Government, WRHA show lack of accountability

Hey there, time traveller!
This article was published 11/02/2009 (6443 days ago), so information in it may no longer be current.

What is a health minister to do?

Theresa Oswald is no doubt working overtime trying to figure out how she became so deeply mired in the growing controversy over the death of Brian Sinclair, who died last fall in the Health Sciences Centre emergency room after waiting for 34 hours.

After Sinclair’s death became public, Oswald did what any Manitoba health minister would do, which is to put all her faith in the vast bureaucratic empire known as the Winnipeg Regional Health Authority. The WRHA is mandated to absorb the body blows for the province whenever someone dies.

And at first blush, it appeared the WRHA did move quickly to do what it does best. Senior WRHA officials admitted mistakes were made. In particular, they concluded Sinclair had never been properly triaged, and thus was never queued to see a doctor. They also admitted numerous people saw Sinclair during his nearly day-and-a-half stay in the ER, and yet no one helped him.

Oswald then did what ministers do best, which is to own up to the same mistakes. And she relied on the best information provided to her by the WRHA, her deflector shield.

So, if everybody did what they were supposed to do, why are opposition leaders howling for Oswald’s resignation and those of senior managers at the WRHA? Turns out that while everyone was doing their part, they were also doing just enough to ensure the full truth never came to light. And the continuing failure of the WRHA management, and Oswald herself, to admit that this was the result of their actions last fall may ultimately prove to be their undoing.

Oswald, like any minister of the Crown, is in a delicate position. She must protect the interests of the public as an elected official. And she must demonstrate support and loyalty for the thousands of people who toil in the health-care system. The irony is that many times, these roles come into direct conflict with each other.

In this case, the WRHA met public outrage over Sinclair’s death with what we now know to be a qualified version of the truth. The health authority admitted having made a mistake, but it also strongly suggested that the homeless, profoundly unhealthy Sinclair contributed to the systemic failure by never approaching triage staff. The WRHA’s chief medical officer, Dr. Brock Wright, stated at a September 23 news conference that Sinclair never even approached the triage desk.

This failure to speak directly to a triage nurse has always been the central thesis of the WRHA’s version of events. It is an assertion that explains, in large part, why no one in particular has been punished for Sinclair’s abominable treatment. How can you punish someone if the patient didn’t do his part to make himself known?

The WRHA has gone even farther on this tack, noting that Sinclair saw a physician at a walk-in clinic prior to coming to the ER. If only that doctor had called ahead to HSC, as is standard practice, everyone would have known Sinclair needed help.

We now know videotape from the afternoon in question shows Sinclair did in fact line up to see a triage nurse. He then spoke to a triage aide. So, while it was true that Sinclair was not triaged, it was not because he didn’t do his part.

There may not be a huge difference between Wright’s assertion and what actually happened, but it was significant enough that Dr. Thambirajah Balachandra, Manitoba’s chief medical examiner, raised an alarm.

Balachandra issued a news release last week to announce he had called a coroner’s inquest into the Sinclair death. And in a marked departure from tradition, Balachandra issued a statement that he had reviewed video evidence that directly contradicted Wright’s official version of events.

Remarkably, in the face of Balachandra’s allegation, Wright continued to maintain that Sinclair never properly presented himself to triage staff. Only after the story broke did Wright acknowledge the video evidence.

On Tuesday, the WRHA board of directors issued a statement that stated Wright "misspoke" when he continued to assert Sinclair never approached the triage desk. The board also indicated it will continue to support Wright and health authority CEO Brian Postl. Oswald has also pledged her support to Wright and Postl, while indicating that she will not seek anyone’s dismissal for this incident.

Of course, firing someone is only one of a number of ways for a public body to ensure accountability. One way is to be as honest as possible, as early as possible, so that the public can make up its own mind about what really happened. Oswald needs to acknowledge that her government failed in this important task.

In the final analysis, almost everything the WRHA and Oswald have said about Sinclair’s death is true. Unfortunately, together they did not add up to the truth.

dan.lett@freepress.mb.ca