The interim chief executive officer (CEO) for the Sun Country Health Region has finally settled into a regular work schedule, if not a regular routine.
Marga Cugnet took time out from her schedule to talk with The Mercury last Thursday. The wide-ranging discussion dealt with physician shortages, financial matters, new facility planning and implementation of some changes to the way in which health care business is conducted in the southeast part of the province.
Cugnet accepted the role of interim CEO last month, following the dismissal of former CEO Cal Tant after he had lost the confidence of the board of directors. Tant's departure came shortly after the resignation of Hal Schmidt, the region's vice-president of finance and administration who left his post in a cloud of controversy following the release of information that indicated he had misrepresented himself and his credentials at a previous posting in Halifax. It was noted he had engaged in a questionable financial (loan) arrangement in another administrative job he held in British Columbia which he had neglected to address.
Sharon Bauche, chairwoman of the board, said she was relieved when she learned that Cugnet, the former vice-president of primary and integrated health care for the region, was willing to step up to assume the duties while Pam Hauptstein, a chartered accountant and a veteran in the Sun Country's finance department was willing to take on the tasks abandoned by Schmidt.
"There is no upheaval at Sun Country," said Cugnet. "There has been a stabilizing at the various staffing levels and it seems that Pam and I will be in these positions for awhile. I don't believe the board is rushing the process to select a new financial vice-president and CEO right now. We have a background in the region, so there appears to be a sense of everyone wanting to leave the situation as it is for awhile, before we move on," Cugnet said.
An acute care study that had been underway prior to Tant's departure has resumed and should be completed by the early part of the new year, said Cugnet.
The doctor shortage being felt in various parts of the region is now being alleviated with the arrival of two doctors in Redvers, while Carlyle has one and three more have set up practice in nearby Arcola.
"There is still a doctor vacancy in Coronach, but the doctor situation is certainly better than it was, except for Estevan. There is continual planning going on regarding the physician recruitment needs," Cugnet added.
"We are still below target for nurses, especially in the rural areas. We are recruiting now to fill specific positions. We have a group of nurses who have just retired or are ready to retire so we're getting some grads lined up," she said.
Chris Stephanie has been appointed the new manager of the Estevan Regional Nursing Home to replace Jean Piel who announced her retirement. Cugnet said the employee base is a continually moving target.
"We have shortages in the therapies department. We're losing another occupational therapist, so we'll continue to recruit in that sector of physio and occupational therapies. It gets a bit tricky because for OTs, there is no Saskatchewan school, we have to recruit in Manitoba or Alberta and often those people have roots. They eventually want to return to there, so that means retention is a challenge."
Cugnet said Sun Country's bursary programs have helped the recruitment process a great deal.
While it was good news to hear that one new doctor was about to start work in Estevan, Cugnet said there was even more heartening news that perhaps another two were contemplating setting up in the Energy City within the next few months.
Cugnet said the recent meeting with Estevan administrative and health care officials was beneficial for her.
"The opportunity to work better together is there. I can see the frustrations from Estevan's perspective, so we'll just have to carry our overall objective forward in a transparent manner," she said.
Doctor recruitment questions have to be ironed out since many communities in the region have taken up the challenge of finding their own doctors, while the region has its recruitment and retention committee and administration. As well, the province has its recruitment team in play. She said it is imperative that all these agencies get on the same page.
"So the City asks us what their recruitment role is supposed to be, and Sun Country then has to turn around and ask the province the same question. We don't need to overlap or gap, we need to communicate and plan."
She said one positive sign is the fact that the provincial College of Physicians and Surgeons is smoothing out the certification process by allowing incoming physicians to write their qualifying exams first, followed by orientation and assessment. She said the process for physicians who have already been screened by the World Health Organization and are part of WHO's "accepted nations" list, can now look forward to an easier track to gaining a licence in Saskatchewan.
Regarding budgetary matters, Cugnet said Sun Country is on target. While vacancies in some key positions have led to additional workloads for some, they have also translated into minor savings from a financial perspective.
"But most of our positions are being filled, and the idea is to provide the services," said Cugnet who said part of her steep learning curve has been to get brought up to speed on the files pertaining to the planning for the construction of three new long term care facilities in the region.
There was also a request coming from Estevan to have the Weyburn General Hospital's financial details broken out in a manner similar to what is required of St. Joseph's Hospital in Estevan, which is designated as an affiliate facility.
"Finance is working on that now. There will have to be follow-up discussions regarding some assumptions that will have to be made. The process isn't as easy as it may first appear because of some of the work the hospital does for the region. They will have to separate the time and work done for the region versus the time and work for the hospital alone. It isn't always comparing apples to apples, but they're working on it."
As far as regional hospital status is concerned, Cugnet said the application for consideration of a regional hospital in Sun Country has been stalled at the ministry level for a couple of years now.
She also said that the matter of subsidized housing for some health care professionals arriving in Sun Country appears to be smoothed out now.
"We were surprised to learn Estevan had an apartment set aside for that purpose," she said, noting that the subsidy in Estevan was being covered by a local committee while in Weyburn two apartments were being subsidized by the health region.
That disparity has been addressed and an ongoing subsidy package has been made known to the local community.
Another proposal for a CT scan and other imaging concerns are also on her plate, she said. She said Internet images on a safe system are part of the plan, along with patient image archival services and more efficient ways to relay images to radiology services.
In other matters, Cugnet said the releasing time to care program that was initiated in Weyburn is now starting at St. Joseph's, which will introduce more time-saving practices to the hospital.
"Because of my previous position, I had a pretty good idea of what the CEO had to do, but it is a challenge, especially the new long term care facilities projects. We have a project manager in place though, so I'll be relying on him for those items," she said.
Cugnet has just returned from a patient safety conference and had completed a lot of her travel commitments around the region, and, she said, was settling into the job with a sense that the immediate tasks had been addressed. She said it was now time to move on with mapping out future plans and tending to the regular business affairs of the health region. The region delivers health care to about 60,000 people within a budget of about $127 million.
