A senior Bay Street financier has quit the provincially appointed board of Toronto's local health authority in protest over the slow pace of computerization of the health-care system.
Tony Fell, chairman of RBC Capital Markets, sent in a stinging resignation letter to the Toronto Central Local Health Integration Network (LHIN) on April 2.
A copy of the single-spaced, four-page letter has been obtained by the Star.
Fell says in the letter that he was "extremely disappointed" with the low priority that had been accorded to computerization, or e-health, by both the Toronto Central LHIN and the ministry of health.
"I was disappointed because I clearly stated when I joined the board that the only way out of Canada's health-care morass was through a major upfront investment in e-health," says Fell.
He then adds, in capitalized letters: "An advanced e-health system could save many billions of dollars annually while, at the same time, providing vastly improved service and care to our citizens and a major reduction in medical errors."
Fell goes on to say the health-care sector is "at least" 25 years behind the Canadian banking and financial services sector in computer systems and technology infrastructure.
"The reason for this," he continues, "is that over the past 30 years no federal or provincial government of any political party has had the vision or been prepared to make the upfront initial investment in systems and technology which is required. This is why Canada's health-care industry is so vastly inefficient." (This paragraph is underscored in the letter.)
Fell is not just a financier but also a man with plenty of experience in the health-care field as past chair of the board of the University Health Network, which encompasses Toronto General, Toronto Western and Princess Margaret hospitals.
While he is a Conservative, Fell was appointed to the board of the Toronto Central LHIN by the Liberal government, which is trying to decentralize the health-care system by devolving power from Queen's Park to these regional authorities.
Barry Monaghan, CEO of the Toronto Central LHIN, said yesterday he was sorry to lose Fell, whom he described as "a very experienced and capable individual." But Monaghan took issue with Fell's stated reason for quitting the board. "E-health is definitely a top priority (for the Toronto Central LHIN)," said Monaghan.
In his letter, Fell notes that e-health is just one of nine priorities for the LHIN, "which means it is not a priority at all."
The other eight priorities identified by the Toronto Central LHIN are: mental health and addictions, rehabilitation, seniors, health human resources, education and research, energy and environment, back office integration, and provincial ministry priorities.
Furthermore, the LHIN's e-health strategy is "not a plan but rather an overview document," writes Fell. "There is no budget, there is no timeline, there is no indication whether we will have a single patient identifier number or whether we will have a drug card like the province of British Columbia, or what will happen to our currently outdated OHIP cards. Will all doctors' prescriptions be entered on computer? Will citizens be able to access their e-health records on the Internet? These are all major issues which must be addressed before we decide what system to build.
"Unless we know what the end game e-health system will look like, there is no way we can put together a plan, a budget, and timeline to get there." (This sentence is underscored in the letter.)
Fell also expresses disappointment that the recent provincial budget did not "clearly establish" e-health as the top government priority.
In an interview yesterday, Fell, who was a major fundraiser for the Conservatives when Mike Harris was premier, also criticized Harris's government for inaction on the e-health file.
Fell said the Harris government received an excellent report on the subject in 1998. "But the report disappeared and never saw the light of day."
Health Minister George Smitherman said yesterday Fell was "off the mark" in his criticisms, perhaps because he was not privy to everything that is happening with e-health.
He said the government has been putting in place the "building blocks" to achieve a fully computerized system, including legislation to protect patient privacy, creation of a "unique patient identifier" for every individual, and a "very, very substantial" investment in the underlying computer infrastructure (over $600 million, according to his staff).
"It's a massive undertaking," said Smitherman, adding that the previous Conservative government had made only "sporadic investments" in the area.
Fell's letter lists other reasons for his resignation, including the "political" nature of appointments to the LHIN board.
He deplores the fact the chair of the board is appointed by the government rather than by the board itself and says this "is not a good governance model."
Fell also expresses concern that the resources available to LHINs are inadequate for the "massive" challenges it faces.
Autor(en)/Author(s): Ian Urquhart
Quelle/Source: Toronto Star, 19.04.2007
