Hundreds of Winnipeggers receiving physiotherapy and occupational therapy services free of charge on an outpatient basis at city hospitals will soon have to shell out their own hard-earned cash at a private clinic.
The services are being privatized as part of a cost-cutting effort by the Winnipeg Regional Health Authority, which needs to find $83 million in savings to balance this year's budget.
An untold number of physiotherapists, occupational therapists and support staff will lose their jobs -- and it's unclear whether existing private clinics will have the capacity to take on all the new patients that could be headed their way.
The WRHA plans to end the adult hospital outpatient services by mid-October, for a savings of $1.5 million by March 31, 2018, when its budget year ends.
Bob Moroz, president of the Manitoba Association of Health Care Professionals, the union that represents many of the physiotherapists and occupational therapists in Winnipeg hospitals, said "dozens and dozens" of his members are expected to receive pink slips. The union represents 181 occupational therapists and 266 physiotherapists.
"Certainly, the members that I’ve talked to that provide these services are devastated," Moroz said Wednesday. "This is removing services from the public system. It’s privatization, plain and simple, from our point of view."
Unaffected by the cuts are patients receiving specialized rehab services at Health Sciences Centre, including those attending the amputee clinic and those recovering from strokes. As well, the Easy Street Program at Misericordia Health Centre for patients requiring extensive rehab services after a life-altering health change is not affected.
Special consideration will also be made for "underprivileged Winnipeggers without private insurance," the WRHA said. But it has yet to define who will receive such consideration, except to say it will be based on income. Only HSC will provide occupational therapist and physiotherapist services to these clients.
Alana Maertins, president of the Manitoba Society of Occupational Therapists, said her organization wasn't consulted in advance of the WRHA announcement.
The society represents occupational therapists in hospitals as well as those in private practice, who will be expected to carry the extra burden once the hospital adult outpatient clinics close.
Maertins said she will write to the WRHA to express her group's concerns with the changes.
"We want to convey that occupational therapy isn’t always included in private insurance plans. So even though individuals are being told that they’re going to have to use private service, they may not have access to that," she said.
Free outpatient hospital physiotherapist and occupational therapist services are only available upon referral by a doctor. According to the WRHA, there were 733 new patients assessed for occupational therapy last year and 6,235 new physiotherapy patients. There were more than 44,000 outpatient hospital visits for these services combined in 2016-17.
Maertins said she is concerned some patients will go untreated because of the changes. Someone living in a Manitoba Housing unit near Grace Hospital, for example, who needs physiotherapy or occupational therapy may find it difficult to travel to HSC for care, she said.
"I think it’s going to cut a lot of people off, in terms of the rehab services that they would access," Maertins said.
Supplementary health insurance plans typically cover a limited number of occupational therapist and physiotherapist visits.
One private physiotherapy clinic told the Free Press Wednesday it charges $74.50 for an initial assessment and $60 for each follow-up session, which typically last about 45 minutes.
Krista Williams, the WRHA's acting chief nursing officer, said she couldn't say how many hospital staff will be laid off as a result of cessation of the services. That will be determined in consultation with the unions involved, she said.
Among the unknowns are system vacancies and what other employment opportunities may exist, she said.
Occupational therapist and physiotherapist services for admitted hospital patients are not affected by the change.
"Our goal is to minimize impact to the staff as much as possible," Williams said, adding ending the outpatient services was a "very difficult decision" for administrators.
"We had a mandate from government to manage the budget. WRHA looked at all services we provide. We know that in many other jurisdictions across Canada this outpatient physiotherapy/occupational therapist service is not covered," she said.
"We had to make hard decisions, and we needed to identify them and move them forward."