Watching the performances at the Public Accounts Committee of the legislature last week has given me cause to ponder. How does NB continue to roll with public servants refusing to disclose essential information accurately to legislators? Where did accountability ever go? Is the legislature only an inconvenience in government?
I remember it well! Impressionable university student, wanting to learn about business and organizations. Business 101: the beginning and introductory course aimed at instilling in young students the fundamentals of organizations.
Accountability was drilled into us. For every person in the organization there must be clear accountability to someone; that someone on the organization chart used to teach us was the person who can hire or fire that person, as well as setting performance standards, expectations of performance and professional behavior.
So, if the CEO is hired by the board of the ANB, and the CEO is disinclined to inform the legislature of information they believe is pertinent, at what point does contempt of the legislature come into play? A lawyer I am not; a citizen I am, and one interested, based on decades of organizational experience, in the fundamental principles of accountability absolutely. Without accountability, organizations fail and chaos prevails. It is a mere technicality that the CEO is not a public servant per se.
That persons in positions funded by the public purse should be awarded bonuses for performance is a matter of major public policy. I have respect for many of the public servants with whom I have worked over the years, but as with all such large organizations, there are the great ones and the non-achievers.
Each person has a job description and is subject to annual performance review. Presumably in the engagement process, the person gets the job description together with performance targets. If not, they should. That, also, is Business 101 and Human Resources Management 101.
In good organizations, the annual performance review is the time at which the employee and supervisor, or the board and the CEO, review the job, the performance expectations, and virtually everything about the job including workplace relationships…. everything relating to effective performance.
The legislature is not the immediate boss of the CEO of ANB; it is more complex than that. ANB is accountable, presumably, to the Department of Health which normally means the Minister, or more practically, the Deputy Minister.
Back in the day, until the late 1990’s, ambulance service in New Brunswick was inconsistent in service, apparently. Regional hospitals operated ambulances that served their immediate areas and often served to transfer highly challenging cases to the provincial neurosurgery, trauma, and cardiac center located at Saint John Regional hospital and Moncton. Many transfer services were also provided by Saint John Ambulance that was a terrific service operated by non-profit organization. They provided service to large events and much more.
In those days, the opposition parties required publication of travel expenses and many routine business expenses. Such was the politics of reform in the 1990’s.
The major challenge of the day was in some of the smaller communities where it was difficult for the local operators, owned by a variety or types of organizations such as undertakers, to maintain staff with current training and knowledge. Standards across the developed world were increasing rapidly in the Emergency transport area. Much of the knowledge and training being implemented in major population centers had its roots in the military’s battlefield experience. In that system, the military had developed proficiency at triage, rapid assessment, transportation, and emergency intervention.
Suddenly in many major urban areas the development of emergency transportation saw vehicles and super-trained staff that often-resembled ICUs on wheels. In parallel, in some jurisdictions, the introduction of sophisticated air transportation using helipads and helicopters became common and was once the plan for New Brunswick. This was particularly common in the highly-densely populated areas in Ontario, New York, and more.
In the early 1990’s NB was “full throttle” into health services reform, having taken the bold step to regionalize hospitals. Once that became somewhat stabilized, it seemed natural to turn attention to the emergency transport system with an entirely different approach taken. Soon the rural operator contracts were replaced with more advanced vehicles and staff trained at a fairly consistent level but not all at the level of fully certified EMTs.
The system has now become a program that serves the entire province under one administrative entity. Initially it was part of the regional hospitals then consolidated in the Department of Health. Then it was spun off to Medavie in the name of Ambulance New Brunswick. The organizational structure is a bit complex in that it does not look like the typical “crown corporation” nor does it look like the classic “service contracted out to the private sector.” Organizationally it looks like a hybrid of private sector and crown corporation.
Performance bonuses are not uncommon in free enterprise. Most successful companies award bonuses to key employees as a reward for meeting production targets and as a tool for retention of essential skills. Normally if their performance targets are met, the cost of bonuses is miniscule relative to the new revenue realized by the success of the executives.
Then the federal government introduced bonuses many years ago and in recent months there have been questions raised by observers about the magnitude of the bonuses paid to Deputy Ministers and other senior officials. The number at federal level, as reported by the Canadian Taxpayers Foundation, shows the average bonus for federal executives at $17,885 with a total price tag of $198,000,000 for all of the federal government in 2022.
This has not always been the pattern; for decades great public servants performed with distinction based on their dedication, love of their work, enjoying the nature of the work and a sense of great satisfaction in a job well done. The public service job security, compensation scales, and retirement benefits was, for the majority, a great motivator.
In the provincial and federal governments, we, as taxpayers, certainly want the smartest, most highly trained and educated, high performance executives leading the various services. The way to excellence is with highly motivated people with high integrity. Paying large bonuses to persons employed to do a job that they should understand and accepted willingly is, for the average citizen, a stretch particularly since so many essential workers are compensated with fairly basic salaries, albeit often with overtime payments.
So, in asking the question, the Public Accounts Committee is justified in asking the overall cost and the amounts together with the classifications of personnel receiving the bonuses. After all, the rather huge cost of ANB relative to “the old model” was incurred not only to improve the standards of service but to ensure that rural services were consistent, effective, and provided by properly-trained personnel in a timely manner. Adding compensation bonuses as reward for doing what the system was set up to do will need to be explained to legislators and the public.
None of this should, in the least, be interpreted as criticism of those great ANB staff who stock the vehicles, maintain them at the ready, and rush to situations that most people would find difficult to handle. That the system performs well generally speaking is not the issue; neither is it that there still are, and always will be, issues of improving performance. The issue simply is public disclosure of how public funds are invested and just how to do that while being transparent and honest.
Ken McGeorge,BS,DHA,CHE is a retired career health care CEO, part time consultant, and columnist with Brunswick News; he is the author of Health Care Reform in New Brunswick and may be reached at firstname.lastname@example.org or www.kenmcgeorge.com
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.