Health promises in NDP’s throne speech just slogans without enforcement

The Kinew government rolled out an ambitious list of health-care commitments in Tuesday’s throne speech: a patient safety charter embedded in law, legislated staff-to-patient ratios, and an end to mandatory overtime for nurses.

On paper, those are all excellent ideas. In practice, though, they mean nothing unless they’re enforced.

Based on Premier Wab Kinew’s answers Tuesday, enforcement remains the giant question mark at the centre of this health-care agenda.

The NDP administration has spent its first two years in office arguing the health-care crisis is primarily one of staffing and culture. They may be right.

Chronic vacancies, high turnover, and a demoralized workforce have been hallmarks of the system for years.

Kinew says his government has made progress — by recruiting 285 net new doctors, adding nurses, boosting home-care staff, and reopening ERs that were closed by the previous Tory government.

Fair enough. More staff and a better work environment are necessary ingredients for rebuilding the system. But they’re not sufficient. And legislating “rights” for patients — or rules for hospitals — won’t magically fix the problems, either.

That’s the problem with the throne speech pledges. The government is promising laws designed to guarantee better patient care, but without saying what happens when hospitals or regional health authorities fail to meet them. So far, Kinew’s explanations are thin.

Take the patient safety charter. The idea sounds fantastic: enshrining in law a Manitoban’s right to good health care. But what does that mean?

Does a patient who waits 12 hours in an ER have recourse? Can someone who doesn’t see their family doctor for months because there aren’t enough in their region file a complaint that triggers an investigation? If a hospital routinely runs short-staffed, does someone get penalized? Fired?

When asked Tuesday what consequences hospitals or regional health authorities would face if they fail to comply with the charter or the staff-to-patient ratios he plans to legislate, Kinew would only say we have to wait for the legislation.

That’s not good enough. When a government legislates standards of care, it should be ready to say what happens when they’re not met. Otherwise, they’re not standards — they’re political slogans.

We all understand throne speeches rarely include detailed information. They’re meant to outline, in broad strokes, a government’s legislative agenda.

However, the premier should be able to say whether these rules will be enforceable, or whether they’ll be mere guidelines — ones in which patents have no real recourse.

To his credit, Kinew did commit to at least one “hard law” — ending mandatory overtime for nurses. Under proposed legislation, mandatory overtime will no longer be an option for hospitals, the premier said.

Regional health authorities have been given the staff they need and must now deliver results, said Kinew, including complying with an end to mandatory overtime.

Those are bold words, but it’s still unclear whether staffing levels are sufficient.

Some areas are improving, yes. But that’s a long way from saying the staffing crisis is solved to the point at which the government can outlaw mandatory overtime.

Either way, Manitoba needs a clear and transparent framework that ties legislated obligations to real oversight and real consequences. Otherwise, these become aspirational principles, not laws.

The government deserves credit for many of its health-care initiatives in the throne speech: expanding pharmacists’ scope of practice is smart policy, ending sick notes is overdue, digital health cards and an online patient portal will make navigating the system easier, investments in paramedic training, new ER construction, and returning birthing services to communities such as Norway House are tangible improvements.

However, even good ideas don’t excuse the lack of clarity on the core promises the government made Tuesday — promises that go to the heart of whether the system can deliver safer, more consistent patient care.

Legislated staff-to-patient ratios, for example, are enormously complex. Ratios only work if the province is willing to put resources behind them and if hospitals face real consequences — financial or otherwise — for failing to comply. If Manitoba’s ratios become aspirational targets rather than enforceable rules, they won’t meaningfully change workloads or patient outcomes.

The same goes for a patient safety charter. If the province wants to enshrine rights, it should also enshrine mechanisms for complaints, investigations, and remedies.

The premier is right about one thing: patients shouldn’t be treated in ERs staffed by exhausted nurses who are working double shifts. They shouldn’t have their safety depend on whether their hospital happens to be well run or chronically short-staffed. If the government wants to legislate standards, it has to be willing to police them.

The throne speech was filled with promises that sound good and may very well be good. But without teeth, enforcement, and transparency, they risk becoming exactly what Manitobans have heard for years: more health-care commitments that don’t change much for the people sitting for hours in ER waiting rooms or waiting months for surgeries.

The government has raised expectations. Now it has to show it can deliver — not just announce.

tom.brodbeck@freepress.mb.ca