On Canada’s Fourth Leading Cause of Death and the Secrecy that Surrounds It

This is the philosophy of health care policy that puts lives in jeopardy

Last year, CBC’s The Fifth Estate conducted a special 9 month investigation – “the longest in our 40 year history” – into Canada’s health care system. Surprisingly, the main topic of the report was what they called the “hidden enemy,” i.e. “the deadly bacteria that lurk in hospitals and kill thousands of Canadians every year.”

In fact there are so many deaths that “Hospital infections could be the 4th leading cause of death [in Canada] … and between cancer, heart disease, and stroke, it’s coming up as number 4,” said Dr. Dick Zoutman, Chief of Staff at Quinte Health Care in Belleville, Ontario.

Just how many such deaths are there? Dr. Zoutman puts it at 8,000 to 12,000 every year, that are “directly attributable” to hospital infection. These deaths are part and parcel of the 220,000 people who become infected while receiving hospital care – again, every year.

While the reflex might be to focus just on the hospitals as being responsible for these sky high numbers, The Fifth Estate says not so fast, you need to take a hard look at our government as well.

To begin with, they say, there’s no one in charge of Canadian health care delivery. Therefore, there are no national standards, no national surveillance system to track the spread of infectious disease, and no national plan of attack to combat infectious disease. Dr. Michael Rachlis, a Toronto-based health care consultant says “The federal government could have a strong role in health care if it wished. It’s not taking that role and I think overall that endangers Canadians’ health.” In other words, with a proper country-wide plan we could prevent a large number of deaths from happening – each and every year.

But The Fifth Estate stumbled across something else – government secrecy – that may help explain why most people would not put hospital-acquired infections in their top 10 list of causes of death, let alone at number 4.

They came across the secrecy quite by accident. For their report they needed data on such things as the number of hospital-acquired infection rates, the number of “foreign objects,” such as sponges, left in during surgery, and weekend mortality rates for several medical issues, a figure that would give patients an idea of whether they were at greater risk on Saturdays and Sundays.

So they contacted provincial and territorial health departments for the information and they also sent a survey to over 600 hospital CEOs across the country.

But nothing much happened. To their surprise over 75% of the CEOs wouldn’t respond and the governments wouldn’t release any data. And no one would tell them why.

So they made a freedom of information act request and discovered that provincial and territorial governments entered into a “national decision” to deny the requests. The provincial governments actually asked the relevant departments not to release the information, and they also contacted hospitals asking them not to respond to the survey.

But why on earth would they do that?

According to The Fifth Estate the government decision to circle the wagons was based entirely on self-interest. Dr. Rachlis explains: “One of the major barriers to finding out more about Canada’s health-care system and its quality of care is that it is a government-paid-for system, [and] governments tend to be secret about what they do. They are concerned about measurements and comparisons in case they look bad,” he said. In other words they’re scared, scared of not measuring up to the next guy.

David Musyj, CEO of Windsor Regional Hospital, and an attorney, is a leading advocate for transparency in health care.

Fortunately, not everyone holds those values. One such person is David Musyj (pronounced ‘Moo-shay’), CEO of the Windsor Regional Hospital. He’s guided, instead, by what he calls the principle of full disclosure – don’t bury the data, broadcast it, make it public, because that’s what makes us better.

And he walks the walk. For example, when he began his tenure as CEO he discovered that his hospital’s hand washing rates were a paltry 40%. So what did he do? He went public and told the Windsor community about the failing rates, adding this sobering thought: “If you don’t hand wash you kill people.” And with that, the rates improved to over 90% and he hopes to eventually achieve 100% compliance.

He’s driven by a very uncomfortable truth that he’s willing to talk about. Approximately 8 – 10% of people who walk through hospital doors are hurt by us, he says. And if you don’t recognize that you have no chance of fixing it.

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