Last week Health Minister Jim Reiter accepted all of the recommendations of the Saskatchewan Advisory Panel on Health System Structure, and announced the province will consolidate the 12 existing Regional Health Authorities (RHAs) into one single Provincial Health Authority.
“One Provincial Health Authority that is focussed on better co-ordination of health services across the province will improve the quality of care patients receive,” said Reiter in a release. “It will also reduce administration and duplication across the health system.
“This change represents a consolidation of administration, not a centralization of services. Our government remains committed to providing high-quality health services in every part of the province. Our goal is better co-ordination between the health services provided in different areas of the province.”
The response to the announcement has been one of caution from many.
Don Rae, the chair of the Sunrise Health Region Board of Director said he was sure change was coming, but the move to one entity was unexpected.
“It was absolutely (a surprise). I’ll be the first to admit it was a surprise,” he said.
But, Rae said he can appreciate the decision.
“The more I read from the panel, I see some of the reasons for going there,” he said, adding “change doesn’t scare me as long as it’s for the right reasons.”
The right reason for Rae is to help ensure better health care for all Saskatchewan residents.
With that in mind Rae said in discussions with the province he made sure to voice his position that there must remain a way for “smaller communities, rural communities, to have their voice.”
Rae said while many expect cost savings from the change, he is not sure that is the biggest focus of going to one authority, suggesting he believes it has more to do with “better patient flow” to make the system more responsive to patient needs.
Of course at this point the details of the new health authority is unknown. Rae said it will be part of the existing Sunrise Board’s role to help implement the change as it is unveiled over the coming months. He added the Board has been told it will remain functional at least until fall this year, but will eventually be dissolved as the new authority takes over.
“Part of my job now is to help with the transition,” he said.
Yorkton Mayor Bob Maloney said the amalgamation certainly did not come as a surprise.
Maloney said given that health care and education take the lion’s share of provincial government spending the likelihood of change was high.
“You had to expect change was coming … Looking at the scope of the problem,” he said.
Maloney said the key moving forward is to see the anticipated savings, while ensuring patient care remains constant.
“One would think they have to achieve some real savings for this thing to work,” he said, adding “… My feeling is that frontline patient care is the most important part of this.”
At the same time, Maloney said on a broader scale people need to begin to answer two questions; what health services are a realistic expectation, “and what are we prepared to pay … Expectations have to mesh with the pocketbook.”
That is the core of achieving balanced budget for all levels of government, something Maloney said he thinks should be a key focus.
The Saskatchewan Government Employee Union has suggested the provincial government must ensure that frontline workers and patient care won’t be adversely affected as it consolidates the province’s 12 Regional Health Authorities into one.
“Workers on the frontlines of health care in Saskatchewan provide quality care for patients, and deserve reassurance from this government that the services they deliver won’t be compromised as a result of restructuring,” said SGEU President Bob Bymoen in a release. “Right now, there is a lot of uncertainty about what this process will mean for both workers and patients.”
Government must maintain existing service levels in order for health providers to continue delivering the vital care that Saskatchewan people rely on, stated the release.
“With change comes concern,” Bymoen sayid. “We’re concerned that health restructuring could disrupt the continued delivery of high-quality patient care, or cause unnecessary stress for frontline workers, who are already overworked. We’re concerned that a single, province-wide authority could jeopardize services in remote and sparsely populated areas of the province.”
The Canadian Union of Public Employees has also come out warning of serious concerns about how the creation of one province-wide health care superboard will impact workers, patients, and quality of care.
“Health care restructuring will disrupt the established systems and relationships of providing health care in the province,” warned Gordon Campbell, president of CUPE Health Care
Council in a release. “Today’s announcement creates more uncertainty for frontline workers and for rural communities across Saskatchewan. It is also questionable that any cost savings will result.”
CUPE suggested past experiences from across the country raise several flags when it comes to reorganization.
“We are concerned that one central superboard will be less responsive and harder to navigate for patients and communities,” said Campbell. “Will this lead to reduced services and a loss of decision making in communities, especially in rural communities? What will this mean for access to health care in communities like Preeceville, Wawota, or Grenfell that have already been experiencing issues?”
CUPE is the largest health care union in Saskatchewan, representing over 13,000 members. CUPE members work in acute care, long term care, home care, rehabilitation, and public and community services as emergency medical responders, continuing care assistants, licensed practical nurses, dietary staff, medical technologists and technicians, housekeeping and laundry aides, security, clerical and maintenance staff, therapeutic and recreation workers.
Along with the recommendation to move to a single Provincial Health Authority, the Advisory Panel recommends the appointment of a single Board of Directors to govern the new Authority. The report also recommends system-wide improvements that include consolidation of health system administrative support functions and some clinical services such as laboratory and diagnostic imaging, and the planning, dispatch and delivery of Emergency Medical Services (EMS).
It will take time to create a new Provincial Health Authority. Work on implementation planning has already begun at the Ministry of Health, according to the release. A plan is being developed that will work through implementation details, including legislation, governance, financial and change management considerations.
While the date the new Provincial Health Authority will come into being is still to be determined, it is anticipated to occur in fall 2017.
Optimizing and Integrating Patient-Centred Care: Saskatchewan Advisory Panel on Health System Structure is available online at www.saskatchewan.ca.
