Sussman should be part of health-care solution

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This article was published 11/6/2016 (2164 days ago), so information in it may no longer be current.

Opinion

When you meet Milton Sussman in person, it is very hard to tell that he is, in fact, a man walking the razor’s edge.

Sussman is president and CEO of the Winnipeg Regional Health Authority, the largest in the province. As such, he oversees a budget of more than $2.6 billion to deliver health-care services through 200 facilities involving 28,000 employees.

Those details alone make Sussman’s job one of the most demanding in the provincial civil service. However, Sussman is also waist-deep in what could be one of the most intriguing and important political debates this province has ever seen.

The new Progressive Conservative government wants to eliminate a chronic budget deficit by bringing expenditures down without eviscerating front-line services. And any time you talk about expenditures, you can bet there will some stern scrutiny of health care, which consumes 40 cents out of every dollar the province spends.

During the election campaign, Brian Pallister told voters there would be "no sacred cows" when it came time to start slowing the increase in expenditures.

True to that word, the premier is preparing to launch a review of health-care services in a bid to find savings.

Into that potentially explosive scenario comes Sussman, a professional public administrator with a long history of serving the NDP. Sussman was a deputy minister of health. He also served as clerk of the executive council, where he worked hand-in-hand with the premier of the day.

Sussman is unfazed when asked about whether his service to an NDP administration could be misinterpreted by the new government. He pointed out he has never been "political staff" in any sense of the word. That includes his current post, which he earned after going through an extensive job-search process. As for the new government’s agenda, Sussman said he sees numerous points of convergence with his own plan for the WRHA.

"They want Manitoba to be the most-improved province," Sussman said. "They talked about reducing wait times. They’ve talked about trying to create a mental-health plan. The views they have articulated on health care are very much aligned with what I came here to do."

In fact, if there are any concerns among Tories about an alignment problem between themselves and Sussman, they need only look as far as the monthly memo titled Message from Milton that he sends out to WRHA facilities and staff. These notes articulate some of Sussman’s goals for the region, but also tackle prickly subjects in a direct fashion.

This month, Sussman tackled the issue of overall communication at the region, a sore point in the past that has sparked a lot of criticism and pumped a lot of gasoline into political brush fires. Sussman pointed out that while WRHA personnel are exceedingly "polite" in their dealings with the public, they are not always "respectful" or frank.

Sussman appeared to be pointing out that politeness can, in reality, be an exercise in passive aggressiveness. It can also be used as a shield to hide the truth or to avoid difficult conversations about problems in the health-care system. In his memo, he advised personnel to "speak truth to people in positions of power" and "have conversations that can move things forward in positive ways."

In another memo, Sussman preached the importance of being transparent, and sharing all WRHA information available on performance and outcomes with government and the media. "Our patients and their families deserve this kind of transparent approach. Our system demands it."

There is an almost elegant resolve to Sussman’s notes, but there is also an edge. Strip away the conciliatory language, and you have strong directives from the president and CEO to change the culture of the health-care system in Winnipeg, a system that has, at times, been under siege for its capacity for conflict and opaqueness.

Sussman is hardly the first chief administrator to confront the cultural flaws in the health-care system. He is, however, the first to offer regular, pointed, unsolicited advice and perspective on the challenges it faces. If open dialogue can play a role in helping smooth the rough edges of health care — and there is every indication it can — then Sussman is heading in the right direction.

His real challenge will be developing a relationship with the new government that allows him to continue improving the culture without being forced to absorb politically expedient austerity measures.

While in opposition, the Tories expressed little faith in the regional health authority structure, and portrayed budget overruns as evidence of fiscal incompetence rather than the stress lines of a system that simply cannot keep up with demand.

The reality is you never really overspend in health care because the system never comes close to meeting the demand. If expenditures go up, it is usually for good reason and not because the system is wasteful or inefficient.

At some point, there is the real possibility of conflict between Sussman’s campaign to effect change from within and the Tories’ mandate to do a better job of controlling costs than their NDP predecessors did.

It seems almost inevitable that at some point, the government is going to prescribe some of its own tough medicine for the WRHA in a bid to get a handle on health-care expenditures. When that time comes, it will be important that it happens in partnership with Sussman, and not against the advice he will provide.

Perhaps if members of the new Tory government take the time to read a few of the Messages from Milton, they will see that he is, at the very least, part of the solution.

dan.lett@freepress.mb.caTwitter: @danlett