Health care in Manitoba: a perpetual struggle

Opinion

Hey there, time traveller!
This article was published 28/02/2022 (1290 days ago), so information in it may no longer be current.

The pandemic has exposed the tremendous weaknesses of the seemingly forever-teetering-on-the-brink Manitoba health-care system.

The cuts and closures of several Winnipeg hospital emergency rooms imposed by the Pallister government before COVID-19, all in the name of centralization and cost efficiency, have instead wreaked havoc and caused undue stress. This, coupled with having to treat the thousands inflicted by the disease, essentially strangled the system.

The need to free up beds for COVID-19 patients has led to the transferring of elderly patients from Winnipeg hospitals and away from their families to hospitals in rural and northern regions. And, worse, to a surgical and diagnostic testing backlog of more than 160,000 cases.

By any measure, that number is untenable— or, more accurately, “catastrophic,” as physicians in Ontario have described that province’s estimated 300,000 surgery backlog. Last December, Saskatchewan’s health authority aimed to reduce the COVID-19-related surgical backlog to a three-month wait time by 2030. Unbelievably, that goal is considered acceptable.

According to a study prepared last June by the Canadian Institute for Health Information (CIHI), the total backlog of surgeries across the country exceeded 550,000. The Canadian Medical Association estimated that dealing with this huge number for six key procedures — coronary artery bypass graft surgery, hip and knee replacements, cataracts and MRI and CT scans — will cost at least $1.3 billion.

Where that money is going to come from is anyone’s guess.

So far in Manitoba, health officials and members of the Diagnostic and Surgical Recovery Task Force established to reduce the backlog have come up with a few recommendations, such as formalizing an agreement with Sanford Health in Fargo for specialty spine services. That still remains a work in progress.

While each province has its own problems, Manitoba’s health-care system has perpetually struggled. Over many years, the province has had some of the longest wait times in Canada to see a doctor in hospital emergency departments.

In September 2008, these issues led to a terrible tragedy when Brian Sinclair died in the HSC emergency room. He had been waiting to have his catheter changed for 34 hours. He was literally “ignored to death,” as later media stories put it. Patient protocols were changed in hospital ERs after this, but the endless waiting has more or less remained the same.

In April 1969, the head of the Manitoba Medical Association (MMA) warned the province was facing a shortage of doctors; in February 1973, it was a shortage of nurses; in early 1978 the anesthesia section of the MMA concluded Manitoba was “rapidly approaching a crisis in anesthesia manpower.”

In February 1983, there were unacceptable provincial government cost-cutting measures and expenditure guidelines; in June 1997, waiting times for ultrasound tests and MRI scans were growing daily; and in November 1998, it was overcrowded emergency rooms and a cancellation of too many surgeries. And, so on and so on.

Indeed, a historical survey of the health-care system in Manitoba is the story on one hand of dedication, innovation and technological advancement; and on the other, of chronic shortages, underfunding, staffing problems and denial, denial, denial.

The Free Press has occasionally run series of articles with such titles as “Hospitals in Crisis” (1983-84) and “Health Care Crunch” (1998-99), among others. And each time, the complaints and criticisms of provincial health care, as highlighted in these stories, were declared to be off-base and exaggerated by hospital administrators and health leaders.

The health care system was never “in crisis,” but rather “evolving,” as one spokesman from the Winnipeg Health Authority — the predecessor to the Winnipeg Regional Health Authority (WRHA) — put it in 1998 in response to the “Health Care Crunch” series.

Possibly the most honest statement ever made by a Manitoba health minster was uttered by Larry Desjardins, who served in that position in Howard Pawley’s government from 1981 to 1985. In response to criticisms by doctors of insufficient funding, he wondered whether too many operations were being performed.

“A few years ago there was no such thing as open-heart surgery,” he said. “If God Almighty … can’t cope with all the people who are sick and so on, where in the heck can I make miracles?”

That has not stopped Desjardins and the health ministers who succeeded him from trying to conjure miracles. Yet while each new infusion of money, announcement of new beds and restructuring of the system — the establishment of the WRHA and the other regional health authorities in the late 1990s and the creation of Shared Health in 2018 — has been implemented with great fanfare, this bureaucratic tinkering has never quite lived up to its potential.

In Manitoba, health care has long been underfunded and unable to meet rising demand, and federal health-care transfer payments never seem to be adequate, as successive provincial governments have routinely complained. In addition, the tax base is too small to deal with the province’s various socioeconomic disparities and an ever-increasing elderly population. COVID-19 has merely magnified these problems tenfold.

Now & Then is a column in which historian Allan Levine puts the events of today in a historical context.