of pay and holidays. The non unionized administrative and medical personnel aspire to enjoy the same benefits, and many do. Both of these things work against efficient delivery of medical services and efficient use of tax dollars allocated to this most important of services.

There is a disconnect between the policy makers, the administrations and those on the floor doing the daily work. This is largely due to a lack of supervision by people such as middle managers whose days are spent just about anywhere but on the floor of the facilities they work in, supervising the personnel they are responsible for. The lack of co-ordinated training and the wide variety of methods being employed and base of knowledge of those actually delivering the Health services is evidence of this. Further, they do not come around after their daytime work day hours expire in order to determine exactly how all of their brain storming, and multiple meetings are working out at ground level. The responsibility for that is left to underlings whose main thrust is to maintain minimum standards, or in other words, whose goal it is not to rock the boat.

Last comment on this line of thought, way too many shingles with professional titles hanging outside of closed doors, the occupants of said offices rarely if ever being seen.

Given the challenges that the many obstacles present, it is especially important to discuss the efforts of those who are committed and manage to perform at an exceptionally high level. They deserve our gratitude and respect and we the Peebles should take care not to associate them with segments that are not gifted, committed and capable. It is unfair to tarnish these people with the short comings of others. They deserve all the praise we can offer not only for what they accomplish day in and day out, but for maintaining a consistent moving forward attitude, in spite of the difficulties that surround them.

It is hard to soar like an Eagle when you work with turkeys, but some do manage it. For them, we should be eternally grateful.