In the fervent drive to slash tens of millions of dollars in health-care costs in Manitoba, even the smallest items — blankets, washcloths and adult diapers — are under heavy scrutiny.
At a treatment clinic in the Southern Health region, the use of warmed flannel blankets is being questioned. They cost a dollar to wash. If 10 blankets are warmed, used, and washed on a daily basis, the price tag grows to $3,650 annually.
"I would ask that we keep use of these to a minimum and use only when necessary," reads a March 7 email from a nursing supervisor obtained through freedom of information requests made by the NDP and provided to the Free Press.
"It may not seem like a significant thing but if you calculate potential costs it can add up," the supervisor wrote.
Making residents pay for pull-up adult diapers
At Boissevain Health Centre and Westview Lodge in the Prairie Mountain Health Region, "disposable white, non-woven washcloths" are targeted for cost-cutting.
A staff memo sent in June advises staff to use disposable peri-wipes instead.
Not all memos are directly linked to savings. Since May, personal care homes in the Interlake-Eastern Regional Health Authority, have used "a selection of appropriate continence-care products" for residents in lieu of pull-up style briefs. While residents can still have pull-ups, they have to pay for them.
The nurses union has been hearing stories about small cuts and changes from its members all summer.
"It just seems like nickel-and-diming," said Sandi Mowat, president of the Manitoba Nurses Union.
Memos have clues regarding cuts
What kind of impact does this really have on your overall budget, as compared to patient comfort and patient care?" she asked.
Months after the provincial government ordered Manitoba's regional health authorities to cut a collective $124.5 million from their annual budgets, the answer is still unclear. Nearly halfway through the fiscal year and Pallister's government has yet to approve savings plans submitted by individual health authorities.
As a result, they've mostly kept details about cuts a secret, leaving the public in the dark.
An April 18 note sent by Prairie Mountain CEO Penny Gilson gives some clues.
"Following analysis of financial data, the greatest opportunities for savings were within medical and surgical supplies in acute and (private care home) facilities," Gilson wrote. "There may be opportunities in certain areas to look at specialized products and appropriate use, such as incontinent products."
NDP health critic Matt Wiebe called that worrisome.
"Its a decision made at the top to implement or enforce these targets," Wiebe said. "It just shows an absolute callous disregard for patients who are at their most vulnerable."
In a statement, Southern Health denied the memo about warmed flannel blankets had anything to do with saving, saying instead "the blankets' main use is to assist in the starting of IVs... it is not related to any cuts. It is about using products efficiently and effectively."
The memo mentions limiting the use of blankets because of finances, noting, "the province and the region are asking us to reduce costs wherever possible."
A spokesman for Prairie Mountain Health was unable to discuss the note about "disposable white, non-woven washcloths" on Thursday.
"We are reviewing and weighing potential options to meet the target," he said.
A spokeswoman for Interlake-Eastern, where personal care home residents were notified about the switch from pull-ups, said the health authority routinely checks in "from time to time to ensure that product use is appropriately integrated into individual care plans."
In this case, she said, "generally, the products for in-facility use are not pull-ups as there are other options... that provide effective absorption and comfort."
Mowat disagreed, saying pull-up briefs are "more comfortable, easier to use. Some would argue better for the actual residents."
'Nobody knows anything'
The Winnipeg Regional Health Authority refused to provide records in response to the NDP's FIPPA request, since they "have been developed for a plan that has not been approved for implementation."
However, one of the possible plans was leaked last month. It suggests new moms and moms-to-be could be asked to take their own postpartum pads and disposable mesh underwear to the hospital. That memo resulted in an online petition to Health Minister Kelvin Goertzen that garnered thousands of signatures within days.
"It's all about communication," Mowat said, "nobody knows anything."
A spokeswoman for Goertzen said the government is reviewing the proposals and noted any clinical initiatives will be reviewed "by the provincial clinical leaders through the formation of Shared Health Services Manitoba." No timeline was provided.
"We're having to dig for the information," Wiebe said. "We're getting information from some (health authorities) and not others. We don't know the full extent... there's a lot more going on here than the public knows about, and I think they deserve to know the full impact."