Fear of closure drove rural MD shortage

Report proposed shutting up to 16 ERs

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A fear of permanent emergency room closures that has left rural communities struggling to recruit staff for years was well-founded, as new documents obtained by the Free Press show provincial health officials proposed closing as many as 16 rural sites four years ago.

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A fear of permanent emergency room closures that has left rural communities struggling to recruit staff for years was well-founded, as new documents obtained by the Free Press show provincial health officials proposed closing as many as 16 rural sites four years ago.

Now the province is under increasing pressure to reveal its plans to overhaul health care outside Winnipeg.

“We’re definitely concerned with it, there’s no doubt,” said Gilles Guertin, reeve of the municipality of Norfolk Treherne, where the local emergency department has been temporarily closed since April.

The emergency room at Carman Memorial Hospita was one of the 16 facilities proposed to be closed as part of the Health System Transformation Program, according to the Shared Health document. (Fred Greenslade / The Canadian Press files)

The emergency room in Treherne — 130 kilometres west of Winnipeg — was one of the 16 facilities proposed to be closed as part of the Health System Transformation Program, according to the Shared Health document.

The others are in Morris, Melita, Shoal Lake, Carman, St. Pierre-Joly, Swan Lake (which closed), Glenboro, Roblin, Beausejour, Teulon, Carberry, Deloraine, Boissevain, Arborg and Ashern — many of which are in areas held by Tory MLAs.

To date, the proposal has not been acted upon.

Guertin said he wasn’t surprised to learn Treherne was on the chopping block at one point; however, the reeve said he’s been assured by regional health officials that they’re looking for staff to keep the emergency department open.

The COVID-19 pandemic likely forced officials to step back from permanent closures, Guertin said.

“COVID taught a lot of people how this kind of stuff really needs to be examined before you start closing a hospital,” he said, adding the municipal council will continue to advocate for local health services.

“What is the long-term plan? I have no idea. We’re certainly not being informed about it. All we can do from a municipal perspective is to keep pushing,” Guertin said.

The province has not shared the specifics of how its Clinical and Preventative Services Plan will affect rural health care.

However, the CPSP plan, released by Shared Health in 2019, noted 16 rural emergency departments had less than 1,000 visits in 2016-17, and recommended some emergency departments be converted to urgent care centres, collaborative emergency centres, or closed outright.

The next phase of the reforms is expected to take aim at rural health care early in 2023.

Currently, three of the emergency departments listed in the planning document are temporarily closed and most others have very limited physician availability or hours. The emergency room at Lorne Memorial Hospital in Swan Lake closed in March 2021 owing to a doctor shortage.

While the list of proposed rural emergency department closures was put together years ago, under then-premier Brian Pallister, Doctors Manitoba president Dr. Candace Bradshaw said her colleagues expect significant changes to be made to rural hospitals.

“Everyone knows there is a list somewhere, and that causes a lot of distress for physicians, their patients, and rural communities,” said Bradshaw. “By keeping that list secret, a growing cloud of uncertainty has been hanging over rural hospitals for several years now, and this is making it more difficult to recruit and retain doctors in those communities.”

Amid a record number of repeated, temporary closures of rural hospitals and emergency departments, certainty and engagement from the provincial government is needed.

The threat of consolidation has been a significant source of uncertainty for rural community leaders, Association of Manitoba Municipalities president Kam Blight said.

“It’s the fear of the unknown,” he said. “It’s hard for municipalities to go forward and plan and to attract investment or residential growth without proper health-care services in their region.”

The association has repeatedly urged the government to reveal its plans, but without clear direction from the province, the ability of municipalities to attract economic investment and people has suffered, Blight said.

“We need action to be taken now,” he said. “We need answers today.”

A timeline for proposed rural emergency department and emergency medical service closures, replacements and upgrades, as published in a Shared Health planning document obtained by the Free Press.

So far, rural municipal leaders have not been included in conversations about possible changes, but they want to be, Blight said.

“There has been a trend towards centralization of services and that definitely is concerning,” he said. “If the overall plan was unveiled… that would be very helpful rather than allow these one-off closures.

“We just want to be consulted,” he said.

A spokesperson for the provincial government insisted Thursday it is working with communities to keep rural emergency departments open.

“At no point since our government took office has there been a consideration to permanently close any rural emergency departments,” the spokesperson said in response to the Shared Health document that lists 16 site closures.

“As part of the Clinical Preventive Services Plan, our government has committed $812 million — the largest single health-care commitment in Manitoba’s history — to improve rural and northern healthcare,” the spokesperson said.

To date, the plan includes a new hospital in Portage la Prairie, Neepawa, a new emergency room in Dauphin, and additional beds to be added in five other communities.

Health Minister Audrey Gordon said more details about the next phase of the transformation plan will be released early next year. The minister said she was unaware of a proposal to close 16 emergency departments.

“We are looking at how services flow throughout rural and northern communities and we’re going to continue with our transformation,” Gordon said. “It’s all about… providing patient care and what makes sense.”

Asked if she would promise to keep all rural emergency departments open, Gordon said she wants to ensure services are available to Manitobans regardless of where they live.

“Our focus is to keep services open in communities and to get health professionals into those locations so that services can remain open,” Gordon said.

NDP Leader Wab Kinew said communities should be concerned about possible closures.

“The ERs that are on this closure list, I think it’s very telling that some of them have been experiencing temporary closures recently,” he said. “It’s very clear that the PCs are moving in this direction.”

— with files from Tyler Searle

danielle.dasilva@freepress.mb.ca

Danielle Da Silva

Danielle Da Silva
Reporter

Danielle Da Silva is a general assignment reporter.

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