When the CBC's Fifth Estate came calling for information on Canada's hospitals, the provinces responded with a collective "no." Data journalism editor Fred Vallance-Jones says it happens all too often.
By Fred Vallance-Jones, J-Source Data Journalism Editor
The CBC and the Fifth Estate rolled out a huge interactive feature this week, comparing hospitals across the country on a range of measures, including rates of hospital-acquired infections and numbers of times surgeons left foreign objects, such as sponges, in patients.
It’s information that the hospitals collect, and share with a national agency called the Canadian Institute of Health Information. CIHI in turn shares the information with the public, but detail on individual hospitals is withheld. This has the effect of sanitizing the information, making it hard to pin responsibility on anyone as the hospitals with poorer records are mushed together with those that have better records.
Since individual hospitals is where Canadians receive care, the CBC, quite reasonably, asked CIHI if it could get the information at that level of detail. CIHI in turn asked the provinces, as it is required to do.
But it seems the provinces weren’t keen.
As reported by the CBC, they worked together to make sure the CBC wouldn’t get what it wanted; the researchers would get no more than was already made available publicly. One province, Nova Scotia, even reversed an initial decision to release the hospital-by-hospital information, just as goverments across the country were communicating with one another about their planned, collective “no.”
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Some of the provinces suggested privacy protection was a key element in the decision to brush off the CBC requests.
In Canada, we have placed a high value on personal privacy, and governments do have a legal obligation to protect that, especially when sensitive information such as health status is involved. But that has to be balanced with an equally important obligation to be accountable for the spending of public monies. Health spending is a huge part of provincial budgets and the quality of care received is of utmost importance to patients and their families.
It follows, that the greatest degree of disclosure possible about the state of that care, limited only by legitimate protection of privacy, should be the rule. That has not happened in this case.
Given that the Fifth Estate’s request was directed at a system in which the provinces already cooperate, one cannot immediately condemn the provinces for talking to one another to develop a reasonable way of serving the twin public interests of disclosure and necessary privacy. But when the discussion becomes a way to coordinate widespread stonewalling and prevent release of any of the information sought, even though privacy interests would not be jeopardized, that is simply wrong.
One can only wish it had stopped there.
But it seems, according to the researchers, the provinces couldn’t resist trying to influence how hospitals would respond to a follow up request. After the blanket no, the Fifth Estate sent surveys to individual hospitals. Provincial officials responded by “suggesting” to the hospitals that they not comply. Given that the provinces fund hospitals, one would expect such suggestions to be given significant weight. And indeed, they were, with many many hospitals echoing the provincial refusal to release information.
The kind of paternalistic, “trust us” attitude that we have seen in this instance is hardly unique in Canada, where officials so often seek ways to prevent release of information, rather than trying to maximize openness. I saw this up close two years ago during research for the Newspapers Canada freedom of information audit, an exercise I conducted four times until last year, sending identical freedom of information requests to governments across Canada. We discovered that provinces had worked together on those requests too, filling each other in on how they were responding even though the requests are legally supposed to be private interactions with each individual province. B.C. officials launched a massive effort to manipulate their response to the audit requests, speeding up processing so they would look good. It became supremely embarrassing when a follow-up FOI request revealed the manipulation.
Maybe governments are simply afraid to make mistakes, and feel they can learn from one another. Or perhaps, they are thumbing their noses are the public, putting bureaucratic interests ahead of the public interests. Or maybe, just maybe, they just don’t like real accountability. A little bit of carefully sanitized information is OK. But don’t point fingers; don’t force anyone to take responsibility.
That seems to be what has happened in the case of the CBC and the hospital records.
Perhaps, someday, we will see governments respond to a request like this by saying, "Of course we will be open; what would you like to have?" But to do so would require an acknowledgement, in action as well as in words, that serving the public interest can sometimes be a little uncomfortable, or even a lot uncomfortable. And I'm not sure our governments are ready to make that leap.