The process has now begun to consolidate the 12 health regions in Saskatchewan under one province-wide body by this fall, after Health Minister Jim Reiter accepted the recommendations of the Saskatchewan Advisory Panel on Health System Structure.
“This change represents a consolidation of administration, not a centralization of services,” said Reiter. “Our government remains committed to providing high-quality services in every part of the province. Our goal is better coordination between the health services provided in different areas of the province.”
Asked what this might mean for the Five Hills Health Region, Kyle Matthies, Vice President, People and Quality said, “Our hope is that for the residents of Five Hills this change will achieve the principle driver of the advisory panel report, which is the intention of providing seamless, integrated, team-based care. A lot of effort has been put into improving the patient journey in recent years and we hope that this will enhance that even further. It’s premature for us to speculate about what this will mean for our staff, though we believe that work will continue as usual for the vast majority. The report is clear that for some people reporting relationships may change and that that there will likely be some job loss.”
The Advisory Panel is recommending the appointment of a single board of directors to govern the new health authority, and 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).
“The panel recommended that within the one region there be a number of service integration areas to ensure that there is effective coordination of care and that community advisory networks are in place to ensure the voice of the public can be heard. We’ll be very interested to see how these unfold and if they are structured well, they will go a long way to addressing concerns,” said Matthies, adding the health region plans on working cooperatively with the ministry to make the transition a smooth one.
“We will work with the transition team as we are called upon to help in planning for the future. We’ll do our best to make sure the needs of our patients and employees are represented well as the decision making unfolds,” said Matthies.
The unions representing health care workers are not convinced that this move will be a good one for Saskatchewan residents or those working in health care, including the Canadian Union of Public Employees (CUPE), the Saskatchewan Employees International Union (SEIU) and the Saskatchewan Union of Nurses (SUN).
“Health care restructuring will disrupt the established systems and relationships of providing health care in the province,” said Gordon Campbell, president of the CUPE Health Care Council, noting this announcement “creates more uncertainty for frontline workers and for rural communities across Saskatchewan. It is also questionable that any cost savings will result.”
Concerns were voiced by Campbell about whether smaller communities will have any input or voice on the new large board. “We are concerned that one central superboard will be less responsive and harder to navigate for patients and communities. 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 that have already been experiencing issues?”
There are 13,000 health care workers province-wide under CUPE, including licensed practical nurses, lab and X-ray technicians, clerical and maintenance staff, and workers in dietary, laundry, environmental services and recreation activities.
“Our members are disappointed with the direction being taken by the Advisory Panel and our government,” said Barbara Cape, President of SEIU-West. “We are of the view that this move has the potential to negatively impact both patient care and the provision of health care services. Labour relations issues have been minimized, at best, or at worst, simply ignored.”
The union is concerned about how these changes will affect local communities, particularly in the rural areas. In response to concerns about the loss of engagement with local communities, the plan is the government will think about it, later. SEIU-West is concerned about the vagueness of the responses offered to legitimate questions asked by us.
“Our members in the health sector, who provide front line hands on care, will continue to face uncertainty,” added Cape. “Between job cuts, privatization of services and the threat of wage rollbacks, how can we ensure that we will retain or attract health care providers to deliver our health care services in such an unstable system?”
For SUN, they are still reviewing the recommendations of the advisory panel, and like the other unions, will be monitoring how the changes will be rolled out in the coming weeks and months.
“Right now, our main focus is on our patients. During all this transformation, it will be important that we can protect the patients from all this upheaval,” said Tracy Zambory, president of SUN, adding they have only seen the initial high-level report. The “proof of the pudding” will be how the changes are manifested in the day-to-day operations at the local level, she said.
SUN hopes that the main concern won’t be the budget for health care, “but that we are looking at what’s best for the patients of Saskatchewan. We are quite unique and have a unique perspective, in that we are the largest direct care providers in the system. We only have one chance to get this right, to make sure we are having communications with all the stakeholders, that we have a health care system that is vibrant and that no patients are left behind.”
“We recognize the changes we are recommending are significant. The advisory panel encourages the provincial government and senior leaders within the health system to take the time required to ensure a smooth transition,” said advisory panel member Dr. Dennis Kendel.
Work on implementation planning has begun at the Ministry of Health. A comprehensive plan is being developed that will work through critical implementation details, including legislation, governance, financial and change management considerations. The date the new provincial health authority comes into being has not been determined yet, but it is anticipated to occur by the fall of 2017.
