Cure for health-care system complicated, critical, undefined

Opinion

Hey there, time traveller!
This article was published 15/11/2023 (661 days ago), so information in it may no longer be current.

Health Minister Uzoma Asagwara says it will take time for the NDP to clean up the health-care mess left behind by the former Progressive Conservative government. A lot of time. Probably years.

The rookie health minister made the statement to the Free Press this week, while commenting on the case of 89-year-old Barney Charach, who recently spent six days on a stretcher in the emergency room hallway at Grace Hospital in Winnipeg.

“These are conditions that were largely ignored by the previous (Tory) government and, unfortunately, Manitoba families continue to deal with the consequences,” said Asagwara.

The NDP, sworn into office less than a month ago, after winning the Oct. 3 provincial election, has not specified when — or how — it plans to “fix” health care, nor offered a definition of what that even means.

Will the health-care system be “fixed” when patients like Charach no longer have to wait days in an ER hallway for a hospital bed? Will it be fixed when a patient deemed sick enough to be admitted to a medical ward gets a bed right away or at least within a few hours?

Will the damage caused by the previous Tory government be repaired when median ER wait times (now at record highs) are cut in half, to levels they were at in 2017, prior to the consolidation of hospital operations in Winnipeg?

Will the system be fixed when wait times for surgical and diagnostic procedures are in line with national benchmarks?

The new government hasn’t said, probably because it doesn’t want to commit to any specific, difficult-to-attain targets. The NDP was astute enough during the provincial election campaign not to make such promises. A soothing, but vague, pledge to “fix” health care (and reopen three ERs,) was all it needed to win.

Still, the NDP will have to show progress at some point.

If, for example, a year from now, ER wait times and the length of time admitted patients are waiting for a hospital bed haven’t improved (or get worse), the NDP will rightly face criticism. If there is little to no progress on wait times generally, including for surgical and diagnostic procedures, two years from now, support for the NDP will soften.

Fixing health care was, after all, the party’s main election pledge. It put almost all of its electoral eggs in that basket.

So, how can it make good on the main campaign pledge?

Most of it will require significant recruitment and retention of health-care staff. There’s no way around it. The main reason wait times are so much worse than five or seven years ago is because there are far fewer front-line staff in the system, thanks mostly to a long list of strategic errors committed by the former government.

It will take time to return to those staffing levels. No one knows how long because there is a national shortage of health-care professionals. Either way, it will be measured in years, not months.

Staffing isn’t the only challenge. There are systemic problems in health care that need fixing.

Take the case of Charach, the man who waited six days in an ER hallway.

He couldn’t get a bed on a medical ward because of what front-line staff call “access block.” It’s another term for hospital overcrowding, when there are not enough staffed beds and resources in the system to meet patient demand, nor ensure patients move through the system efficiently (which hospital analysts call “patient flow”).

The cure for that is complicated. Hiring more staff and opening more beds alone won’t solve it. Absent other changes, new beds would simply fill up and people like Charach would still be languishing in ER hallways.

Reducing access block requires systemic changes to ensure patients aren’t warehoused in hospitals longer than necessary and that supports are available (home care, personal care homes, palliative care, etc.) to speed up patient flow through hospitals.

As it turns out, Charach didn’t even need a bed on a medical ward. Following an evaluation and a period of monitoring, what he needed were resources to recover at home with the right staffing and equipment. He got that eventually, but not until a Free Press reporter made inquiries.

It took a call from a reporter to light a fire under someone to get Charach the supports he needed to return home. How many other patients are in that situation? It’s an example of something the new government should address immediately.

There are other short-term solutions to help solve access block in hospitals. Asagwara and the NDP would be well-advised to consult with those on the front lines to find them.

It’s something the former government was not very good at.

tom.brodbeck@freepress.mb.ca