Time to slay five-headed health-care hydra By: Tom Brodbeck Posted: 7:00 PM CDT Tuesday, May. 2, 2023

Opinion

Hey there, time traveller!
This article was published 02/05/2023 (859 days ago), so information in it may no longer be current.

When then-Tory health minister Darren Praznik invited media to his third-floor office at the Manitoba legislature in April 1997 to unveil details about the new Winnipeg Hospital Authority, he was ecstatic about how it could improve patient care.

Two new “health authorities” would be created in Winnipeg: one for hospitals, the WHA (as it was then called), and the other — Long-Term Care Authority — for nursing homes. The idea was to centralize decision-making through government-appointed boards.

No longer would health facilities operate as silos, each with its own mandates and service-delivery priorities, Praznik explained.

Resources would be shared and decisions made to benefit the system as a whole. Health care would be “modernized” by collapsing hospital administrations and replacing them with regional health authorities.

“By bringing the management of Winnipeg’s health services under these two authorities, we will be able to maximize the use of our resources, reduce waste and duplication, pool expertise and improve the consistency and quality of patient care throughout the system,” said Praznik.

Hospital administrations were never eliminated and regional health authorities became bloated bureaucracies.

It sounded good on paper, but the promise of a more efficient, streamlined system never happened.

Hospital administrations were never eliminated and regional health authorities became bloated bureaucracies. Some steps were taken to centralize hospital operations, such as laundry, food preparation and the allocation of medical resources.

However, patient outcomes didn’t improve. In many cases, they got worse.

After a change in government in 1999, the NDP merged Winnipeg’s two health authorities into a single agency: the Winnipeg Regional Health Authority. Rural health authorities were also consolidated.

However, the new health authorities operated just like the old ones — and they got bigger. The WRHA soon occupied six floors of office space on Carlton Street in downtown Winnipeg. When it ran out of room there, it moved into its own building on Main Street.

Efforts to centralize operations continued over the years, but patient care never got any better. It got worse in many areas.

According to the Canadian Institute for Health Information, Manitoba had among the highest health-care wait times in the country in 2015.

When the Progressive Conservative party returned to power in 2016, it added another layer of bureaucracy to the system: Shared Health.

When the Progressive Conservative party returned to power in 2016, it added another layer of bureaucracy to the system: Shared Health. The new super-agency was supposed to take over operations from Manitoba Health (the provincial government department headed by the health minister) and co-ordinate services provincewide.

However, instead of replacing existing institutions, Shared Health became an added level of bureaucracy, in addition to hospital administrations, RHAs and Manitoba Health. It hired its own high-priced executives, communicators and administrators.

If that wasn’t enough, the Tories added a fifth cook to the health-care kitchen in 2021: the diagnostic and surgical recovery task force.

Its job was originally limited to reducing hospital backlogs created during the COVID-19 pandemic but, last month, the Tories expanded its mandate to “increase capacity” in the system. The task force is now embedded in government operations.

Each additional layer of bureaucracy claims to have a distinct and necessary role within the system. However their existence is based primarily on empire-building, not patient care.

Manitoba’s health-care system is now run by a five-headed bureaucratic hydra, each with its own decision-making powers and its own internal interests. It’s an administrative monstrosity, where no one really knows who’s in charge.

There are so many levels of approval required to make decisions, change happens at a glacial pace, if it occurs at all.

There are so many levels of approval required to make decisions, change happens at a glacial pace, if it occurs at all. When decisions are made, they’re often disjointed and erratically executed, owing to competing interests between government agencies.

The disastrous manner in which hospital roles were consolidated in Winnipeg between 2017 and 2019 was a perfect example.

The system needs to be blown up.

Individual health facilities need to reclaim their independence and identities. Health care needs less government and more medical professionals making decisions based on the needs of patients.

What Praznik presented 26 years ago may have made sense in theory, but centralized government control took on a life of its own. Ultimately, it added little, if any, value to patient care.

It’s time to slay the five-headed hydra.

tom.brodbeck@freepress.mb.ca

Tom Brodbeck
Columnist

Tom Brodbeck is an award-winning author and columnist with over 30 years experience in print media. He joined the Free Press in 2019. Born and raised in Montreal, Tom graduated from the University of Manitoba in 1993 with a Bachelor of Arts degree in economics and commerce. Read more about Tom.

Tom provides commentary and analysis on political and related issues at the municipal, provincial and federal level. His columns are built on research and coverage of local events. The Free Press’s editing team reviews Tom’s columns before they are posted online or published in print – part of the Free Press’s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.