Big organizational shake-ups are coming to two of the territorial government’s biggest departments: Health and Education.
Reform is welcome. A fifth of Yukoners don’t have a regular health care provider according to the Canadian Institute for Health Information, and critiquing the Yukon education system seems to have become a rite of passage for generations of beancounters in the Auditor General’s office.
But it is relatively easy to shuffle the reporting lines on an org chart. It is much harder to make sure change cascades all the way to the front line to improve learning for a student in the classroom or a patient in the clinic.
The scale of these departments won’t make it any easier. Both are big bureaucratic beasts. Health’s budget is almost half a billion dollars a year, and Education about a quarter billion. Combined, just these two departments are half again as big as the entire Yukon government twenty years ago.
The recent votes that will see eight schools join the to-be-created Yukon First Nations School Board were as welcome as they were historic. Voting was strongly in favour of the move, with 60 per cent in favour and only one school community voting against the idea (J.V. Clark in Mayo).
It is a testament to how far the Yukon as a whole has come since Together Today for Our Children Tomorrow was written five decades ago.
Such a bold move away from the status quo is also a testament to how parents and citizens feel about the Department of Education’s management of our schools.
On the Health side, the plan is to create a new health authority “that delivers a people-centred healthcare system.” It would coordinate the hospitals, primary care, long-term care and various other services provided by government, private doctor’s offices and non-government organizations.
Both reforms involve creating a new organization that sits between the department and the citizens being served. The new First Nations school board will be funded by Education and will run the schools in question. The new health authority will be funded by Health and will run the hospitals and facilities.
The conceptual model is the easy part. To make things work better in practice, the magic will be in the details.
There is a myriad of details to get right. How is the organization structured and who is on the leadership team? How will the funding formulas work? Who will make decisions on hiring, firing, budgets and computer systems? Will there be new resources to do things in new ways? How will major projects be set up for success and tracked? What metrics will be used by managers and citizens to know how the new institutions are performing?
These details matter. The premier’s Financial Advisory Panel (remember them?) warned specifically about the risks in reorganizing Health and Education, noting that “institutional reorganization can take many forms from moving around senior civil servants and reorganizing departmental mandates to consolidating [and then decentralizing] stakeholder boards in areas such as healthcare and education. This is the easiest change to undertake and the least likely to increase efficiency or effectiveness in the operations of government … this is otherwise referred to as ‘rearranging the deck chairs.’”
Amidst all the details, there are three critical elements that will shape whether these new reorganizations are successful.
The first is whether the Yukon government can really let go and allow these agencies to be run independently. Change will be limited if the First Nations school board has to go back to Education constantly for funding approval or to make decisions about school calendars, educational assistant staffing, busing, school hours and other day-to-day decisions.
The second is funding. There will need to be more of it, and it will need to be provided on a transparent and predictable formula. I don’t see how the 8,000 Yukoners without a regular healthcare provider can have one without a budget to hire more nurses and doctors. There may be inefficiencies in the current system, but not that much slack.
A predictable and formula-driven budget is important because, otherwise, agency managers will spend most of their time writing and negotiating budget applications.
The third element is accountability. We all hope these new agencies succeed, but if they underperform in the long run they would not be the first new government institution to do so.
There should be clear, quantitative and qualitative objectives shared with the public. Then there should be annual public reports. These reports should be done by an independent body, not the departments and their spin doctors. Having the federal Auditor General visit every ten years is not good enough. We should have a Legislative Budget Officer reporting to the legislature directly who is tasked with these reports. There are similar offices in Ottawa and some provinces. If the government won’t agree to this, the other parties in the legislature should compel it.
The final aspect of accountability is citizen choice. Yukoners should be free to choose to stick with their current doctor, or go to a new polyclinic set up by the new health agency. The only First Nations school board schools in Whitehorse will be in Riverdale and Takhini. First Nations and non-First Nations children who live in other parts of Whitehorse should be able to enroll at Takhini Elementary or Grey Mountain Elementary. Likewise, students in the Takhini and Grey Mountain catchment areas should be able to enroll in other schools if they choose.
Such citizen choice is important, not least because it allows citizens to vote with their feet if a public agency is underperforming.
The issues in our health and education systems are deeply rooted and will not be solved overnight by new org charts. The reforms have the potential to make major improvements. But they must be done right.
Keith Halliday is a Yukon economist, author of the Aurore of the Yukon youth adventure novels and co-host of the Klondike Gold Rush History podcast. He is a Ma Murray award-winner for best columnist.