Results of Tories’ desperate attempt to right health-care wrongs won’t be in for years By: Tom Brodbeck Posted: 7:00 PM CDT Friday, Mar. 31, 2023

Nothing moves fast in health care. Cash infusions to hire more staff, expand health facilities and invest in new technology rarely produce measurable results right away.

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Nothing moves fast in health care. Cash infusions to hire more staff, expand health facilities and invest in new technology rarely produce measurable results right away.

Prospective employees have to be recruited and trained, if they’re available at all. Requests for proposals have to be written, issued and bid on. Construction and expansion projects are invariably delayed.

By the same token, it takes months and years for the full impact of funding cuts and changes to human resource policies to wind their way through the health-care system. Budgetary restraint is slow to trickle down to the front lines. When it does finally hit, it usually lands with a thud.

That’s what is happening in Manitoba’s health-care system right now, as evidenced by fresh wait-time data released this week. Measures to counteract that through recent spending announcements probably won’t produce results for at least a few more years.

Measures to counteract the problems plauging the health cares system through recent spending announcements probably won’t produce results for at least a few more years. (Mikaela MacKenzie / Winnipeg Free Press files)

Cuts to acute-care facilities and the reorganization of Winnipeg hospitals, implemented shortly after the Progressive Conservative party formed government in 2016, had a rippling effect throughout the health system. The harm caused by staffing shortages on medical wards, in emergency departments and in operating rooms has had a compounding effect. It has led to delayed care, which usually results in more acute illness and requires more intense medical intervention down the road. That comes at a hefty cost — to patient health, quality of life and to hospital budgets.

The COVID-19 pandemic exacerbated all of that. But the domino effect triggered by the Tories’ health reforms occurred long before the pandemic hit.

Those reforms are the main reason emergency-room wait times continue to grow. Staffing shortages on medical wards caused by budget cuts mean fewer beds are available for admitted patients in ERs. As a result, the length of stay for admitted ER patients continues to grow, which drives up overall wait times.

The latest ER data released this week by the Winnipeg Regional Health Authority shows the median wait time in February was 2.77 hours (half of patients wait longer, half wait less), up slightly from 2.72 hours the previous month. It was 2.18 hours the same month last year and 1.5 hours in February 2021. ER wait times have nearly doubled.

A shortage of hospital staff also limits operating-room capacity. Even if there are enough surgeons and support staff to perform more surgeries, output is restricted by a lack of staffed medical beds needed for in-patient recovery.

That also has a compounding effect. Delays in surgery often cause patients’ conditions to deteriorate, which drives up the number and duration of future hospital stays and further restricts surgical capacity.

It’s partly why surgical wait times continue to grow. After showing some signs of progress in the fall, the median wait time for hip-replacement surgery grew again in January (23 weeks, up from 16 weeks in December). Knee-replacement surgery was also up in January (25 weeks from 23 weeks the month before).

A shortage of hospital staff also limits operating-room capacity. (Mikaela MacKenzie / Winnipeg Free Press files)

The problem: there isn’t enough capacity in the system to clear the pandemic backlog (still well over 1,000 cases for hips and knees) and meet the growing demand for orthopedic surgery, which is increasing by an estimated five per cent a year. As a result, wait times for hip and knee surgery were longer in 2022 than in 2019, the year before the pandemic.

Perhaps the most damaging aspect of the Tories’ health-care reforms is the impact they’ve had on front-line professionals. Staff shortages from hospital budget cuts have caused severe worker burnout, which has triggered mass resignations and early retirements. That, in turn, has led to more shortages and worse burnout. The fallout from that appears to be getting worse and no one really knows when it’s going to peak.

It’s the main reason Health Sciences Centre is having trouble staffing its sexual assault nurse examiner program.

Money alone won’t fix these problems. But increased health-care spending in the Stefanson government’s 2023 budget (funded largely through record increases in federal transfer payments) is a start. However, it likely won’t have an impact on wait times for several years. It will take that long to reverse the damage caused by budget cuts and severe government mismanagement.

tom.brodbeck@freepress.mb.ca