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When there is no vision and no leadership then our work environment becomes distrustful and confusing at an ever growing rate, discretional power dictates the policy directions of the day, private long term big contractual arrangements are entertained at the expense of innovation, savings of money becomes the most important concern against creation of wealth, loyalty to "the powers that be" becomes more important than service. This is what has been happening in health care for the last two decades, and this is why consciously or unconsciously we have been experiencing a relentless and spiralling move to centralize managerial and intelligent resources in urban centre against the interests of rural Saskatchewan. Our politicians, bureaucrats and academicians are all wrapped up in asking more money for medicare rather than looking at themselves in the mirror and see where really the problems are, that is within ourselves.

Sometime ago I was explaining how double-talking is a true mark of our current political excellency of our astute politicians(1). Our politicians are always right, as the wind changes direction so they flip-flop in their decisions. When the North East Health District announced the closure of the Carrot River Hospital, board chair Margaret Anderson stated that the closure was inevitable since they had " been told there is no more money" from the government(2). Carrot River mayor David Stanger felt betrayed by this announcement, after in concert with Saskatchewan Health he put almost two years into the planning of an integration project of the hospital and long-term-care home. When the people of Carrot River revolted against the closure of their hospital(3), Minister of Health Pat Atkinson realized that this revolt could translate into a provincial political nightmare and flip-flopped the previous stance of "no more money" of the government by saying "there has been much confusion about the status of this important capital project... I would like to confirm that the Government of Saskatchewan remains committed to the construction project that I approved last August(4)."

Again, sometime ago I was explaining that the hiring of Louise Simard(5), former minister of health, as CEO of the Saskatchewan Association of Health Organization (SAHO) could have been a sign that Saskatchewan was contemplating new legislation to make a new kind of centralized public health care to the detriment of rural Saskatchewan and people at large. In her last meeting of March 24 with her provincial counterparts, Pat Atkinson has stated "Unless the federal government makes a major commitment to the provinces and the territories and a major commitment to the Canada Health Act, all of us are going to be in a position where we are going to have to say to our taxpayers 'what are you prepared to pay for through your tax system, and what are you prepared to pay for as individuals(6)"

Our government has mortgaged the future of health care, and their management by confusion and flip-flopping is a deliberate practice to cover up their ongoing failures, while they contemplate new health legislation for the ultimate solution to save medicare. Again and again we experience a leadership with no vision and a leadership executed by coercive legislation.

Endnotes

Quote by Donella Meadows "challenging a paradigm is not a part-time job. It is not sufficient to make your point once and then blame the world for not getting it. The world has a vested interest in, a commitment to, not getting it. The point has to be made patiently and repeatedly, day after day after day" ftp://sysdyn.mit.edu/ftp/sdep/Roadmaps/RM1/D-4143-1.pdf http://iisd1.iisd.ca/pcdf/meadows/default.htm

General reference: Articles by Mario deSantis published by North Central Internet News

1. A question for Minister of Health Pat Atkinson: How much money is costing Telehealth? By Mario deSantis, March 15, 2000

2. North East Health District: the Closure of Carrot River Hospital and Telehealth, by Mario deSantis, March 9, 2000

3. Street rally protests hospital closure. Protest draws crowd of between 300 to 400, by Ernest Unrau, The Nipawin Journal, March 22, 2000 Nipawin, Saskatchewan (includes picture of rally) http://www.bowesnet.com/nipawin/Z01_Story1.html

4. ATKINSON CONFIRMS COMMITMENT TO CARROT RIVER HEALTH PROJECT, Government News Release, March 23, 2000, Health - 146, March 23, 2000 http://www.gov.sk.ca/newsrel/2000/03/23-146.html

5. Louise Simard is the new CEO for SAHO, by Mario deSantis, March 13, 2000

6. Money key issue in health care, provinces insist, by Anne McIlroy, the Globe and Mail, March 25, 2000 http://www.globeandmail.ca/gam/National/20000325/UHEALN.html