Reality check timely

Enlarge Image

(DALE CUMMINGS/ WINNIPEG FREE PRESS)

Faith-based hospitals and nursing homes need a reality check -- they operate on public funds and taxpayers should be able to judge if they do so appropriately. That means salaries and other remuneration they pay to CEOs must be posted publicly.

But the 13 hospitals and nursing homes affected by government amendments to the Regional Health Authorities Act have reason to complain -- Health Minister Theresa Oswald waited until after the amendments were passed before declaring her intention to consult with affected health centres.

The amendments, which have not yet been proclaimed into law, legitimately assert the province's authority over health-care planning. The province, through the Health budget, fully funds the medical services provided in hospitals and nursing homes and in the 1990s, established regional health authorities to co-ordinate planning and delivery of those services.

Back then, the health centres owned and operated by religious organizations balked at the imposition of provincial authority. They were allowed to continue to operate under special agreements that recognized their independent boards.

The new amendments, however, would essentially scrap the vestiges of that autonomy. Bill 6 will clip the authority of the 13 health centres, including St. Boniface and Ste. Rose hospitals and the Misericordia Health Centre, to hire executives.

The province will regulate the use of any surplus a health centre has at the end of the year -- an entirely legitimate exercise of funding power. But the amendments would also control the use of revenue from operations such as parking fees and gift shops, or fundraising campaigns for development plans. Development plans that involve operating budgets must align with regional plans, but no health authority should butt into a health centre's plan, for example, to build a rooftop garden to enhance patient and visitor experience.

Where hospitals once could raise funds to purchase expensive equipment such as CTs or MRIs, they now must ensure they fit into the regional plans for operating budgets.

Prior to the creation of regional health authorities in the 1990s, hospitals largely decided what programs and services they would offer. Smaller hospitals tried to be everything to everyone; large ones competed to dominate in expensive, specialized services. This model of health care did not serve patients well and did not use tax dollars efficiently.

Empire building has evaporated with regionalization. Much of what Bill 6 will do is done now, but by co-operation. To a degree, Bill 6 legislates the status quo.

Faith-based organizations have a legitimate fear their ability to hire appropriate leaders will be nipped by legislation that prescribes conditions of employment. Ms. Oswald will have to show the organizations how her legislation allows them the latitude to select CEOs who understand what makes a religious-based health centre different from others.

Ultimately, the province could exert more control over the way all health centres spend public funds by tying operating grants directly to the volume of specific services provided to patients. This would tightly restrict the use of public funds, and assert the influence of health authorities more vigorously in that exercise, while leaving some autonomy in the hands of the health centres themselves.

Republished from the Winnipeg Free Press print edition July 20, 2012 A12