Clashing over care: The 1991 battle for B.C. healthcare

I was lucky enough to meet and speak in-depth with both Peter Seaton and Dr. Gur Singh, and it was clear that both over-achievers respected each other very much.But that doesn’t present well during a pitched battle on the field of public opinion.Mr. Justice Seaton, of the B.C. Supreme Court and Court of Appeal, was courteous, compassionate and sympathetic when I visited at the Smithe Street courts downtown in January of 1992. The chairman of B.C.’s Royal Commission on Health Care and Costs obviously had points to make, and he made them bluntly days after release of his report.Dr. Singh, president of what was then called the B.C. Medical Association forewarned the press and public that his group would take a few days to have a response, but that it wouldn’t be nice. It wasn’t.“It’s hard to imagine anyone making a valuable contribution without knowing how the system works,” railed Dr. Singh in repudiating members of the commission. “This shows through. Some of the report’s recommendations are very naive. . . . Having physicians involved in the process is a must.”Justice Seaton had choice words too: “It doesn’t take a degree to understand some of the things going on in healthcare today. Our recommendations might be idealistic or naive, but I don’t mind at all being idealistic as long as I’m also being practical. I think that’s the case with some of our recommendations.“Just look at the people involved,” he added. “All the commissioners are practical people. They aren’t people working in some rarified atmosphere. Each has lots of real-world experience.”The commission was set up by a dawdling, ultimately defeated Social Credit government. The newly-elected NDP was left to do something with its recommendations.The panel was well-resourced. Over 18 months, $4 million was spent receiving 1,500 submissions and producing 300 pages.Its six members put on more than 16,000 kilometres visiting 51 communities across the province before making an astounding 360 recommendations, some of which are still the source of water cooler conversation in healthcare facilities around the province today. Not many rocks were unturned.Dr. Singh’s fusillade was of equal caliber: “I have trouble imagining how many recommendations there would have been if (B.C.'s healthcare system) were not world class.”A “more realistic title,” he added, would have been: “Throwing Baby out with the Bathwater. The report is really a document about economics, not a means of realistically improving healthcare.”The Medical Post had many conversations with Dr. Singh during his year as BCMA president.But it was an off-the-record remark by Justice Seaton that is most memorable.He compared the size of B.C.’s health-care system at the time with General Motors—and I’m paraphrasing now—he asked rhetorically “are you going to tell me that an efficiency expert couldn’t go into GM and make improvements?”Panelists were told repeatedly “the system is littered with barriers that reinforce inequities, kill initiative and stifle changes.” (That sentence is straight out of the report.)After 35 years, the remark still resonates.Shortly after the interview, Justice Seaton revealed that he and his wife Doreen would soon leave on vacation . . . to Antarctica! When asked why that unusual destination, he replied that Doreen liked to travel. (They’d already been to Russia and China.)He was 68 years old at the time of the interview. He died the following year.Matt Borsellino was national editor of the Medical Post for many years.

Clashing over care: The 1991 battle for B.C. healthcare

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