Manitoba’s regional health authorities could be dramatically scaled back if portions of the KPMG health sustainability review are any indication.
The provincial government released 154 of the report’s 639 pages Monday – just two months after Finance Minister Cameron Friesen said the document would not be made public before May 31, since to release it "would not bring about a sense of comfort."
The now-public pages, which contain some redactions, recommend eliminating whole swaths of bureaucracy from the system by reducing the number of organizations that deliver health care across the province.
"It is critical for the government to reset expectations and operating parameters for all stakeholders," the report says.
Beyond a broad reduction in organizations, including the regional health authorities, KPMG suggests some form of unspecified managerial "alignment" between CancerCare Manitoba, Addictions Foundation of Manitoba, Diagnostic Services Manitoba and Manitoba eHealth.
Such structural changes could save at least $3 million in 2017-18, according to the consulting firm, and at least $5 million in 2018-19 "and beyond."
Health Minister Kelvin Goertzen was careful with his words after question period Monday when asked about the province’s plans for the future of the regional health authorities, given the creation of Shared Health Services.
In June, Goertzen announced the new entity to centralize the operation of an array of provincial health services so as to avoid administrative duplication. At the time, he said Shared Health Services will see the Winnipeg Regional Health Authority’s role "scaled back."
The minister’s explanation that the WRHA will stick to the job of delivering health services to patients seems to have been inspired by the KPMG report, which says: "The highest probability of success would involve refocusing the WRHA as a delivery region with similar accountabilities to other regions."
But as to whether that means the government sees Shared Health Services as a precursor for reducing the number of health authorities in the province, Goertzen wasn’t saying.
"It would have been difficult to make the jump to one RHA without an entity like Shared Health Services," he said Monday. "It’s not our immediate intention to go that way, we’re undergoing a lot of different reforms in the health-care system."
The health minister wouldn’t comment about the future of organizations such as CancerCare Manitoba and the Addictions Foundation of Manitoba, despite a government release noting the KPMG "background information" released Monday was the information relevant to decisions the government has already made.
"I’m not going to identify any particular organization," he said. "We think there are ways we can reduce the bureaucracy, and we’ll continue to do that."
The KPMG sustainability review — typically referred to as a value-for-money audit — is a two-part report. The first is meant to serve as a brief overview of "potential areas of opportunities," while the second is meant to be a work plan for those opportunities picked for further investigation.
KPMG qualifies its Phase 1 observations with a reminder it has "not otherwise verified the information" it obtained and its work does not count as "an audit, examination or review in accordance with standards established by the Chartered Professional Accountants of Canada."
Manitoba NDP Leader Wab Kinew said the report raises more questions than it answers.
"Kicking out a third of a report and just leaving that for the public to consume is not transparency," Kinew told reporters.
"If the government is thinking about things like consolidating the regional health authorities, is talking about closing emergency departments in rural Manitoba, is talking about rolling CancerCare and the Addictions Foundation into larger organizations, then they should tell us that is what they intend to pursue."
– with files from Larry Kusch