Sunday November 29, 1998

In the Spring of 1995 I met with Mr. Wayne Strelioff, Provincial Auditor, and Mr. Michael Heffernan, Executive Director for the Office of the Provincial Auditor. In this meeting we casually discussed the operations of the Saskatchewan Association of Health Organizations (SAHO) and the need for the office of the Provincial Auditor to audit this association. Both Mr. Strelioff and Mr. Heffernan stated that SAHO falls under the jurisdiction of the Provincial Auditor and that it was only a matter of time before SAHO would finally be audited on an ongoing basis as any other district health board. Mr. Heffernan stated that SAHO was fighting the jurisdiction of the Provincial Auditor by claiming that it was a private organization and that it was receiving "...taxpayers' money indirectly...(1)." We are now in 1997 and there is no indication that SAHO will fall under the jurisdiction of the Provincial Auditor.

SAHO has a public influence well beyond what one may comprehend to be a 90-employee organization. The understanding of the extent of SAHO's influence and related business and political power can be appreciated by sizing up the money it handles and the services it provides. In particular, SAHO manages a billion-dollar pension fund, experiences an annual cash inflow of tens of millions of dollars for the management of health care employee benefit plans, and manages a multi million dollar group purchasing program on behalf of district health boards. The services provided by SAHO include the participation for the establishment and management of collective agreements for some 35,000 health care employees, the management of employee benefit plans, educational and professional services for district health boards, provision of accounting and payroll computerized services, information technology services and many other services. The importance and influence of the money and services managed by SAHO are put in a proper social and political perspective when we consider the provincial population of one million people and an approximate health care budget of 1.8 billion dollars.

No man is a master of all trades and I wonder how a single organization can master the wide spectrum of the services provided by SAHO. Obviously, there must be a functional problem in the organizational structure of SAHO. Anyhow, the possible functional problems of SAHO are not an issue effecting the private legal charter of SAHO and the related private benefit to avoid the professional auditing of the Provincial Auditor. The issue affecting the public interest in the charter of SAHO is the fact that the money managed by SAHO is public money originating from governmental funds. SAHO's claim that such money is "indirect" public money and therefore not necessarily subject to the jurisdiction of the Provincial Auditor is a legal frivolity which doesn't impinge on the fundamental public interest to account for this money. Therefore, since SAHO manages money for which there is a strong public interest, public remedies should be taken so that SAHO's services fall under the jurisdiction of the Provincial Auditor. Further, the pure size of the governmental monies managed by SAHO is enough to support a public interest in the operations, restructuring and legal definition of the charter of SAHO. The present private legal charter of SAHO is an anomaly which can only be justified by a reactionary movement to the creative progression of health reform in Saskatchewan. This anomaly seems to be an isolated occurrence in Canada and it violates the governmental principle of setting appropriate "checks & balances" in the provision of public services through agencies which are independent, balanced and accountable. If we refer specifically to the provinces of Alberta and Manitoba we will notice that there is no health care umbrella organization which is as big and powerful as SAHO and which is not subject to the jurisdiction of the Provincial Auditor. Further, health care is a responsibility of the Federal Government as well, and therefore this is an additional reason why any relevant governmental money spent in health care should be subject to public scrutiny.

The public interest in the spending of health care money and the need to restructure the services provided by SAHO is further supported by the experienced corrupted administration of this organization(2), and the continuation of an obsolete autocratic management philosophy where centralization, planned miscommunication, bigness, wastes of public money, and management by fear are the main ingredients(3). My personal experiences in health care have been an eye opener with respect to the integrity of some of our politicians and some of our public administrators(4), and therefore in such difficult times of change I have nothing but praise for the current outstanding work of the Provincial Auditor(5) in trying to improve and rectify the distortions taking place in the administration of public money in health care.

Endnotes

1. Article in the Leader Post "Severance not disclosed", Regina, September 29, 1993 http://www3.sk.sympatico.ca/desam/paper-article-HelmsingSettlement-Sept29-93.htm

2. M. deSantis' letter dated April 14, 1997 directed to Hon. J. Nilson, Hon. E. Cline, Hon. A. Rock, Mr. W. Strelioff http://www3.sk.sympatico.ca/desam/paper-letter-MLAsMPsPA-Apr14-97.htm

3. M. deSantis' letter dated April 28, 1997 directed to all Saskatchewan District Health Boards http://www3.sk.sympatico.ca/desam/paper-letterToChairsCEOs-Apr28-97.htm

4. Refer to M. deSantis' 1995-97 communication with the Office of the Provincial Auditor

5. Report of the Provincial Auditor, Saskatchewan, Spring 1995/1996/1997