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machado: holding leaders accountable is the only way we'll see the change we desperately need

it's every canadian's right and duty to challenge decision-makers and make them responsible and answerable for the choices they make.

decision-makers must be held accountable
by challenging leaders outright, we remind them that we're watching. getty

last may, two healthcare advocacy leaders, louise binder and gail attara, wrote an oped that ran in the windsor star . they took aim at the shambles that was — and still is — canada’s healthcare system: unacceptable wait times to see specialists, doctor shortages, delayed breast and colon cancer screening, just to name a few. they also questioned the targets of the $198 billion healthcare system improvement investment that had been pledged by prime minister trudeau three months earlier.

after almost a year, five provinces so far , including ontario, have grabbed hold of their share, with plans to use the funds to pack their wounded healthcare systems, focusing on gaps like lack of staffing, overcrowded emergency rooms and the inequities in care that are harming first nations communities. certainly, all good things take time, but still, it has been twelve months since trudeau’s initial investment promise and canadians continue to suffer and lose their lives for all the reasons binder and attara mentioned.

but outlining the needs of canadians wasn’t the most powerful point of their piece. that part comes about midway through: “canadians deserve accountability.”
there have been many opinion pieces since then, all saying the same thing. we deserve a government that’s answerable and responsible for how these funds are spent and one that measures impact. we also deserve one that owns up if things go south and faces the consequences. after all, isn’t accountability in healthcare the most critical, what with the role of keeping people’s hearts beating, and stuff?

holding people to account seems to work well in practice in the business world where some angry tweets, storytelling and derogatory emojis are usually enough to stoke the fire underneath those in charge. consider toyota ceo’s personal condolences to families who lost loved ones because of accidents caused by its shoddy safety standards, or   sony’s response to the leaking of the personal information of 77 million playstation users, which consisted of an apology, acknowledgment of the implications, as well as a free month of playstation plus and identity theft insurance to make it better. 

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but in healthcare, which is a gazillion times more important than automobiles and video games, we see much of the opposite — clever ‘bob and weave’ moves as politicians and policymakers sidestep a healthcare system collapsing from inaction and lack of attention. and it’s killing us. like the victims of accidents and data breaches, we also write angry tweets and post nasty emojis when a loved one can’t get access to the medicine they need to live, or our neighbour dies waiting in an emergency room. heck, we even stand on the lawn of queen’s park with signs and sad stories and yet, canadians continue to need medicine, and no one would judge you if you crossed your fingers and said a prayer before passing through the doors of an er.
it’s this that makes the binder and attara piece, and others like it, so critical: not only are these the important voices that speak for those who need medicine, those who have died waiting for care and those who are sick and tired, but their words also remind us that we have rights — we vote (!). by challenging leaders outright, we remind them that we’re watching.
i have seen binder and attara, and other health advocates, in action when politicians and policymakers are in the room — the gloves come off, as they should.

accountability is also an important theme in a recent documentary targeting for-profit long-term care. directed by helene klodawsky, and co-produced by intuitive pictures  and the  national film board of canada (nfb), stolen time follows lawyer melissa miller as she battles with companies like extendicare, sienna senior living and revera, seeking justice for families whose loved ones suffered atrocities such as malnutrition, physical abuse and neglect while living in their homes. the film’s hidden camera footage of a resident with a cane being spoken to rudely and not helped to sit and the photos of a bedsore that a fist could fit into are nothing we haven’t heard or seen before, and the first-person accounts from people who worked in these homes were also not surprising. at the end of the screening in toronto, hands waved in the air with questions. there was comfort in knowing that we’re saying all that’s wrong with ltc out loud, and yes, extendicare, sienna senior living and revera, we’re watching you.

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but are eyeballs enough to achieve justice and spark change? in the film, we are left to assume that miller, in between anguished clips from a psw, a union rep and a teary mother and daughter, has her gloves-off moments with these companies in courtrooms behind closed doors. but all of the pain begs for more of that getting-the-guilty-ones-on-the-hook feeling. where were the company ceos? their discomfort and prickliness would have been deliciously palpable in their words if they were brave enough to share their side of the story and equally as obvious between the lines of the more likely pat email response from their crisp communications team: “no comment.” then the message would have held so much more sting than ‘we’re watching you.’ instead, it would also screamed, ‘we know who you are and what you allowed to happen.’ all of this to live on and on in film, lest we forget.
while accountability in healthcare may not spark the same kind of rapid response and change that we see in the corporate world— although it should — it’s certainly our duty and right, if we expect to see meaningful change, to hold healthcare players and government leaders responsible and answerable for the decisions they make. and to challenge them freely and openly every chance we get.

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it’s the only way we will spark the improvements we desperately need.
lisa machado is the executive producer of healthing’s advocacy & better health. she can be reached at lmachado@postmedia.com.
lisa machado
lisa machado

lisa machado began her journalism career as a financial reporter with investor's digest and then rogers media. after a few years editing and writing for a financial magazine, she tried her hand at custom publishing and then left to launch a canadian women's magazine with a colleague. after being diagnosed with a rare blood cancer, lisa founded the canadian cml network and shifted her focus to healthcare advocacy and education.

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