Stefanson government exits with one final health-care blunder

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This article was published 17/10/2023 (770 days ago), so information in it may no longer be current.

It’s not enough that the outgoing Progressive Conservative government badly mismanaged health care over the past 7 1/2 years, including closing hospital beds, laying off staff and driving up wait times.

In a final act of incompetence before handing over the reins of government to the NDP, the Tories cut funding to a valuable community paramedic program.

As of Sept. 30, three days before the Tories lost the Oct. 3 provincial election, funding for two community paramedic vehicles operated by the Winnipeg Fire Paramedic Service ended, as reported by the Free Press Tuesday.

The funding was originally allocated to help boost community paramedic services during the COVID-19 pandemic. But because Winnipeg has been chronically short of ambulances and patient demand on hospitals continues to grow, community paramedics — staffed by specially trained advanced care paramedics — have helped relieve stress on the heath-care system post-pandemic.

The program has allowed more patients to be treated at home, reduced the need for ambulance transports and cut down on emergency department visits.

Not only has it improved patient care, the program has saved taxpayers money. The savings from the program far exceeds its costs, according to a recent report going to city council next week.

“The community paramedic program not only assists the individuals seeking care by identifying the most appropriate resources to meet their needs (avoiding ER attendance), it also builds capacity for the WFPS emergency response resources,” the report says.

Despite the obvious benefits, the Tories have allowed funding for the program to lapse. It’s exactly the kind of penny-wise and pound-foolish decision-making Manitobans have seen from the PC government, whose time in office officially ends Wednesday when a new NDP cabinet is sworn in.

The cut to the community paramedic program is a frustratingly dumb decision.

Manitoba now has five layers of bureaucracy in health care — including Shared Health, which funds the community paramedic program. Despite that, none of the high-paid bureaucrats working in the system seem capable of making the obvious, evidence-based decision that this program improves patient care and reduces costs.

As a result, the city now has to go through a senseless and lengthy municipal services review process to convince the province that keeping the two community paramedic vehicles is worth the money.

Not everything in health care is an easy fix. The system can’t be improved solely by throwing more money at it. Reform is needed in many areas.

However, there are some low-hanging fruits that don’t require additional studies. This is one of them. The net benefits from community paramedic services are so obvious, the province should be expanding the program.

It provides supports to those who make multiple trips to ERs, so-called “frequent users,” accepts referrals for at-risk people with chronic diseases, provides patients discharged from hospitals with followup care and does secondary medical screening over the phone for patients who have accessed 911 for low-acuity medical issues.

Community paramedicine has also been an effective resource for screening HIV patients. The program uses more rapid HIV screening tests than any other program in Manitoba, according to the city report. It also helps connect patients diagnosed with HIV with ongoing care, including life-saving medication.

“It is unknown exactly how many cases of HIV they have prevented by stopping the spread, but it has been estimated that it is approximately 10 individuals per identified case,” the report says. “The focus on identification and prevention has saved tens of millions of dollars, and more importantly has offered clients an improved level of health and well-being.”

Cutting funding for this program, which will reduce the number of community paramedic vehicles from four to two, is absurd. It’s a stark example of how too much bureaucracy in the system has stifled front-line decision making in health care.

Shared Health’s email response, when asked by the Free Press whether it’s considering restoring funding to the program, sums it up perfectly: “(Shared Health) recognizes the value of community paramedicine in Winnipeg and is working closely with the Winnipeg Fire Paramedic Service on ensuring the design and funding for their community paramedicine programs continues to meet the needs of the populations it serves.”

The response is meaningless. It’s an insult to the taxpaying public. The spokesperson who responded did not answer whether funding would be restored, nor what impact the cut would have on the demand for ambulances or emergency rooms.

This is one of the main problems in health care. The bureaucracy is set up as a faceless administration that is not accountable to the public. It exists primarily to provide political cover for politicians, not to make smart, evidence-based decisions to improve patient care.

The incoming NDP government has promised to reduce the layers of bureaucracy in health care to allow more decision-making at the front lines. Manitobans should hold them to that.

This funding cut is a perfect example of why Manitoba needs fewer bureaucrats in the system and more health-care professionals on the front lines.

tom.brodbeck@freepress.mb.ca