Earlier this week, the Times Colonist's Sarah Petrescu reported the provincial government had fined Maximus Inc. - the American firm that won the privatization contract to administer PharmaCare and British Columbia's Medical Services Plan. The reason: "it's taking about 15 minutes to answer a call, instead of the under three minutes required in its contract." But, according to a former bureaucrat familiar with the plan, there's more at stake than how fast the company answers calls.

In a letter, sent to Public Eye and Times Colonist columnist Les Leyne, 32-year civil service veteran Christine Toucher writes when the medical service plan was first established the government "recruited staff and placed them into a training process which offered six months intensive training followed by a two year "trial" period before the person was considered to have enough experience to operate independently."

But now "The contract holder has hired new workers but those workers have two weeks training." All of which makes Ms. Toucher wonder, "Does it really matter how many thousand calls you answer if you cannot assist the caller, if the information you give is incorrect?" The following is a complete copy of her letter.

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I am now retired but worked for 32 years for the BC Government, twenty of those in MSP. A point which seems to be missed by many in looking at privatizing government services, such as MSP, is what defines service and how do you measure quality.

BC medical Plan arose out of the amalgamation of the three major medical insurance plans in BC in the early seventies , when the government assumed the responsibility for delivering health insurance to all eligible BC residents. The three were MSA, Cu&C and Government employee medical services.

BC Med was tasked with two responsibilities. To insure all eligible residents and to pay medical practitioners for appropriate services. When we think of MSP we generally think of the coverage aspect as this is where most of the public has direct contact with the public.

As with all things new, there are a great deal of rules and regulations written around the legislation to clarify roles and responsibilities. The early managers of the plan set the style and the objectives for staff at that time. For the registration and premium billing section the purpose of the work became the integrity of the system and the ability to communicate regulations to the public.

To meet this objective the plan recruited staff and placed them into a training process which offered six months intensive training followed by a two year "trial" period before the person was considered to have enough experience to operate independently.

Over the years there were the usual problems with the need to mechanize a paper burdened system, the need to keep up with a changing medical system worldwide. The increased population, move to phone usage for business pressures and an increasingly mobile population all added to the work flow problems. With the advent of the nineties and downsizing MSP fell into the spiral of lack of trained staff resulting in processing delays which led to increased phone call which resulted in processing delays ans so on. Complaints made it to the floor of the house about the time it took to get through to MSP (as it was now called). It can be noted however that the public felt that when they got through they were dealt with courteously and efficiently.

Now we see the government setting the plan out to a private company to deliver the services. The contract, which for matters of privacy, is not a public document and we do not know what the deliverables are. The recent fines would suggest that "numbers" and telephone standards (time taken to answer) are the key. What of the integrity of information received and given? Does it really matter how many thousand calls you answer if you cannot assist the caller, if the information you give is incorrect.

The contract holder has hired new workers but those workers have two weeks training, mostly on the equipment they use. Just prior to MSP being privatized the staff won a classification appeal because "the knowledge required to do the job adequately was not available in a manual, but required extensive use of knowledge, prior experience and decision making"

The private sector thinks of work in a quantifiable way with deliverables and a bottom line of "profit". It has been long recognized that many citizen services need a different approach and thus the need for public service is identified. I note that Mr Abbott clarified that saving money was not the issue. That is just as well as MSP had been noted and commended for running a very cost efficient system. The question is service to the public. But is having the phone answered really the service the public is looking for or do they want their problems resolved, their questions answered and their requests actioned. It is no use answering the telephone in 3 minutes if the information you then give out is incorrect.

Christine Tocher

Retired, Manager, Health Information Line