Commentary: What were they thinking?

by Simon Hally

Hudson follows Kramer out of eHealth Ontario

Recent developments at eHealth Ontario are nothing short of tragic. Board Chair Dr. Alan Hudson and President and CEO Sarah Kramer, both highly regarded as exceptionally capable and dedicated healthcare professionals, have been forced out of their positions in humiliating circumstances.

It now seems a safe bet that provincial Health Minister David Caplan will follow Hudson and Kramer out the door, despite Premier Dalton McGuinty’s latest assurances of confidence in him. Expect a cabinet shuffle sooner rather than later.

The biggest tragedy of all is that the province’s excellent new strategy for eHealth (linked from the end of this article), which was crafted under the direction of Hudson and Kramer and unveiled just a few months ago, has now been derailed and the whole notion of eHealth has been tainted in the public mind. The completion of this critically important project has been delayed, and finding future funding for it will be more difficult.

The charitable view of this depressing turn of events is that Hudson and then Kramer, in their eagerness to implement their new strategy without delay, overlooked or ignored procedures that may be tiresome but are fundamental to the responsible administration of any public agency. They should have known better.

What outraged taxpayers the most, and turned out to be politically unforgivable, weren’t so much the consulting contracts that were let without tender, but the relatively trivial items discovered in personal expense accounts approved by eHealth Ontario. To charge taxpayers for drinks and snacks on top of per diem expense allowances, not to mention generous consulting fees, was astonishingly insensitive, to say the least, especially in the depths of a recession that has hit Ontario harder than most provinces.

In healthcare, a lot of stock is put in personal contacts and related experience. It’s rare for a senior healthcare executive to be recruited from another industry. There are clear advantages to this practice: it makes the most of accumulated knowledge and expertise, and people can work together more efficiently when they share the same organizational culture and language.

But there are clear dangers as well, including a reluctance to accept innovative ideas from external sources and a tendency to develop a sense of entitlement, cliquishness and a belief that “we know what’s best.”

Healthcare leaders across Canada should read the story of eHealth Ontario as a cautionary tale.

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