This was the Citizens Accountability Group follow-up op-ed in the Victoria Times Colonist on the Ministry of health 27 March 2008

Explaining policy to the people they serve is an obligation of public officials: a submission from the Citizens Accountability Group for health (Victoria)

The problem for citizens dealing with government is how to get useful answers to fair questions – answers that are not fog or spin responses.

The obligation of an authority to explain how it is carrying out its responsibilities is called public accountability. It means that governments will publicly explain what they intend to achieve, for whom, and why; what costs and risks would flow from the intentions, for whom, and why; the performance standards for what they intend and for the agencies they oversee; and what resulted. To make society work properly, citizens must hold to account (i.e. extract the needed accountings).

The requirement for public explanation cannot be refused because it is nonpartisan, tells no one how to do their job and asks only for explanation needing no more information than officials themselves need to do their jobs properly. What they know, they can report.

Holding to account is a powerful force. The key is public explanation. This produces a beneficial self-regulating influence on officials. When their intentions and reasons are known from public validation of what they say, they become subject to the “Dracula Test” – meaning that if true intentions are judged by citizens to be against the public interest, they tend to self-destruct.

Holding to account also gives us useful information that we would not otherwise have. George Washington put it succinctly in 1796: “I am sure the mass of Citizens in these United States mean well, and I firmly believe they will always act well, whenever they can obtain a right understanding of matters…..”

Health Minister George Abbott’s “Conversation On Health” forum in 2007 produced a pioneering project in citizens holding fairly to account. Participants at one Victoria discussion table formed a Citizens’ Accountability Group for Health, and posed basic questions direct to the Minister. The group was not lobbying for or against anything; just requesting explanations.

The group gave the Minister an authoritative concept and definition of public accountability and asked him whether he agreed with it. The group’s questions were straightforward. For example, whether the Minister agreed that Medicare as Canadian national policy should be legislated in BC as a human right, and what the Minister meant by his term “adequate health care” as a VIHA funding criterion for hospitals such as Mount St. Mary.

The group also asked whether the Minister would meet Canadian premiers’ 2003 and 2004 public commitments to report to their citizens their province’s health system performance — something not yet produced, as the Health Council of Canada recently stressed. Useful annual accountability reporting would include what the Ministry intends to achieve, for whom and why; its performance and public accounting standards for itself and the entities it oversees, and Ministry assertions on whether it is meeting standards of performance, management control and public accounting that citizens are entitled to see met.

In a Times Colonist op-ed 2 August 2007 the citizens group reported non-answering and pointed out that it was time for citizens themselves to hold government to account.

In a letter dated the same day, a senior Ministry official offered to meet with the group. In advance of the meeting the group sent follow-up questions for response in the meeting. These included whether the Ministry agreed with the meaning of public accountability sent to the Minister twice, and whether the earlier questions to the Minister were fair questions.

In the meeting the group’s representatives were immediately asked how many members they had — a telling question but not relevant to citizens holding fairly to account. The Ministry said that it answers all questions put to it but does not assess their fairness, and since it had already responded to the group’s 2007 questions it would not answer the group’s questions for the meeting.

The Ministry does not accept anyone’s view of public accountability — “There are many different views of it out there.” Yet the Ministry had earlier told the group, “The Ministry of Health is working hard to strengthen public accountability in health care.” Staff were presumably working on a concept without a credible operational definition of it.

In the absence of standards for full and fair public accounting, citizens can reasonably conclude that ministry responses are whatever the ministries want them to be, whether to citizens or to Opposition members in the Legislature. Hence spin.

The Ministry asked for a proposal from the citizens group of what adequate Ministry accounting to citizens “would look like.” This was agreed, but the request was odd, given that the premiers’ commitment to report was five years old. Logical citizen advice to the Ministry would be public accounting standards that a ministry can be expected to meet.

Apart from a natural reluctance of authorities to publicly account, one main reason for the lack of useful public explanation is that ministers and officials have never been taught what public accountability means for citizens, why it is needed to make society work properly, and what full and fair public explanation means.

For every set of important government responsibilities, citizens can form public accountability groups to hold fairly to account. They can identify in common sense the key responsibilities and the performance standards and public accounting that attach to them. For example, a citizens group for accountability will be formed for VIHA’s responsibilities and public accountability reporting.

The Citizens Circle for Accountability at www.accountabilitycircle.org offers a primer on public accountability and will develop web space for nonpartisan citizen accountability groups to work together.

Citizens need the media to support full, fair and public explanation by government and to support citizens groups asking for adequate explanations. Web sites can help, but thus far they create less direct public pressure on decision-makers than media can. Interviews can include asking officials simple accountability questions on behalf of the public such as: “How would you answer the following basic question if asked by a citizen…?”

It is time to by-pass elusive “political will” and citizens simply deploring things and to start using accountability levers to produce greater fairness in society.

The Citizens’ Accountability Group for Health (Victoria) is made up of Merv Adey, Elizabeth Cooey, Christopher Conroy, Philip Lyons, Henry McCandless, Wendy Strong, and Elizabeth Woodworth.