This posting is to illustrate first steps taken by citizens holding to account members of a governing board. In this example it is the board members of a major Canadian provincial government agency,  the Vancouver Island Health Authority (VIHA). VIHA is charged with healthcare  on Vancouver Island and running the facilities for it, under the direction of the provincial Health Minister. The Minister has ultimate responsibility  and public accountability for how the province’s several health authorities carry out their tasks. Each authority is the face of the Minister for that area of the province. What health authority board members intend and do, or fail to do in their duty, affects citizens in important ways.

Below is the third-stage letter from the Citizens’ Accountability Group formed on VIHA to each individual member of the  board, again asking for their view of their own public accountability. Each earlier asking was rebuffed. The letter exchange below shows that the Board members feel accountable only to the Minister, which means that they do not feel publicly accountable to the citizens they affect — only to the official who appointed them.

The letter followed earlier fog responses from both the then-responsible Health Minister  and the VIHA board, when the respective citizens’ groups for each of the Ministry and VIHA asked them to state what they saw as their own public accountability obligation. They were specifically asked to state  whether they agreed with a commonsense and unassailable concept and definition of public accountability given them by the the citizens’ groups. In January 2008 the ministry group representatives had met briefly with the Assistant Deputy Minister of the  Ministry presumably responsible for the Ministry’s public accountability . He disdainfully stated: “We don’t accept anyone’s definition of public accountability: there are too many out there.” Note that this astonishing assertion did not prevent the Minister  from credibly defining and installing  his own view of the public accountabilities of himself, his senior civil servants and his agencies, and installing the  standards throughout the Ministry to produce  full and fair public accounting.

As noted in the October 10 2009 post, public accountability means the obligation of authorities to explain publicly, fully and fairly, before and after the fact, how they are carrying out responsibilities that affect the public in important ways. Explaining the discharge of responsibilities includes authorities explaining their intentions and their reasoning for them, and their intended performance standards. It further means publicly explaining the outcomes of intentions and performance carried out and how the available learning was applied.

Following the VIHA group’s September 16, 2009 letter to the Board below, the Board’s response included a sum-up of  the Board members’ collective stance. Since the group received no responses from individual members,  it is not possible to identify who wrote the response — whether the Chair of the Board, the employee CEO Howard Waldner, or some other  employee.

The letter to each individual member is as follows:

September 16, 2008

To the Members of the Board of Directors,

Vancouver Island Health Authority,

2101 Richmond Rd, Victoria, BC

Dear____________________

The Public Accountability Obligation of the Vancouver Island Health Authority Board of Directors

In the 1990s the prestigious national Canadian Comprehensive Auditing Foundation (CCAF) in its study on governance stated, as its 5th principle of governance, that effective governing bodies will be able to state:

“We understand what constitutes reasonable information for good governance…and we obtain it.”

In the case of VIHA, obtaining reasonable information for good governance means that the VIHA Board must: (1) have its own processes that identify and monitor the critical success factors needed to have all VIHA units significantly affecting citizens meet performance standards that citizens have the right to see met, and (2) have effective management control exercised by the Board itself, as VIHA’s directing mind, to ensure that performance and the accounting for it in all areas meets the needed standards for each unit. Management control by the Board means having effective processes that ensure that what should happen does, and what shouldn’t happen, doesn’t.

Our first question to the Board in May 2008 asked whether the Board carries out these responsibilities. The Board’s response can fairly be judged as not meeting a reasonable standard of useful public explanation.

Our second question to the Board in July 2008 dealt with the Board’s obligation to publicly explain its intentions fully and fairly to those who would be affected by them. This would obviously include all those residents and families affected by the Board’s intentions for residential care.

We simply asked if the Board agreed with the statement of its commonsense public accounting obligation that we had given to the Board, which we regard as unassailable, and, if not, to state its reasons.

Again the Board replied to questions we did not ask, and did not reply to those we asked. It stated only what it reports in compliance with the Ministry and that it has guidelines for Board decision-making.

Responsibility is not accountability, and compliance with a directive is not explaining publicly the Board’s own intentions and reasons and its intended performance standards for VIHA operations. Full and fair public accounting includes giving credible evidence whether all those under the Board’s jurisdiction are meeting performance and public accounting standards that citizens are entitled to see met.

VIHA Board responses to citizen questions appear written for its web site PR and, by not faithfully answering the questions asked, to try to lead readers to think that all is well with the Board and that it is the questioners who are off base.

Adequate public accounting before the fact includes full and fair public explanation of what the Board intends for residential care homes on Vancouver Island, why it intends it, and allotting enough time for knowledgeable, fair and valid public challenge of its intentions before deciding on a course of action.

As the world’s leading management consultant Peter Drucker, once said, “Without dissent, you don’t know what the problem is.” We have no evidence that the VIHA Board and top management genuinely seek and respect dissent, either within VIHA or externally.

The public accountability issue was brought to a head in the July 30 public Board meeting in Qualicum. Ms. Joanna Neilson, spokesperson for the Concerned Citizens for Cowichan Lodge in Duncan, cited many examples of the Board’s refusal to explain publicly, fully and fairly before the fact its intentions, reasons and intended care performance standards in closing Cowichan Lodge and shifting its residents to a private sector facility. For example, the public accounting would have included the Board’s decision-making on transfer trauma risk for old residents wholly dependent on the staff and environment they know, which can be expected to be lethal for some.

Ms. Neilson summed up her remarks by pointing out that the Board had lost the public’s trust. She said that citizens wished to trust the Board, but could not. The Board cannot use the Victoria Times Colonist reporter’s failure to quote Ms. Neilson, who had made the most important statement of the whole day, quoting instead what the CEO wished to say about other things, as evidence that public trust is not a vital issue. One would think that the Board members at the table at the public meeting would have been personally devastated by the citizens’ indictment.

Full and fair public accounting increases trust in an authority. Failure to do so decreases trust. It is legitimate that citizens not place their trust in any Ministry or authority that does not publicly explain its intentions adequately before the fact, to a standard that citizens have the right to see met.

Our July question set out what we regard as basic standards for acceptable public explanation by authorities. VIHA Board members do not have to wait to be instructed by the Minister on what the Board’s public accountability obligation is. VIHA employees on the front lines likely wouldn’t be invited to help with that, and it is not likely that the Minister and his staff could, because public accountability is not taught to civil servants and politicians.

We think it is reasonable that the Board members, as VIHA’s directing mind, publicly explain what they themselves think are the public accounting standards before the fact that citizens are entitled to see them meet.

A useful Board reply to our letter would need the reply to be an agenda item in the next Board meeting. We know of no governing body mandate in Canada that would prevent the Board from usefully and publicly giving a credible view of its public accounting obligation. Simply re-stating existing Board public comments about its accountability obviously will not do, and can be expected to lower public trust in the Board still further. We regard the Board’s reply to us as something separate from the next public Board meeting Q&A and web site statement process.

We expect each member of the VIHA Board to receive this letter as written.

Our July 2008 question to the Board is attached as an appendix.

Sincerely,

Members of the Citizens’ Accountability Group on VIHA

CC: Auditor General of BC, BC Ombudsman, Minister of Health, Leader of the Opposition, Editor the Times Colonist

Appendix to the September 16 VIHA CAG letter to Board members

The question put to the Board July 14, 2008, by the Citizens’ Accountability Group on VIHA

VIHA’s current intentions for its responsibilities for seniors’ residential care (such as transfer trauma) highlight the issue of the Board’s public accountability. Does the Board, as VIHA’s governing body, agree that its public explanation obligation before the fact is the following:

The Board has the obligation to explain fully, fairly and publicly, for VIHA’s achievement goals and intentions that would affect citizens in important ways, exactly what the Board intends, and why the Board intends it, stating, in the Board’s view:

(a) who would benefit from the Board’s aims and intentions and how they would benefit, in the short and longer term, and why they should;

(b) who would bear what costs and risks from what the Board intends, in the short and longer term, and why they should;

(c) the most important performance standards the Board would require professional and other staff under VIHA’s jurisdiction to meet, in carrying out their assigned responsibilities under the intentions;

(d) what the Board thinks is a reasonable period of time for public challenge of its intentions and performance standards by knowledgeable and affected citizens, before the Board decides to act, and

(e) who would account, publicly and regularly, for the discharge of what responsibilities flowing from the intentions, and be required to publicly report what been achieved (as opposed to reporting activity)?

If the Board disagrees with any or all of the above, please tell us why. Note that the public accounting requirement does NOT tell Board members how to do their jobs; it is only the obligation to explain, meeting a standard of public explanation before the fact that citizens have the right to see met.

***

Extract from the Board’s October 20 2009 response to the CAG September 16 letter:

“We believe that we are fulfilling our obligations toward public accountability. We also feel that we have addressed your questions and comments; though apparently not in the way that you would like us to. Perhaps we need to agree that your thoughts and ours on this topic are incongruous. Ultimately, the Board is appointed by the Minister of Health and is accountable directly to a Minister, who is an elected representative of the citizens of the province of British Columbia.”

The Board’s response makes clear  that its members feel no obligation to account fully and fairly to the public, to a standard of public explanation that citizens have the right to see met.  Doing so would concede that they are accountable to the citizens they affect.

This shows why citizens’ duty includes requiring  their legislators to install in the  law the obligation of ministries of the Crown and their agencies to explain publicly, fully and fairly their intentions, reasons and performance standards before the fact, and later the outcomes of their performance as they see them, and how they applied the available learning. Once they do this, auditors general can give their opinion to the legislatures (ie to the public) on whether the governments and their agencies met the legislated accounting standards, the implications of failure to do so or of refusal to account fully and fairly, and what action it would take, by whom, to produce the needed public explanations. Knowledgeable citizens’ groups can also publicly assess the fairness and completeness of the explanations.

The next step for citizen action is to ask the current BC Minister of Health, new in 2009,  what he sees as the public accountability obligations of himself, his senior officials and his agencies, and the public explanation standards for those  assertions that he thinks citizens are entitled to see met. In a democracy this request cannot be denied, because it is  a legitimate request only for information needed by citizens to do their civic oversight duty, and to decide their level of trust in accountable elected and appointed officials. It is not something telling officials how to do their jobs.