Sunday, May 23, 2004

Consult This!

For years the county hospital has been a treated like a stepchild by Alameda County’s top bureaucrats, Sheriff Plummer and the Health Czar, Dave Kears. They’ve complained, huffed, diverted funds and mostly just plain neglected the Medical Center. Highland Hospital, Fairmont, and the County clinics have stayed alive mostly because of the work and dedication of care providers, patients, real leaders like Supervisor Carson and community groups. Measure A put it to the voters. The people of Alameda County were asked if they would pay a little more to keep the public hospital open and they answered,” yes” by more than a two thirds majority.

And that’s where the trouble began, 70 million dollars worth of trouble. Supervisor Steele appointed her best “buddy” to the Authority Board and even tried to put the Sheriff on it. All of a sudden everyone wanted to help the Medical Center, consultants came crawling out of the woodwork. An Authority Board runs the Medical Center. This is a device designed to keep a comfortable distance between the politicians and public.

All of a sudden the Authority Board had money in its pocket. County Supervisors calling them daily and top bureaucrats lobbying them. They became important people. Money and power, they had to do something. Actually they had to do exactly what the County Supervisors who appointed them wanted. That’s why they needed every politician’s best friend, consultants. They’re solicitous, they’re loyal; they’re not burdened by strong connections to the community or institutions they serve; and if it doesn’t work out the consultants can be blamed. The Board got really extravagant when they hired Cambio, who brought in their turnaround team, a bunch of guys from Tennessee in dark suites and tight shoes. The turnaround team turned around and hired more consultants, they then fired the entire executive staff of the Medical Center and replaced them with, that’s right, you got it, more consultants. The Board also hired $100,000 dollars worth of public relations consultants to explain the activities of the other consultants to the confused taxpayers, who just wanted a public hospital.

Why consultants? Have they been successful in the past? No. Do they understand the Byzantine complexities of the County of Alameda’s Health Care Services Agency? No. Do they have strong ties to the community, or the trust of the labor and community groups who advocate for the hospital? Of course not.

So why does the Board of Supervisors have such a never-ending romance with consultants? Politicians bring in consultants to solve their political problems. They don’t strengthen public institutions; they cut costs and take the heat, so politicians don’t have to get involved. Fixing the Medical Center would require political involvement, investment in infrastructure, committed permanent administrators, and real leadership from the Board of Supervisors. This clearly isn’t happening, so what do we get, consultants, cuts in services, and public relations, to tell us it’s a good thing. McMedicine, brought to you for the bargain price of 3.2 million dollars per year, and if you don’t like it, don’t call your County Supervisor; it’s not their problem, it’s yours.

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