There are many pages of text, many words, many references and many qualifying comments found in the document prepared by Mr. Ken Fyke at a cost of 2 million dollars.

But what message, if any, can be found within that text?

What specific actions are recommended and are those actions clearly explained and rationalized?

Mr. Fykes report follows two themes.

1. Quality

2. Efficiency

He spends much of the content of the report alluding to the benefits of focusing on quality and how efficient a system would be, were the focus on quality.

Much of the document mirrors this thought but alludes to how inefficient the present system is because it is volume focused.
 

The greatest disappointment in the report is the lack of detail found in the solutions/conclusions sections.

We see items such as the closing of facilities, renaming facilities, restructuring of management regions and districts and so forth.
 

But what do we see for the front line?

What do we see for the hands on caregiver and service recipient?

What we see is more than a bit frightening!
 

• We see pages and pages devoted to an obsessive description of an imaginary need to guarantee that no healthcare provider ever be placed in position to offer care that a lesser qualified caregiver could offer.
• We see pages and pages devoted to an obsessive description of an imaginary need to guarantee that no healthcare facility ever provide care that could be offered in a cheaper (more appropriate) facility or by a cheaper method.
• We see pages and pages devoted to an obsessive description of an imaginary need to guarantee that no healthcare diagnostic procedures be performed that might be unnecessary or premature.

Mr. Fyke intends to second guess many of the decisions made by those healthcare providers who make the best of an impoverished system on a daily basis.
Mr. Fyke intends to second guess the physicians who must attend to a patient load far in excess of reasonable, on a 24 hour a day basis.

Mr. Fyke is laying blame and pointing the finger directly at front-line providers while claiming he is referring to a flawed system.
 

Mr. Fyke demonstrates an ignorance of the system as well as an ignorance of front line healthcare service that even I cannot believe!

For example:

25 years ago or perhaps a bit longer healthcare professionals were introduced to the multi-disiplinary approach to the delivery of health services.
The Physician was no longer the master to be served coffee and worshipped by the lowly nursing staff and all others.
The team approach was actively taught in healthcare education and the team approach was actively promoted in the workplace.
The team approach has become the standard over the course of the last quarter of a century.

Mr. Ken Fyke is currently proposing that great gains could be made in efficiency today were the system to establish "Primary Health Service Teams" and an 'interdisiplinary' approach. (notice that he changed the name slightly!)

Mr. Fyke is proposing that we begin to do exactly what has been common practice for decades!
 

For example:

Mr. Fyke is vaguely proposing some type of healthcare hotline enabling the isolated patient to have access to healthcare information and advice by telephone.
This proposal is a recipe for disaster! 
A health information hotline would be fine as an alternative to speaking with one's pharmacist, but in no way, shape or form can healthcare of any kind be offered over the telephone by a healthcare professional.
Only recently has it become common practice for Physicians to telephone prescriptions to a pharmacist.
Only recently has it become common practice for Physicians to order medication by phone within a hospital and it is almost certainly still technically illegal to do even that!

Mr. Fyke is proposing that the entire Doctors consultation occur on the phone, or even worse that the entire consultation occur with a registered nurse or someone even less qualified, as a cost saving measure and as a way of improving the quality of care available to Saskatchewan residents!

The simple fact of the matter is that any attempt to exchange complex information on the telephone results in confusion, misinformation, incomplete information and huge amounts of wasted time for even simple explanations or exchanges. Physicians cannot afford the time it takes to do a 'hands on' examination with full and intimate access to the patient, never mind fiddling around on the phone with someone who can't decide if they should go to the emergency room or the Doctors office!
 

Even though Mr. Fyke's report goes on and on and on in a repetitive manner these comments will conclude here.

By way of a conclusion we see that:
 

• Mr. Fyke's sweeping changes amount to nothing more than more of the same old NDP move to centralization of services.

• Mr. Fyke's deepest insights into identifying ways to make the system more efficient amount to nothing more than blaming front line providers for making poor decisions and to implement a methodology that has already been in effect for 25 years.

• Mr. Fyke has, with an eye to the future, recommended the establishment of a "Quality Council", which would be a group of individuals appointed to keep an eye on healthcare. This would certainly be a great job opportunity for Mr. Fyke now that he is close to being unemployed!

In his quest for quality and efficiency Mr. Fyke has reminded us that "efficiency" spells the larger part of "deficiency".

We are also reminded that quality can be a subjective thing and that even though 2 million dollars has bought a lengthy volume of information for the NDP government, the Fyke report is sadly lacking in quality.
 

What should Mr. Fyke have recommended?
 

• Competitive wages and benefits with the rest of the country.
• Family friendly workplaces.
• Adequate, accessible, timely healthcare.
• Elimination of the majority of funding for costly, so called "wellness initiatives" that offer questionable benefits for a fraction of society.
• Elimination of SHIN. E-mail can be sent without a 40 million dollar Crown corporation to oversee it. Not to mention all the other provinces are contracting out electronic health services.
• Eliminate costly independant studies and consultants and promote existing managers and staff who stand out as effective producers and leaders. Get rid of those who just hang on and fail to realize practical efficiencies.

(and I don't mean managers who manage to persuade their staff to work short-staffed thereby saving money, I mean managers who manage to adequately staff their units in the first place, thereby minimizing overtime, sick time, employee turnover and unsafe patient care!)

(as I re-read the paragraph above for the umpteenth time I am reminded of the NDP and Mr. Fyke, who continue to reduce and cut services therebye maximizing overtime, sick time, employee turnover and unsafe patient care. )