Health boss speaks out

By Dan Hilborn
Published Feb. 4, 2004


The health system in British Columbia has been through a lot of change in the past two years, and that change isn't finished yet, Fraser Health Authority president and chief executive officer Bob Smith said this week.

In his most extensive interview with this newspaper since assuming the top post in the most populated health region in the province more than 18 months ago, Smith admitted that human resource issues will continue to be one of the more perplexing problems facing the authority.

"Maintaining the supply of professional services such as medical doctors, community nurses and critical care nurses is one of the biggest concerns we have," Smith said during a 90-minute meeting with reporters on Monday morning.

And even though the local health region is doing its part to keep ahead of a worldwide shortage of health-care professionals, Smith acknowledged that it's not easy.

"I think the general perception around the health-care industry, both here in British Columbia and elsewhere, is that the working conditions are bad," Smith said. "We acknowledge that."

And he admitted that the massive degree of change implemented since the B.C. Liberals were elected two years ago has provided the biggest source of friction.

"Recognize that this is our third major reorganization of Fraser Health in 10 years," Smith said. "These changes cause an emasculation of the people who work here. Remember we merged 20,000 employees overnight and that was a pretty big recipe. And there aren't very many successful mergers of that size.

"What I tell our employees when we hold forums or other discussions is that we are going to talk about having a future. Employees have to understand, we will not go back to where we were before. You are part of an organization that will reconstruct itself into the future."

Smith also said that workers can no longer count on the health- care system as a place where they can find a job for life. "To count on us for that for the future is not on. That means I can't guarantee you unlimited job security. So what I need to do is try and develop the skills to make you employable where the choices are available.

"The traditional trust - I can't offer that. It's not part of a sustainable health-care system. However, I will try to make it worth your while to stay with us through the hard knocks."

As far as rebuilding trust with the public, Smith acknowledged that part of his role is simply to be the bearer of bad news. "How do you form trust, that's through open and frank discussion so that you can make an informed choice. How do I build the trust you want from me? If I have bad news, you know I gave that to you. I can't promise you everything will be good news for the future."

Smith also said that funding will continue to be the number 1 factor behind long-term health-care planning long into the future.

"I joined the health industry in 1975 and it's always been budget, budget, budget," he said. "I don't remember the day when I had all the money I needed to do all the things I wanted to do. And there will never be enough money to do all we want to do.

"Seventy per cent of every dollar we spend is on people, and we need money and we need people - they are very intertwined and there's not enough of either."