SOMETIMES, even a successful relationship needs some fine-tuning. That is the case now in regard to the relationship between King County, the University of Washington and the management of Harborview Medical Center. King County is about to begin the process of negotiating a new operating agreement for Harborview. The workers I represent hope that process will make a great hospital even better.
Harborview is owned by King County and, under state law, is operated by a board of trustees appointed by the Metropolitan King County Council and the county executive. The county hospital’s core mission is to care for the less fortunate and for those held in the county jail.
In 1970, King County decided to contract with UW to run this traditional county hospital. The results have been spectacular. The UW has turned Harborview into one of the world’s great burn and trauma centers, and has made Harborview part of their outstanding system of teaching hospitals.
Medically, the UW has made Harborview into a great hospital. But concerns have surfaced about other aspects of the UW’s management, which prompted the County Council to unanimously adopt a motion calling for the most thorough review of the King County-UW relationship in the last 40 years.
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Specifically, my organization, the Washington Federation of State Employees, and other stakeholders are concerned that Harborview is straying from its core public mission as it becomes more and more integrated into the UW’s system of primary-care clinics and medical training.
At public hearings, speakers have voiced concerns about the financial situation at Harborview as part of the larger UW system. My union’s members continue to be troubled by the treatment of employees at Harborview, from custodians to those who assist patient registration.
Last year, the UW merged the Harborview call-center employees into a larger UW medical operation, and announced plans to close the primary-care clinics at the hospital that predominantly serve the most disadvantaged people in our community.
A dubious English test was used to deny extra pay for custodians performing specialized infection-control duties. These, and other actions taken by the UW, are the types of steps taken by a for-profit health-care corporation, not a public hospital.
In short, Harborview is a great hospital, but it is not being operated in a manner consistent with this community’s progressive values. It is widely assumed that the UW will continue to operate Harborview. But to keep the community’s trust, the UW must agree to a new management contract that follows the guidelines recently adopted by the County Council.
The council’s motion spells out five requirements for a new Harborview management contract. It calls for a commitment to the hospital’s historic mission to serve the poor and to value employees and improve the relationship between labor and management. The council’s motion declares there is to be independent governance and recognizes that Harborview is owned by the people of King County, not the University of Washington. It also aims for transparent financial management and environmental stewardship.
Today, competition among hospitals and health-care systems for market share has become fierce. In addition, the UW faces challenges relating to its mission to train medical professionals. Understandably, the university has to face these pressures, but Harborview must not be subsumed nor its employees made to suffer as a result. A new management contract must ensure that Harborview, as patients and King County citizens have known it, will be there for generations to come.
Greg Devereux is executive director of the Washington Federation of State Employees, which represents about 1,100 Harborview Medical Center workers.