THE BLOG

In Both Politics And Medicine, It's A Question Of Trust

When people look at the legislature and say, they're in there for money and power, it cheapens all of our work.

06/21/2017 12:55 EDT | Updated 06/21/2017 15:08 EDT

It was recently revealed that fifty-three companies that donated a total of $1 million to the Saskatchewan Party in recent years subsequently received $100 million in government contracts. This led to a heated debate in the Saskatchewan legislature on the corporate donations. As a family doctor and newly minted MLA, I had some thoughts about the real question in such a debate.

When we talk about the problems with political donations, we're not really talking about campaign financing. We're talking about something much more fundamental. We're talking about trust.

2017-06-18-1497755265-9389689-LegislatureSteps.jpg

We're talking about the way that the public views political leaders. Do they trust us to do the right thing? Do they trust us in our interactions with companies, in our interactions in handing out contracts, to be objective? To make the best decisions for this province and its people, rather than for companies seeking favourable laws and contracts?

Our primary goal is not to help any particular business or any particular company. Our primary goal is to achieve the best for the people of this province. One way to measure this is to look at the health outcomes of our policy choices. In fact, the health field offers us some important insights on this question of trust.

In the field of medicine, there's a long-standing practice whereby pharmaceutical companies give gifts to physicians. Sometimes those are simple things like a pen or a mug, a pad of paper. Or it could be something bigger: a golf trip, a fancy dinner. Or something even bigger like payments directly to that physician for enrolling patients in a drug study. The greater the degree of connection, the more expensive the gift, the greater the influence.

But it doesn't have to be a big gift. The research shows that even the smallest gifts - a pen, a lunch, a pad of paper, or the logo on an anatomy poster -- influence behaviour. The pharmaceutical companies aren't giving doctors mugs because they want them to have a good hot cup of coffee. It's because they want them to prescribe their drugs.

As Dr. David Grande said in a 2010 article in the Journal of General Internal Medicine, "Gifts associated with pharmaceutical detailing are motivated by a single goal - to increase the sales of a company's products."

The same is true for corporate gifts to political parties. The big donors giving tens of thousands of dollars aren't doing it because they believe in the party's vision. They're giving large sums because they believe it will pay off, that it will influence the government's thinking and behaviour. These are not gifts, they're investments.

There have been mounting efforts in recent years among medical associations to try to decrease the influence of pharmaceutical companies through gifts. Personally, I've avoided taking gifts or meeting with pharmaceutical representatives.

Those efforts to decrease influence are happening in one of the most trusted professions. Physicians are consistently ranked by the public in the company of such trusted groups as pharmacists and firemen. Sixty-five per cent of Canadians trust doctors, only six per cent trust politicians.

Physicians realize that trust is our greatest asset, with the public and with our patients. If we want our patients to take our advice and change their behaviour, we need to have their solid trust. Those of us in elected life should also want to be trusted as a profession. For the good of the public, we want people to be able to trust that we are not being influenced, and corporate donations impede that trust.

Even if one could set up some perfect barrier preventing any influence from donors, the public would still think that the influence is there. Whatever the reality is, the perception is very clear. The public doesn't trust this profession and they don't trust it for some very clear reasons.

What are those reasons? In Saskatchewan, there are very questionable donations. Public institutions -- universities, libraries and municipal governments -- are donating to political parties, as are out-of-province corporations. We have big gala dinners where people pay extra money to have closer access to members of the government. We have, up until a few months ago, regular top-ups to the Premier's salary directly connected to those donations, amounting to nearly half a million dollars in the last decade.

Fifty-three companies donated $1 million to the Saskatchewan Party and were awarded $100 million in contracts. Whether the choice to give them those contracts was influenced by the donations or not, the perception is there, and the trust of our profession is damaged by that perception.

The public knows this, and they are not impressed: 81 per cent of the Saskatchewan public says no public institutions should be able to contribute to political parties; 69 per cent said we shouldn't have out-of-province donations; and 74 per cent said no money from charities.

But the Sask Party insists that behaviour is absolutely fine despite the fact that it is damaging their reputation and the reputation of all legislators. When people look at the legislature and say, they're in there for money and power, it cheapens all of our work.

When the Premier doubles down on this practice, when he further entrenches the idea that we are all in this for money and power, he cheapens the work of every one of us. It hurts the reputation of the province and of the profession.

We need to kick this drug. We need to get out from under the influence and catch up with the rest of the country. Under increased scrutiny of cash-for-access and other questionable practices, jurisdictions across Canada have been limiting corporate and union donations. Saskatchewan is left with the worst political donation rules in Canada.

We need to cut the connection between granting contracts and the corporations that lobby or donate. We need to ban corporate and union donations. We need to set a reasonable personal limit so we don't have individuals with outsized influence and outsized ability to determine who wins government. We need to eliminate out-of-province, charity, and public institution donations. And we need to take a good look at the internal party finances as well.

The current situation presents us with an opportunity to remove the real and perceived influence of corporate donations that corrupt the reputations and the actions of political decision-makers. There is an appetite for a better way. People want to be able to count on their representatives to put their health and well-being before the bottom-lines of donors. Healthy democracies put people at the centre of the political process. For the good of the profession and the province, we need to sever the ties of influence and take action to restore trust.