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COMMENTARY: Health P.E.I. was meant to fix governance. Why is it now in crisis?

Eighteen years after the Corpus Sanchez report laid the groundwork for structural reform, Prince Edward Island finds itself confronting a difficult but unavoidable question: is the governance model for health-care delivery we adopted still fit for purpose?

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The creation of Health P.E.I. in 2010 was intended to bring clarity, accountability and operational independence to health-care delivery. By separating policy from operations, elected officials would set direction, while an independent board and professional management team would deliver care. In theory, this model balanced democratic accountability with managerial expertise. In practice, the past decade suggests something very different.

The recent dismissal of CEO Melanie Fraser is not an isolated incident. It follows the termination of Dr. Michael Gardam just two years earlier, the resignation of the entire board in 2018, the departure of board chair Derek Key in 2022, the resignation and / or firing of senior members of the Health P.E.I. leadership team, and the steady exit of other board members since. Viewed individually, these events might be explained away as leadership turnover. Taken together, they point to a deeper and more troubling pattern: a governance framework that is not being respected, and perhaps cannot function as intended under current political realities.

At the heart of the issue is the erosion of the fundamental distinction between governance and management. Crown corporations depend on this separation. Boards are meant to provide oversight, strategic direction and accountability, while management handles operations. Ministers and elected officials, in turn, are........

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