Mammoth mission: Kinew directs health minister to repair, repopulate broken system

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This article was published 26/10/2023 (729 days ago), so information in it may no longer be current.

Manitoba Premier Wab Kinew directed Health Minister Uzoma Asagwara to get a handle on runaway emergency-room wait times and immediately begin hiring 1,000 promised health-care workers in a mandate letter released Thursday.

“Your goal is to make it easier for every Manitoban to access health care at every level no matter where they live,” Kinew wrote to Asagwara in a letter dated Oct. 19, one day after the Union Station MLA was sworn into cabinet.

Asagwara was handed four “immediate priorities” that include launching a health human resources strategy and reducing ER wait times.

Kinew instructed the health minister to achieve the latter by adding beds to all major hospitals with emergency departments, opening five new minor illness and injury clinics and opening an ER at Victoria Hospital.

“Your task starts with retaining and recruiting health-care staff by changing the culture in health care so frontline workers know their voices are heard and their work is valued,” Kinew wrote.

St. Boniface Hospital emergency room Dr. Alecs Chochinov applauded the government for recognizing the need for more staffed beds at the province’s acute-care hospitals to address patient flow.

“Increasing hospital capacity directly impacts emergency department functioning and it probably is the thing that most directly impacts it in a positive way,” he said.

However, the veteran physician who co-led the 2017 wait times reduction task force’s emergency department committee said the work cannot stop there. A “demand-driven overcapacity plan” is needed so the entire health system can stretch with surges, Chochinov said.

Last month, one-third of patients who went to the Health Sciences Centre emergency room left without seeing a doctor. In 2019, just 13 per cent of patients left without being seen.

“Your task starts with retaining and recruiting health-care staff by changing the culture in health care so frontline workers know their voices are heard and their work is valued.”–Premier Wab Kinew’s mandate letter to Health Minister Uzoma Asagwara

At St. Boniface’s ER, 22.5 per cent of patients left without seeing a doctor and 15.7 per cent left the Grace Hospital ER last month.

“No parts of the system can say, ‘Sorry, I’m too busy,’” said Chochinov, who also chairs the Canadian Association of Emergency Physicians’ task force on the future of emergency care.

“We really depend on people upstream and downstream to go over capacity and it’s going to be really, really hard.”

In the mandate letter, Kinew reminded Asagwara of the NDP’s commitment to “take better care of people — the health care workers that care for us and the patients they serve” and that the NDP is a “listening government.”

Chochinov said it’s in the government’s interest to consult the front line before moving on its promises to improve access to emergency care, including the reopening of three Winnipeg ERs.

People working in emergency medicine and nursing want to contribute, and policy-makers may be surprised by what they hear, he said.

“Sometimes the answer to what ails the emergency department, isn’t in the emergency department,” the doctor said.

“The emergency department manifests all the ills of the system… we’d probably tell them look at the root causes and don’t treat the symptoms.”

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Increasing capacity, driving down escalating wait times and adding the necessary staff will be a hard slog, he said.

“We have to give this government an opportunity to take the time that it needs, but it’s got to start with making sure the people in the emergency community trust that the plan is the right plan,” Chochinov said.

He also expressed skepticism the NDP’s promised “neighbourhood illness and injury clinics” will reduce ER wait times, as stated in the mandate letter. Low-acuity, ambulatory patients are not the underlying cause of “bed block” in ERs, he said.

“That is much more complex, much older, much more disabled, much sicker patients who lie and languish for weeks (on stretchers),” Chochinov said.

A spokesperson for Doctors Manitoba described the mandate letter as reassuring.

The professional association’s president Dr. Michael Boroditsky was in surgery and unavailable for comment Thursday.

“We have offered physicians’ support and advice as they begin implementing a very ambitious plan to fix health care,” the spokesperson said in a statement.

“The emergency department manifests all the ills of the system… we’d probably tell them look at the root causes and don’t treat the symptoms.”–St. Boniface Hospital emergency room Dr. Alecs Chochinov

Several of Doctors Manitoba’s recommendations to improve health care were included in the letter, the spokesperson noted. And while aggressive, the government’s promise to hire 400 physicians over five years is achievable with a “comprehensive and focused” training, recruitment and retention plan.

Doctors Manitoba was also asked by government to provide its opinion on how to open new minor illness and injury clinics, the spokesperson said.

“We believe that with additional provincial support and a fair and competitive selection process, many doctors will be interested.”

The NDP’s promises to cut health-care bureaucracy were not explicitly stated in the mandate letter. It did not mention surgical and diagnostic backlogs caused, in part, by the COVID-19 pandemic.

“The government will take decisive action to empower and uplift our health care workers and change the culture of the health bureaucracy,” government spokesperson Naline Rampersad said in a statement.

On Thursday, the government did not offer a timeline for the release of its health human resource strategy or the details of how it will hire 1,000 additional staff.

The strategy remains a work in progress and is being given the diligence, care and consideration that is required, Rampersad said.

danielle.dasilva@freepress.mb.ca