Accountability at the ballot box

Opinion

Hey there, time traveller!
This article was published 20/09/2023 (746 days ago), so information in it may no longer be current.

The upcoming Manitoba provincial election, like all elections, is a complicated process. Some citizens will vote to express a political identity or long-standing affiliation, others will try to secure a good outcome for themselves by assessing which party is making promises that most improve their personal situation.

But there is another motivation — central to democratic theory — that will move at least some voters and that is the necessity to hold political rulers to account for their actions while in power.

The Oct. 3 Manitoba election might become a classic case of the potency of accountability in determining election outcomes.

What distinguishes democracies from authoritarian regimes is that in free and fair elections voters eventually get to judge how well or badly the representatives have used the power they have been granted. V.O. Key, the great Harvard expert on parties, wrote, “The electorate, in its great, and perhaps principal, role is an appraiser of past events, past performance, and past actions. It judges retrospectively.”

In appraising the performance of the past two Conservative governments, led from 2016-2021 by Premier Brian Pallister with Heather Stefanson as deputy premier, then from 2021 to today with Stefanson as premier, Manitobans will be judging actions that go to the heart of the core beliefs of the Conservative and New Democratic Parties, the two dominant parties in provincial politics.

The Pallister-Stefanson regimes have not been run-of-the-mill governments: they have, instead, implemented radical reforms to achieve the traditional Conservative goals of balanced budgets (for one year in 2019-2020) and tax cuts, which are ongoing.

The method chosen to balance the budget and fund tax cuts was to reduce the growth in public spending, especially in health care. In significantly reducing health-care capacity, these actions challenged the pre-eminent values of the NDP whose legendary former leader Tommy Douglas introduced medicare to Canada.

To appraise performance and make democratic accountability work, however, voters must have unbiased sources of information and this is difficult in our world of party spin doctors.

Happily, Manitobans interested in an impartial review of how Manitoba is doing in health achievement can turn to the August 2023 report Prescription for Health Care by Doctors Manitoba, which outlines an action plan for improving health care over the next five years, and has statistics in key areas like physician shortages, lengths of stay in ER care , and surgery wait times — showing how far Manitoba lags other provinces in health outcomes.

The report’s key conclusion about recent health history in Manitoba states: “The health care system was pushed beyond its limit during the pandemic, resulting in delays and disruptions in care for patients and record levels of burnout for health care workers”.

And why was the health system pulled beyond its limit during the pandemic?

Because the system was already in turmoil prior to 2020 trying to cope with the magnitude of changes and cuts imposed by the Conservative government.

In February 2017 a billion dollars worth of health projects to build capacity were cancelled (including $300 million for cancer care); in March 2017, cuts of $83 million were imposed on the Winnipeg Regional Health Authority; in April 2017 half of Winnipeg’s emergency departments were closed down and the list goes on. In September, 2020, Premier Pallister announced that in 2019-2020 the government had indeed balanced the province’s budget (with a modest surplus of $5 million), two years ahead of schedule.

But the triumph was short-lived: with the arrival of Covid, the province was soon in a double deficit, both fiscally and in health capacity, with hospitals having to mandate overtime, emergency care wait times increasing and surgeries being delayed. In August 2023, for example, documents were revealed showing that nurses at Shared Health hospitals worked over 224,000 overtime hours from September 2022 to May 2023.

The personal impact of forced overtime was brought home to me recently when I went for an MRI. The health staff were caring and efficient but when asked about how they were coping, one nurse replied, “Oh, Mr. Axworthy, I’m so tired.”

Democratic accountability requires memory. In the rush to balance the Manitoba budget prior to COVID, we should never forget that the Conservatives rolled the dice on health care and made the decisions on capacity and staffing that have led to so many dedicated health professionals being so exhausted.

We must remember this past and resolve to do better in the future.

Thomas S. Axworthy is a former principal secretary to Prime Minister Pierre Trudeau.