A horse with a silver blaze, curried mutton and a dog that did nothing in the night-time helped Sherlock Holmes get to the bottom of a mysterious death. Will it take a legendary detective to uncover the problem with lung surgeries in Alberta? Below: Dr. Verna Yiu; Dr. Raj Sherman; Dr. Ciaran McNamee.

Scotland Yard Detective: “Is there any other point to which you would wish to draw my attention?”

Sherlock Holmes: “To the curious incident of the dog in the night-time.”

Detective: “The dog did nothing in the night-time.”

Holmes: “That was the curious incident.”

There was something eerily familiar about the Edmonton Journal’s report Tuesday, “Alberta lung cancer patients are typically waiting twice as long as other Canadians for surgery, a distressing trend the provincial health authority says it is struggling to understand.”

But what was it? There was no hint of it in the story, which was published on April 1 although it was evidently not meant as a joke.

The story was based on a report by the respected Canadian Institute of Health Information, known throughout the medical field by its acronym, CIHI, which is inevitably pronounced Ky-High. The CIHI study compared wait times across Canada for a variety of medical operations, putting Alberta close to the national average for many.

But Alberta was “dead last” in the Journal’s unfortunate turn of phrase when it came to lung surgery, with patients last year undergoing the procedure within 85 days. The Canadian average was 49 days; Ontario’s was 36 and B.C.’s 32, CIHI said.

“It’s a real challenging issue,” the Journal quoted Alberta Health Services Chief Medical Officer Verna Yiu as saying. The Journal’s reporter intoned: “Yiu did not have a definitive explanation for the delays in Alberta.”

Well, does anyone in Alberta remember retired judge John Z. Vertes’ Health Services Preferential Access Inquiry? Professional journalists are forgiven if they have forgotten. After all, since the summer of 2013 there’s been a lot of water under the bridge behind the Legislature that crosses the North Saskatchewan River to the University of Alberta Hospital.

Nevertheless, the report contains a hint of something that might be related to the mystery that is stumping Dr. Yiu – or, rather, its absence, rather like the Dog that Didn’t Bark, contains the hint. Let me explain:

The inquiry, created back in the days when Premier Dave Hancock was still loyally toiling in the cabinet of Alison Redford’s already troubled government, seems to have been ginned up in response to the premier’s leadership-contest promise of a real judicial inquiry into accusations of line-jumping and bullying in the health care system.

Apparently an inquiry by a retired judge reporting to Health Minister Fred Horne was deemed good enough for most voters, and the whole $10-million affair now seems to have drained quietly down the Memory Hole.

After months of testimony, the commissioner reached the conclusion there was no basis for the startling allegations of routine line jumping that contributed to the brouhaha that sparked the inquiry – claims made in public principally by Alberta Liberal Leader Dr. Raj Sherman and former AHS CEO Dr. Stephen Duckett.

The final report of the inquiry all but called Dr. Sherman a liar – or, as I wrote at the time, at the very least a deluded fantasist.

But at this late juncture, the April 1 CIHI report suggests a glimmer of vindication for Dr. Sherman.

Why was it that the inquiry failed to call a witness who was at the centre of one of the most spectacular allegations of medical queue jumping in recent decades? To wit: that lung surgeons were being denied operating room time and resources because other kinds of surgeons had political access to the people who ran the health care system in the late 1990s?

That accusation was made by Dr. Ciaran McNamee, once the head of thoracic surgery at the U of A Hospital, who had sued the former Capital Health Region.

In his lawsuit, Dr. McNamee claimed he’d been improperly hounded out of his surgical practice for complaining publicly about his patients’ long waits for surgery. He also claimed Capital Health Region officials had improperly questioned his competence and even his sanity.

Indeed, according to the CBC at the time, one allegation in Dr. McNamee’s lawsuit was “that his budget for lung surgery had been all, or in part, effectively taken over by other surgeons at the hospital.”

But despite the fact that this was one of the incidents that led to calls for a real judicial inquiry into bullying and intimidation of medical professionals in the Alberta health care system, Mr. Vertes’ inquiry declined to call Dr. McNamee as a witness because, as a spokesperson said at the time, “it was decided his information was ‘dated’ and would provide little useful information about queue-jumping that may be occurring now.” (Emphasis added.)

Dr. McNamee – who by then was practicing medicine in a little U.S. backwater called Boston and teaching at a provincial school known as Harvard University – had made it very clear he was “willing to co-operate, in any form or fashion” with the inquiry.

His allegations became public at about the same time as Dr. Sherman’s assertions in the Legislature that 250 people had died, many from lung cancer, while on a 1,200-name surgical waiting list in the 1990s.

Unfortunately for those who would have liked to cast a light on what was going on in Alberta’s health care system back in that decade, the lawsuit was settled out of court in 2001 and Dr. McNamee was bound by a convenient non-disclosure agreement – unless he was subpoenaed to testify.

In a contemporary blog post by Calgary-Mountain View MLA David Swann, which has since disappeared from the Internet, the former party leader accused the inquiry of “deliberate avoidance of the most dramatic allegations of queue jumping.”

“Many of (Dr. McNamee’s) lung patients were ‘bumped,’ allegedly by other surgeons given preferential access, resulting, allegedly, in preventable deaths among his patients,” alleged Dr. Swann, who like Dr. Sherman is a physician.

Of course, much has changed in Alberta health care since the late 1990s. Most importantly, Capital Health and nine other health regions no longer exist – they have all been rolled into Alberta Health Services. Most of the key players have been shuffled around, and some of the most important ones have changed, been fired, quit or retired.

But as this week’s CIHI report has made clear, serious, life-threatening problems persist in how lung surgeries are provided in Alberta.

Could it be that the problems in the Capital Health Region pointed to by Doctors McNamee, Sherman and Swann were real, and have never been resolved?

Could it be that the same kind of politics that Dr. McNamee pointed to in his now settled lawsuit are still being played within Alberta Health Services?

Could it be that like so much else done by the Redford-Hancock Government, the Health Services Preferential Access Inquiry was a half-baked promise at best that no one intended to keep and that, by accident or design, didn’t achieve very much?

Perhaps this curious coincidence is something Dr. Yiu should look into.

This post also appears on Rabble.ca.

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  1. Surprise Surprise – a government inquiry designed specifically to obfuscate actual problems while mollifying a rarely engaged public. Perhaps 43 years isn’t quite long enough for them to get to grips with actual problems – I suggest we give them another 43 years.

  2. Excellent connection you’ve made here between the two reports! Chalk it up to institutional memory and a nose for detail, skills that are lamentably lacking in too, too many newsrooms today. Good work.

    1. Thank you, Ronda. But in my view it is simply not acceptable that our local newspaper of record did not connect these two dots, separated by a very short distance and a very brief period of time. This kind of missed link is what happens when you outsource your copy editing to a bunch of clowns in Hamilton, Ontario, who don’t know or understand local issues in Alberta and could care less. It was always the Desk that was the repository of institutional memory on great newspapers, and without a good copy desk you simply can’t have even an adequate journalistic enterprise. For heaven’s sake, the Edmonton Journal had a story yesterday in which former premier Redford’s first name was spelled “Allison”! Now, THAT is pathetic! And they want us to PAY to read their copy? Please!

  3. That was Red frauds trick, during the Leadership campaign she Promised Full Public Judicial inquiry into Dr. Intimidation. And the alleged Lung Cancer wait list Patients Well after she got in, she provided a watered down manufactured narrow “Queue Jumping inquiry instesd”, which Dr. Sherman nor anybody else for that matter even ever asked for. This Inquiries’ sole purpose was to Whitewash this affair and defame Dr. Sherman and Duckett, at the same time the hand picked Judge Vertes disallowed the Dr.McNamee Affair, as did the HQC., the very thing Simple Ed has tried to keep under wraps. 10 million bucks to whitewash the problem and defame a few individuals. Perhaps Red Ferd should personally pay for a narrow whitwash inquiry that she forced at the behest of Tory insiders? They are hiding something and they provided a false narrow inquiry that nobody wanted and disallowed real information from being presented. They should have every chance to face their past. What are they hiding and why?

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