Anonymity Allows Hospitals to Avoid Responsibility

Media Appearances, Healthcare & Welfare, Frontier Centre

All sorts of reasons exist for refusing to divulge information. Some are legitimate, others laughable.

For example, it’s legit for a woman to consider her facelift a personal matter. Overweight people might feel the same about their poundage.

But a taxpayer-supported hospital not being willing to ‘fess up about its health care performance?

Such an absurdity was revealed this week through release of a “report card” on hospitals by the Fraser Institute.

The Vancouver-based think-tank occasionally measures school and hospital performance in various provinces, releasing comparative data for the enlightenment of the public.

For the first time this year, it scrutinized data from 95 B.C. hospitals, on everything from mortality rates to volume of procedures. All data derived from the Canadian Institute for Health Information.

Sounds like a useful exercise. But the province’s health authorities refused to allow the hospitals to be identified by name.

And so, the Hospital Report Card: British Columbia 2008, by researchers Nadeem Esmail and Maureen Hazel, ranks “Anonymous Hospital 1” through “Anonymous Hospital 95.”

Health consumers apparently are entitled to know that Anonymous Hospitals 11, 12, 26, 93 and 42 consistently have sustained top-10 performances since 2001-2002. And, that Hospital 28 is lowest-ranked hospital in B.C. with a score that has been deteriorating each year. How’s that for providing B.C. taxpayers with information they can use?

The Fraser Institute report opines that the health authorities’ refusal to have any of the institutions named reflects “a setback to the empowerment of patients in B.C. regarding the care they receive and for the ongoing commitment of hospitals to quality improvement through accountability and transparency.”

More colloquially, this is an outrage, allowing hospitals to avoid responsibility for their records. The only motivation health authorities could have in holding back hospital identities would be to protect poor performers.

Studies in Ontario revealed a similar, though not quite as blatant, disrespect for health consumers.

In 2006, 43 of 136 acute-care hospitals agreed to have their names cited in a Fraser Institute hospital-ranking report. This year only 29 Ontario hospitals cooperated.

By contrast, numerous health report card initiatives in the U.S. regularly identify the hospitals studied.

Revealing specific hospitals that do poorly surely would translate into pressure on the weakest links to address their poor records. At present there’s no such impetus to spur improvement.

If competition is so effective in the private sector, why should it be off-limits in the public sector?

People freely compare automobile models and performance when they buy cars. “Yet when it comes to health care,” observes the Fraser Institute, “consumers are left with remarkably little information about where the best services are available.”

The refusal by hospitals to stand by their performance records reinforces a broader problem, highlighted in a January report sponsored by Winnipeg’s Frontier Centre for Public Policy.

The centre worked with the Health Consumer Powerhouse, based in Brussels and Stockholm, to compare health care in 29 European Union countries plus Canada. Among the findings — Canada performed especially poorly on patients’ rights and accessibility:

“Canada lacks a culture in which consumers have high expectations of health care services, and significant reform is unlikely without this.”

It noted Canadians do not enjoy an automatic right to refer themselves for specialist care. They don’t have access to electronic health records, viewed as the property of doctors. No patients’ rights charter exists. And health policies are crafted exclusively by the providers and government.

The Fraser Institute plans within the next seven years to expand its hospital report card effort across the country, which would give consumers some badly needed empowerment.

But provincial governments are going to have to nudge the health authorities to get with the program, to recognize that those who pay the piper should at the very least be permitted to hear the tune.