Outspoken MD risks losing independence in legislature office

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This article was published 04/01/2024 (659 days ago), so information in it may no longer be current.

The first mistake Dr. Eric Jacobsohn made — if he wants to be seen as an impartial expert on health-care reform in Manitoba — was to endorse a political party during the provincial election campaign.

The second mistake he made, after the NDP government announced this week he will become special adviser to Health Minister Uzoma Asagwara, was agree to move into an office at the Manitoba Legislative Building. From that perch, he will find it difficult, if not impossible, to maintain his impartiality.

Once someone takes a politically appointed position in government and moves into the legislature, it’s tough not to drink the Kool-Aid.

That’s not to say Jacobsohn, an outspoken critic of the former Progressive Conservative government, can’t provide government with valuable insight on how to improve the health-care system. No doubt his 30 years on the front lines, including as a cardiac anesthesiologist, positions him well to provide that level of expertise.

But he could have done so without endorsing the NDP in the Oct. 3 election and without joining the partisan team at the legislature. By doing so, he will be less effective as a trusted expert in his field. As a special adviser to the minister working directly in Asagwara’s office, Jacobsohn will become a political staff member, not an impartial observer. He will be expected to toe the government line.

Jacobsohn is not the first physician or front-line health-care worker to sign up as an adviser to government. Most new governments commission doctors and others from the front lines to sit on task forces or advisory bodies to at least give the appearance that government is “listening” to front-line staff.

Even former Tory premier Brian Pallister (not known for his consultative skills) struck a task force of health-care experts in 2016 to provide advice on how to reduce hospital wait times. Like most of those types of reports, the task force’s recommendations (which included pausing some aspects of the former government’s hospital reorganization plan) collected dust on a shelf in the health minister’s office.

The difference with Jacobsohn is he’s taking on a more partisan role. By moving into the legislature, even on a half-time basis, he will lose at least some of his independence in the eyes of front-line health care workers and the public. He will become part of the system.

Jacobsohn could do a few things to mitigate that damage. For starters, he should scrap the idea of taking an office at the legislature. It’s a bad idea, entirely unnecessary and it will harm his credibility. Government wants him in the building to keep an eye on him, to keep him close. He should resist that, no matter how flattering it may be to get invited into the partisan den.

Jacobsohn should also make it crystal clear from the outset that he will call out decisions he disapproves of. Surely not everything the NDP does on the health-care file will be praiseworthy. When it isn’t, or when government fails to act in important areas, Jacobsohn should be able to criticize it publicly.

If he can’t, or won’t, his credibility will fade quickly. He will be seen as a government booster, not an independent expert in the field looking out for the best interests of patients and front-line workers.

Jacobsohn should also be able to select who will sit on the health-care advisory table he has been commissioned to chair. If government chooses those members, it will lose its independence, especially if some of the members are partisans or government cheerleaders.

Finally, the new special adviser and his advisory body should produce quarterly reports detailing government’s progress on health care. They should include wait times for surgical and diagnostic procedures, detailed analysis of emergency-room wait times (more granular than what the Winnipeg Regional Health Authority publishes online every month) and data on staff shortages, including nursing.

Those would be useful functions that would provide the public with valuable insight into how well, or how poorly, government is doing in achieving its main election promise of “fixing” health care. But it would require Jacobsohn to be a fearless critic, not a partisan booster.

If he could fulfil that role, maintain his independence as a clinician and resist becoming a partisan player within the inner circle of the health minster’s office, he may be able to provide the public and front-line workers with a valuable service. If he can’t, he will simply become another political staffer using up office space at the legislature.

tom.brodbeck@freepress.mb.ca