CALGARY - The head of the publicly funded Colon Cancer Screening Centre conceded Wednesday that patients from one private clinic were allowed to jump the queue.
Darlene Pontifex told an inquiry that from around 2008 to 2010, patient referrals from the Helios Wellness Centre in Calgary were kept in a special file and booked much faster than others.
"They (Helios patients) had their own booking folder and they were booked in faster than the regular waiting list?" asked inquiry lawyer Ryan Penner.
"That's correct," said Pontifex.
She said that during that time period her centre's database was in such disarray that staff couldn't track down enough patients to fill testing slots.
The files from Helios, located two floors down from the screening centre at Calgary's Foothills Medical Centre, were available with names and contact information, so they were used, she said.
"They (the Helios patients) were up to date and easy to contact."
"So they were given this special treatment as a matter of convenience?" asked Penner.
"It was a matter of us being able to fill our endoscopy time," Pontifex replied.
"Did other clinics get this special treatment?" asked Penner.
"Not that I can recall," she replied.
Other doctors and staff at the colon centre have testified they believe Pontifex and Dr. Ron Bridges, a University of Calgary associate dean in the medical faculty, were co-opting the resources of the public centre to serve Helios patients.
Pontifex testified that she is seen by a doctor at the Helios clinic, but is not required to pay the annual $10,000 membership fee.
"It was a professional courtesy."
Testimony to date has painted two different pictures of what was happening at the screening centre from 2008 until the early months of 2012, when the Alberta government announced it would hold an inquiry into allegations of queue-jumping.
Clerks and doctors have testified that soon after the public screening centre opened in 2008, Helios patients were receiving colon cancer tests within weeks. The wait list for everyone else was three years.
Clerk Samantha Mallyon said all Helios files came to her and Pontifex came by her desk once a week to make sure they were fast-tracked.
Patient referrals and inquiry testimony indicate Helios patients were even allowed to pick a date that worked best for them for screening.
The inquiry has heard how one patient continually missed appointments, once because he was at the Calgary Stampede, but was immediately rebooked every time.
Gastroenterologist Dr. Jon Love has testified that Dr. Doug Caine of the Helios clinic told him the facility was set up to reward people who donated to the University of Calgary. Caine has denied saying this.
Dr. Chen Fong, a University of Calgary radiology professor and Helios founder, has testified that the clinic is a non-profit organization set up in 2007 to fund scholarships for University of Calgary medical students.
For $10,000 a year, Helios patients get a range of services, including yoga, diet tips and exercise advice, Fong said. Any profits go to the university.
The inquiry has been told that from 2008 to early 2010, doctors who worked at the public screening centre, including Bridges, were allowed to bring in patients from their own practices for screening while the CCSC worked to create one common patient queue for everyone.
Clerks said prior to 2010 the Helios patients were fast-tracked via the speical folder.
After 2010, said the clerks, the special file was shut down, but Bridges continued to book Helios patients based on referrals sent to him directly by email from Helios.
Caine and Leah Tschritter-Pawluk — the day-to-day leaders at Helios — testified Tuesday that in 2010 they did begin directly emailing Bridges to get their patients seen at the public screening centre because they still considered the centre's database a mess and that patient files were getting lost.
Caine said at no time did they expect Helios patients to be pushed to the head of the line.
On Wednesday, Penner showed Pontifex two emails from Bridges to Pontifex and her assistant that said Helios patients were to be booked directly.
Pontifex testified she doesn't remember those emails.
"I receive a lot of emails. I don't necessarily read them."
Even from Bridges — founder of the screening centre, a leading gastroenterologist and a man she had known for 15 years? asked Penner.
"As I said, I don't always read my emails," Pontifex replied. "I've been notorious for that. People know that about me."
Penner asked Pontifex if she agree the emails were an improper deviation from the booking procedure.
"Yes I do," she replied.
She also testified that Bridges was the one who "implied" that the separate file of fast-tracked Helios patients be set up prior to 2010.
Bridges did not have any formal title at the screening centre, but he had informal authority, Pontifex said.
"He did have a management role with us. He was our adviser."
Dr. Valerie Boswell, a general practitioner at the screening centre, has testified she warned Pontifex in person twice that she had concerns about Bridges fast-tracking patients. A clerk said he personally warned Pontifex of the same thing in 2011.
Both said Pontifex either ignored them or brushed off their concerns.
Pontifex testified she doesn't recall those conversations.
Bridges began his testimony Wednesday. He told the inquiry he knows Fong well and worked with him five years ago on the University of Calgary's Reach! campaign, which raised $312 million from 700 donors for projects that included the CCSC.
He is slated to return to the witness stand Monday to answer questions relating to the allegations of queue-jumping.
— By Dean Bennett in Edmonton
Jan. 22, 2008: Colon Cancer Screening Centre, or CCSC, officially opens at the Foothills Medical Centre as a joint initiative of University of Calgary and Calgary Health Region. It is Canada's first free-standing colon cancer screening clinic designed to assume 30 per cent of the colon-cancer tests in the region to take pressure off hospitals. CCSC medical director Dr. Alaa Rostom is hired by clinic founder and University of Calgary associate dean Dr. Ron Bridges. Rostom testified in order to change colon cancer testing from individual patient lists to one common queue at CCSC, doctors are allowed to fill half their slots with their own patients during the transition.
2009: Samantha Mallyon joins CCSC as a booking clerk. Mallyon testified she was soon directed to take all patient files coming from the private Helios Wellness Centre and book them within week or two, while regular patients waited three years or more. She testified CCSC administrator Darlene Pontifex directed her to do it and came by her desk once a week to make sure Helios patients were indeed fast-tracked.
April 2009: All Alberta health regions are folded into one superboard titled Alberta Health Services under new president Stephen Duckett. Duckett issues a memo a month later to health leaders saying that he had heard queue-jumping was going on and would not be tolerated. Around this time Alberta Health Services begins the process to take full control of CCSC.
Early 2010: Patients from the Helios Wellness Centre are being systematically seen much sooner than the normal three-year waiting period for routine tests, according to the testimony of Dr. Valerie Boswell, a general physician hired to pre-screen patients at CCSC. Boswell said she made a phone call to Helios to learn more, but was berated by the person at the other end of the line, who demanded to know why she wanted the information.
March 2010: Boswell brings up concerns about Helios patients jumping the queue to Rostom, Pontifex, CCSC research director Dr. Robert Hilsden, nurse Heather Stubley and Pontifex assistant Olga Koch. Boswell testified she got a frosty reception and no response. She wrote "Yikes" on her meeting notes.
Nov. 1, 2010: Dr. Jonathan Love — site chief for gastroenterology at Foothills Hospital — checks a patient for a colon cancer on expedited basis on referral from Helios doctor Doug Caine and Bridges. The patient was marked urgent but Love testified case appeared routine. Love visited Caine at Helios clinic. Caine gives him a tour and, according to Love, told him the clinic was set up to reward deep-pocket donors at the University of Calgary. Love said he raised the issue of possible queue-jumping involving Bridges and Helios at subsequent meetings of gastronintestinal doctors from Foothills and CCSC, including Rostom, but nothing was done. Rostom testified he doesn't remember such comments. Around the same time, CCSC policy is changed to forbid doctors from booking their own patients because CCSC is moving to one common patient queue.
December 2010: Two boxes of wine with a bow are delivered to CCSC from Helios. Rostom testified he ordered the wine sent back, but didn't explore the issue further. Rostom denied testimony from Barb Kathol, an executive director at the Foothills Hospital who works with the CCSC, that he didn't send the wine back until she ordered him to do so two months later.
Early 2011: David Beninger begins working as booking clerk at CCSC. He testified he saw Helios patients being fast-tracked, with many of them tied to Bridges. He testified he mentioned it to Boswell and was told the practice was supposed to have stopped. He told her it was still happening. Dr. Mark Swain, the head of gastroenterology for the Calgary region but with no authority over CCSC, is told by Love and Boswell about possible queue-jumping involving Bridges' patients.
Alison Redford 2012
Oct. 2, 2011: Alison Redford voted Alberta PC party leader and premier after campaigning on promise to hold a public inquiry into health system problems including queue-jumping.
November 2011: Boswell has second meeting with Rostom, Pontifex, and Hilsden over queue jumping involving Helios. She testified Rostom told her: "This is not a hill we want to die on."
Early 2012: Love asks CCSC clerks if queue-jumping is going on. He testified they replied: "Sure it's going on. Like, duh."
Feb. 28, 2012: Health Minister Fred Horne announces he has asked Health Quality Council to strike an independent panel to examine any queue-jumping in Alberta's health system.
March 16, 2012: After Swain tells Kathol she needs to again look into queue-jumping allegations, Kathol phones Rostom to advise him a second time of concerns that Bridges is directly booking patients at CCSC. This time, Rostom tells her he'll look into it, but testified that he didn't because he didn't have the time or resources.
March 19, 2012: Instead, Rostom sends out an email warning to senior staff reminding them that queue jumping in endoscopy procedures is not allowed. This catches the attention of his boss Dr. Francois Belanger, the head of the Calgary medical zone.
March 21, 2012: Belanger talks to Rostom. He said Rostom confirmed to him there had been charts flagged with him, but told him it was largely the result of organizational confusion and had been fixed. Belanger let the matter drop.
All parties agree any queue-jumping stopped after this point.