EDMONTON – The second day of the public inquiry looking into allegations of preferential treatment in Alberta’s health system included questions to Dr. Stephen Duckett and Dr. David Megran regarding the controversial "Duckett memo".
Megran is the Executive Vice-President and Chief Medical Officer for Alberta Health Services.
Much of the discussion during Tuesday morning’s proceedings centered on a so-called memo prepared by Dr. Megran and sent to senior Alberta Health Services executives that addressed “requests for preferential or expedited care” within Alberta Health Services (AHS).
The memo in question reads: “It is not uncommon for executive members or other leaders of health care organizations to receive requests to provide preferential or expedited care for “prominent” individuals or the family and acquaintances of “prominent” people.”
Dr. Megran told the Commissioner Tuesday morning that Dr. Duckett had asked him to prepare the memo “to underscore that practice was not endorsed by the executive of Alberta Health Services.”
When asked for more details regarding the origin of the memo, Dr. Megran responded, “I have no recollection of exactly why or how he asked me,” in reference to Duckett, who was the CEO of AHS at the time. “Obviously I received direction from Dr. Duckett,” said Megran.
Legal counsel said it believes Duckett will say it was Dr.Megran who initially brought the issue to his attention, not the other way around.
While the background portion of the memo indicates “it was not uncommon” for certain people to receive expedited care, Dr. Megran told the Commissioner “I’ve never been asked to provide that care.”
Read the full memo below:
"Dr. Duckett Memo"
Dr. Megran said the so-called prominent people “have health problems too,” and added “for those people, if they have a personal acquaintance with a CEO” it is understandable that they would ask questions and raise health concerns to that person. XXXXXXXXXXX
Dr. Stephen Duckett, former CEO of AHS, testified Tuesday afternoon by video from Australia.
Duckett said when he first took the job in Alberta, he was made aware that preferential treatment for prominent patients was an accepted practice back when care was delivered by a network of smaller health regions, each with their own bosses.
“In my recollection, in one of my one on one meetings with David Megran… he introduced the conversation… that he’d been approached by people … to ascertain from me what my view was on preferential access," testified Duckett Tuesday.
"He intimated to me that previous leaderships… there was an acceptance of preferential access, and he wanted to know what my views were on that issue. I said I was opposed, and I asked him to draft a memo to make explicit my views about that. I can’t recall whether he asked me write a memo, but I asked him to draft a memo which he did.”
“He certainly intimated that previous heath authorities… had accepted that practice,” he added.
Dr. Megran testified Tuesday morning that it was Duckett who initially brought the issue of preferential access forward.
“Obviously I can’t be a million per cent sure that my memory’s better than Dr. Megran’s," admitted Duckett, before adding, "It would never of occurred to me that this type of behaviour was occurring in Alberta… unless it has been raised to me.”
When asked by Counsel if he asked Megran which individuals approached him about the issue, Duckett responded no.
"I wasn’t particularly interested in witch hunts or delving into this issue," said Duckett.
"The past was the past as far as I was concerned. I was interested in ensuring that the practice stopped.”
Duckett said he instituted a policy where all requests for special access would go through him, and that he wanted to make sure the procedure was stopped as the agency took over from the regional health boards.
He added he can't recall any violations of that policy while he was in the job. He did say, however, that looking back, a special flu shot clinic for the Calgary Flames hockey team was wrong, but at the time, he "didn't think of it as violation of the policy."
The inquiry Tuesday also addressed the distribution of the H1N1 vaccine to members of the Calgary Flames in 2009. Media reports at the time indicated that members of the hockey team received those vaccinations at a private location on October 30, 2009.
Dr. Megran said he was “one of three executive members… designated to be the executive leads for the Alberta Health Services’ response to the impending, anticipated H1N1 epidemic.”
In regards to the private delivery of the vaccinations to members of the Calgary Flames, Dr. Megran testified it occurred “as I understand it, Friday October 30, 2009… I became aware of it Monday… reports of it happening were appearing in the media… that was the first I heard of it.”
After the media reports surfaced, Dr. Megran said an AHS investigation was launched.
“There was a physician involved who did work with the Flames, who I was told, had initiated a request … about how the Flames would best be vaccinated,” he said Tuesday.
“That physician had a friend who was married to a public health nurse… the Flames had indeed been vaccinated at a private location.”
Dr. Megran said he was verbally notified of the results of the investigation and that “they had made a decision to terminate two people who were directly involved.” He added “the physician involved was not a member of AHS staff… he was certainly not an employee with AHS.”
The inquiry is being broadcast live online here.
With files from the Canadian Press
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