The province’s former top health bureaucrat is questioning why doctors get pay raises when they deliver poor quality care. Speaking at a lecture last month in Toronto, Penny Ballem - who is a practicing academic physician - says, "40 per cent of the patients in (British Columbia) with diabetes are getting good care. That's atrocious! Who would ever get a bonus and a raise in their salary when they've got a 40 per cent alignment with the best practice rate? Where does that happen other than in healthcare and with my profession?" And she says the powerful medical advisory committees at British Columbia's hospitals should working to improve patient care rather than worrying about labour relations.

Dr. Ballem says these committees "over the years got confused - certainly in our province - and thought they were the (British Columbia Medical Association) and negotiating for doctors" when they should, in fact, be improving the "quality of care and supporting the organization."

But changing that focus will only happen if healthcare administrators start talking tough. For example, Dr. Ballem says a national study shows that only 20 per cent of patients leaving hospitals after a heart attack "get the right drugs.” These are drugs, she says, that “actually save lives, prevent re-admission and make a difference in the long-term. It's like a duh. But 20 per cent of the patients are getting them.” So administrators need to "take that data to your local institutions, to your MAC and say what are you going to do about this? You're killing people."

And using that kind of data, she says, is "how we're going to start lifting out all of the talk about safety and quality and really get it down to the hard facts. Are we killing people this week or not?"

Dr. Ballem resigned from the civil service in June, charging that the plans the premier and his deputy minister "have established for the organization of the Ministry of Health are unsound and reflect a lack of confidence in my leadership on your part" - this according to The Vancouver Sun's Miro Cernetig. She hasn't yet returned a call from Public Eye seeking comment on her remarks, which were delivered at a "breakfast with the chiefs" speech organized by Longwoods Publishing Corp. The video of that speech was recently posted on the publishing company's Website.