Amy Hamm: We need a cure for Canada’s toxic health-care culture

Canadians have historically been braggarts about our once world-class health-care system. Not these days. Our health care has morphed from something we could collectively gloat over to something we must all fret over. 

A case in point: Five emergency rooms in B.C. closed due to lack of staff over the Labour Day long weekend. Who knows what harms resulted. These closures are becoming commonplace — a glaring sign that our system is in dire shape. Canadians frequently hear about staffing shortages and the resulting burnout that plagues our doctors and nurses. What we don’t hear about so much is what’s driving these problems. It is multifactorial, yes; however, as a registered nurse of 13 years, I can tell you that one major driver is a cultural crisis within our public system.  

Canadians are well-aware of managerial bloat in health care; in a recent Ipsos poll, 78 per cent of us agreed that the system is “too bureaucratic.” But it’s deeper than a matter of excess bureaucrats and red tape. 

Health-care culture is toxic and ruled by an ideologically-captured managerial class that often appears to care more about enforcing their orthodoxy than they do for patients and staff. It wasn’t like this when I started just over a decade ago. Today, you effectively must join an extreme leftist cult just to be employable in the field.  

Nurses and doctors are afraid of their employers and regulators. They are afraid of getting disciplined, abused, or fired if either organization discovers that they’ve committed wrong-think — even while off duty.  

The unions that we pay handsomely with our dues are often even more ideologically driven than the employers that we pay them to protect us from.  

Everywhere, there is a culture of fear and distrust among workers in the system. Nurses and doctors reach out to me regularly to share similar tales of nervous silence, coupled with a dread of being outed as a heretic. 

I’ve lost count of the nurses and physicians who’ve told me that they plan to leave their profession. I know ones who’ve retired early. Or were fired for refusing a COVID vaccine and won’t go back. Ones who tell their family and friends to never go into either profession to begin with. Ones who look for work in private care, or hope that legislation changes so they can one day escape the public system. (The public wants this too — the same Ipsos poll showed that more than half of us want private care options.) And then there are the ones who are simply terrified of making a misstep and drawing the ire of a Diversity, Equity, and Inclusion firing squad.  

What should be the focus of our work as nurses and doctors — caring for people — has been subverted by rampant expectations of political purity. 

There was once a general rule about never talking politics at work. Now, in health care, the politics (of the hard left) comes to you. It can’t be escaped. Staying silent only helps minimally, as we are all expected to participate enthusiastically. It’s stifling to those who disagree (perhaps upwards of half of us, judging by new nationwide polling data on our support for federal political parties).  

Purity demands come in many forms: when organizations tell staff that they are racists working inside of a “systemically racist” system, and we are to accept this horrible insult as truth; by forcing staff to perform mandatory, personalized—and useless — land acknowledgements each time three or more people meet; through heavily-politicized corporate emails that, by all appearances, were written by irate 20-year-old social justice activists; via care guidelines re-written to replace the word “woman” with “pregnant person”; via blanket “gender affirming” policies that fly in the face of evidence-based care; and via the adoption of “harm reduction” as an unquestionable philosophy of care, rather than a potential source of evidence-based initiatives. I could go on. 

So, what if you disagree? Well, our public health authorities not only demand conformity, but they also want to make snitches of their own staff. Over the last several years in B.C., health authorities have created and staffed entirely separate, entirely redundant human resources departments called the “respectful workplace” department. It is within these departments where staff — and even the public — can go wild with anonymous complaints about healthcare workers who deviate from an institution’s orthodoxy. Staff are pitted against one another. Snitches wield immense power to harass and abuse others. 

Public health authorities are more than happy to haul their own staff before a hostile panel of upper management, human resources, and respectful workplace representatives to slide a printed screenshot of a “liked” or “shared” social media post across the table towards you — demanding an explanation. Who gave you permission to think independently? We are watching you.  

This is not a culture that attracts our best and brightest, or those driven by beneficence—as all care providers should be. It is not a culture that puts patients first. We won’t save Canadian healthcare unless we treat its raging ideological infection. Physician, heal thyself.  

National Post