The politics of wait times

Originally posted at BCer in Toronto

In Toronto today Steve Harper took a baby-step towards fulfilling his infamous missing fifth priority. Appropriate it was a baby step, since he made the announcement at the Hospital for Sick Children.

The unfulfilled priority I refer to of course is this one:

…work with the provinces to establish a Patient Wait Times Guarantee

And I say infamous because, as first noted by Paul Wells, it simply seemed to disappear from Harper's list of priorities at some point without much progress having been made or acknowledgment given. Over the last few months the sense of abandonment on this priority generated a dollop of media attention, and with an election coming some time soon (I'm betting not before a by-election in Outremont though) Harper's need to nip this one in the bud grew, no doubt bringing us today's announcement:

Ottawa will invest $2.6-million to help 16 pediatric hospitals across Canada set up a data base to collect information on how long children are waiting for surgeries…The 15-month pilot project will develop the first pan-Canadian system to measure waiting times for six key surgical areas: cancer, neurology, cardiac, sight, spinal deformity and dental treatment that requires anesthesia.

The problem with Harper's campaign promise on the wait times priority was that it was one he knew he couldn't follow through on. But it was still politically attractive at the time to make it anyway. It was an election and he wanted the votes.

Take a look at the income trusts issue: again, he new economically he'd have to tackle trusts, but it was politically advantageous in the campaign to promise otherwise.

Back to the vaunted five priorities though. All the other five priorities were quick deliverables that he could easily deliver on himself, solely within the federal realm: child care, GST. Bam, done.For wait times he needs to rely on the provinces. Health is a provincial domain. The only lever he has to get the provinces to act is money, but even if he had lots of money for it and was willing to use it as a club to beat the provinces with, the fact is fixing wait times isn't as simple as spending more money. You need to identify metrics and standards, set definitions, and get multiple cross-jurisdictions on board. It's a real logistical and management headache.

The Libs made their own wait times promise in 04 as part of Paul Martin's healthcare "fix for a generation" (we loved that double entrende out in B.C. btw, our jaws dropped in our little rural campaign office when we heard it...might have moved a few votes out in EastVan) and when he tried to follow through on it post-election he ran into a wall, threw some money over it and declared victory.

So, when I heard that promise from Harper in the last campaign I knew immediately that was going no where. And so did Harper.

Therefore, politically they should take a hit for not keeping the promise. They knew full well keeping it wasn't near as easy as they implied, yet they decided to reap the political benefit (votes) for making the promise anyway.

However, if Harper and Clement are actually serious about starting the hard work to tackle this problem (jury is still out there) then I'll be happy. From the brief bit I've heard on today's announcement I think they may be on the right track; it sounds like a good start on doing the work that needs to be done. Let's hope it is.