By Greg Nikkel
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.”
Sun Country Health Region’s CEO Marga Cugnet was able to have input to the advisory panel, along with the province’s other CEOs, and she said the work that all the regions have been doing in the last few years will help with the new single health region, such as standardization of services and efficiencies in health care.
“I can see some advantages to dealing with some things with one board. There will be challenges, as for example, our region has always had community advisory groups. That’s something the new board will have to look at,” said Cugnet, noting there are more options than having the board drive out to communities to hear their concerns.
Cugnet pointed out that the need to provide quality health care to all residents will not change, and added, “Some people are worried about what changes will come about. There are no plans so far to reduce services. They might combine services … but it’s too early to comment on that. They haven’t developed the transition plan yet.”
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).
Cugnet said the ministry is now recruiting personnel for the transition team, to help move the province forward to one health region, noting the new board will have just one CEO.
“We certainly would have the opportunity to bid for that position. Other than that, it’s too early to see what the new board will look like. They will still need middle management, I would think,” said Cugnet, adding she is hopeful that those who are currently serving in vice-president positions with the health region will be able to continue having a role to play under the new administration. They won’t know, however, until they have seen what the new organizational structure for the provincial health authority will look like.
Meantime, Cugnet noted that the Sun Country board will continue to operate the health region’s facilities as normal, including drawing up a budget for the 2017-18 fiscal year.
“Change is scary for many people, but it’s also an opportunity for improvement of health care services in Saskatchewan,” said Cugnet.
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.”
The province’s move to consolidate health regions is going to be closely monitored, added Sandra Seitz, president of CUPE Local 5999.
“One of the concerns is how all the changes will affect the delivery of services for patients, so we’ll be paying close attention to those areas,” said Seitz, adding among their concerns also are how rural communities are going to be affected by this major change, and whether they will have any voice on such a large board.
These concerns were echoed by Campbell. “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, and currently about 1,600 health care workers under CUPE in the Sun Country Health Region, 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.”
SUN has a total of 124 registered nurses (RNs, RPNs) and Nurse Practitioners (NPs)) in the Sun Country Health Region.
“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.
