Dr. Michael Gardam, the new CEO of the Island’s health system, spoke to the CBC about the challenges of overcoming our 18,000-person waiting list for a family doctor.
Impenetrable bureaucracy has beaten down more than one Island health system revolutionary over the years; Dr. Gardam appears refreshingly frank in his assessments of the problems and the possible solutions, and I hope he sticks with it.
His take on one reason the solutions are taking so long:
“If we want to buy new computers, we go through a different branch of government. If we want to find space, we go through a different branch of government. If we want to spend more than $100,000 of money that’s in our budget, we have to go to the Treasury Board. These are rules. These are things that were identified a long time ago.”
The Achilles heel of all re-engineers is a desire to keep re-engineering until they fix everything, down to the roots.
Several years ago I attended a seminar by a senior Ontario government bureaucrat, a high level rumination on the work of the public service. Rather than rail against “silos,” the usual target of almost anyone making a case for what’s wrong with government, he suggested that compartmentalization was and always will be a part of public administration, and that we need to get over that, move on, and become better at navigating the complexity.
Although I’ve fallen victim to the silos many times, I tend to agree with that assessment. As much as Dr. Gardham might wish that the bureaucratic waters would part to accommodate his revolutionary plans, that is not going to happen, and the sooner he accepts that and embraces the confounding thicket on its own terms, the sooner his plans will bear fruit.