Winnipeg physician vows to crusade against ‘endless buck-passing’ that puts patient care at risk By: Carol Sanders Posted: 7:00 PM CDT Tuesday, May. 9, 2023

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A longtime Winnipeg physician is on a mission to cure Manitoba’s health-care system of its bloated bureaucracy rife with “endless buck-passing” that he says jeopardizes patient care and sends doctors fleeing from the province.

“The obstacles they put in place, doing this endless buck-passing, undermines the public health-care system,” Dr. Dan Roberts said in an interview.

Roberts, the acting head of neurology at Health Sciences Centre, wrote an opinion piece that was published in Tuesday’s Free Press. He described the bureaucratic runaround that could drive away a neuro-ophthalmology specialist, who had planned to practise in Winnipeg this July.

“The young doctor is deeply frustrated and is now looking for another job,” Roberts wrote in the piece that explained the delays in getting Shared Health approvals for the costed and vetted office support and equipment required by the doctor, a specialist in brain-related visual problems.

The request has been bumped to the diagnostic and surgical recovery task force for further review.

“This kind of situation, repeated again and again, illustrates the profound dysfunction that has been engineered into our health-care system by this government,” the outspoken doctor wrote.

A doctor who echoed Roberts’ concerns, and agreed to speak on condition of anonymity, said the governance structure of Shared Health “is completely a mess,” and the diagnostic and surgical task force has added another layer of bureaucracy.

“If you need funding for something, do you go to the task force? Do you go to Shared Health? Do you go to your own (health) region to pay for the task force? Do you go to your own region to go to Shared Health?” he asked. “It’s an absolute mess. You have to get rid of some layers and you have to fix the governance: who reports to whom?” he said.

Health Minister Audrey Gordon told reporters after question period Tuesday that she met with Shared Health’s new CEO, Lanette Siragusa, Tuesday morning and laid out her government’s priorities.

“One is to ensure there is a streamlined process for proposals and new ideas that come forward to be dealt with as quickly as possible.”

Roberts said he’s going public with his concerns because they’re no longer being addressed within the system and he doesn’t think Siragusa or any one person can change it.

“Before, we could always work within the system,” said Roberts. “There was transparency. You could have resolution to an issue that made some sense.”

Health-care system mired in red tape

That’s no longer the case, said the doctor, who no longer practises clinically but is intent on fixing his department and doesn’t plan to retire.

“With these people, there’s nothing,” he said of the bureaucrats and political appointees in charge.

“There are lots of issues where delays have affected programs or the initiation of solutions to problems,” said Roberts.

In 2021, he spoke up about the departure of a brain surgeon hired to establish a groundbreaking epilepsy program. Dr. Demitre Serletis told the Free Press at the time that he decided to leave Manitoba with his family after five years because the province failed to fulfil its promise to fund the program.

Roberts pointed to other delays.

It took nearly a year to roll out the program after Gordon announced the province would cover the upfront costs of insulin pumps to Type 1 diabetics aged 18 to 25.

“There are lots of issues where delays have affected programs or the initiation of solutions to problems.”–Dr. Dan Roberts

A proposal had been established to implement it, but there were “interminable delays” caused by Shared Health revisions “until they came back to the one they already had,” Roberts said.

The doctor slammed what he called the “four silos” of the health care system that he says get in the way of patient care: Shared Health, Manitoba Health, the Winnipeg Regional Health Authority and the diagnostic and surgical recovery task force that was set up to address pandemic backlogs.

“They’re basically shunting issues back and forth. You don’t get resolution,” said Roberts.

Only proposals that involve private care don’t appear to get the runaround or much scrutiny, he said.

For example, a proposal to deal with the backlog of cancelled endoscopies, by offering them on Saturdays at Seven Oaks Hospital, was made nearly 18 months ago. After jumping through hoops, it was approved in October, but expired in March and has since limped along on an extension, waiting to see if it’s renewed.

The request for service agreement to perform 2,500 endoscopies at the Manitoba Clinic, meanwhile, was approved with little scrutiny or delay, he said.

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The task force, Roberts said, “seems to be taking its direction from the government and looking for opportunities to privatize.”

The health minister denied that Tuesday, claiming no proposal — public or private — is given “preferential treatment.”

“There’s a process, regardless of where the proposal is initiated from within the health system whether they’re internal or external,” she told reporters.

“There’s a process and all the proposals are going through that process. Due diligence is being done to make sure the proposal meets the needs of our health care system,” Gordon said.

She said she was aware of Roberts’ request concerning the neuro-ophthalmologist who is expected to start in July.

Letters, April 25

“There have been many conversations leading to the finalized proposal being submitted to the diagnostic and surgical recovery task force,” she said. “It’s under review and a decision is forthcoming.”

In question period Tuesday, NDP Leader Wab Kinew mentioned Roberts’ opinion piece and asked the premier why her government puts private business over the health system.

“What’s important to us on this side of the house is that Manitobans get the surgeries they need when they need them,” Stefanson said. “We are making progress,” she said as she thanked task force leaders Dr. Ed Buchel and Dr. Peter MacDonald.

carol.sanders@freepress.mb.ca

Carol Sanders
Legislature reporter

Carol Sanders is a reporter at the Free Press legislature bureau. The former general assignment reporter and copy editor joined the paper in 1997. Read more about Carol.

Every piece of reporting Carol produces is reviewed by an editing team before it is 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.