Exhausted health workers know ‘what’; the NDP has to explain ‘how’

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This article was published 22/11/2023 (710 days ago), so information in it may no longer be current.

This week’s speech from the throne offered abundant evidence the new NDP government is going to put enormous resources into shoring up the province’s sagging health-care system.

What the speech did not offer was any detail about getting it done.

That is not necessarily a criticism of the speech or government; throne speeches are anchored on broad expressions of intentions, with only a sprinkling of specific plans.

Keeping with that tradition, there was precious little in the way of specific actions on health care in Tuesday’s speech. There were references to the addition of 10 surgical slates at the Grace Hospital and expansion of surgical capacity at Health Sciences Centre, Concordia Hospital and the Brandon Regional Health Centre.

However, these pledges were almost solely focused on the “what” and not on the “how.” And in this case, the how requires this government to somehow, some way source hundreds of new health-care professionals, particularly nurses.

Was there anything in the speech that speaks to the “how?” The closest we got was a reference to a government commitment to conduct a “listening tour” to hear directly from health-care staff about what’s going on in our tortured system.

Again, specific details of what is involved in a listening tour are hard to come by. It will apparently involve Premier Wab Kinew and Health Minister Uzoma Asagwara visiting facilities across the province. But it’s unclear what the premier and his minister will do with the knowledge they acquire.

What we do know is that the issue at the heart of a listening tour — a profound distrust of government among front-line staff — is deeply seeded in the psyche of doctors, nurses and other health workers.

In short, Manitoba’s health-care system has been hemorrhaging staff for most of the period governed by the Progressive Conservatives, which unleashed a torrent of change while showing nothing but disdain and indifference to the perspectives of those working on the front lines.

Shortly after taking power in 2016, the Tories launched a plan to reorganize Winnipeg hospitals by closing three emergency rooms and concentrating emergency medicine in the three other, more completely staffed and resourced ERs.

The idea had merit; for too long the province had been paying exorbitant costs of shuttling patients among hospitals because not all emergency rooms had access to the same roster of medical specialists. The theory was that three fully staffed ERs was better than six that were partially staffed.

The mistake made by the PC government was not spending the appropriate amount of time consulting with health-care professionals over the changes it wanted to make. Instead of bringing staff into the planning process, the Winnipeg Regional Health Authority adopted the bully tactics of former premier Brian Pallister and started making changes with the expectation staff would simply fall into line.

The consequences of this profoundly botched initiative are still being felt today.

Hundreds of highly trained professionals left the system. Some moved away, while others — notably nurses — joined private agencies where they were paid better and had more control over when and where they worked.

The tragic irony for the Pallister government was that it was forced to turn to those private agencies for help plugging holes in hospital schedules. That meant hiring back many of the nurses it had lost to the private sector at a much greater cost. Manitoba spent $60 million on private-agency nurses in the 2022-2023 fiscal year, a nearly 50 per cent increase over the previous year.

Can a listening tour heal the open wounds that exist between government and health-care workers? The organizations representing those staff are expressing cautious optimism early in the NDP government’s mandate.

The Manitoba Nurses Union said in an emailed statement the tour could be “the first step in mending the relationship between government and the people (who) staff our public health-care system.”

Doctors Manitoba said the listening tour should focus less on capturing opinions and more on a “find and fix” approach where problems and solutions are identified and acted upon with urgency.

“Fixing health care starts with listening to the people working in it, and that can’t start soon enough,” said Dr. Michael Boroditsky, the physician-advocacy organization’s president.

And Thomas Linner, head of the Manitoba Health Coalition, said the previous government made a point of ignoring the ideas of health-care workers, while targeting for retribution those who spoke up publicly about problems in the system.

“Our hope is that (the listening tour) will result in real and sustainable change for patients, families and health care professionals,” Linner said in a statement.

Put it all together, and you have a community of health-care staff — from medical professionals to support workers — that really wants to believe the NDP’s listening tour will result in meaningful change.

Listening is always a good first step when problem-solving. But listening without showing a willingness to act will be seen less as a genuine effort to repair relationships, and more as a cynical piece of political performance art.

And the people who are holding our tattered health-care system together with little more than sheer will have seen far too much of the latter.

dan.lett@winnipegfreepress.com