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This article was published 8/4/2019 (190 days ago), so information in it may no longer be current.
The overhaul of Manitoba’s health-care system has been met with repeated calls to slow down from those on the front lines of care. The stories from patients and front-line workers, detailing chaos and upheaval within the system, are consistent and persistent.
However, the province is going full steam ahead with its overhaul, and is paying little attention to the concerns of workers and Manitobans. The overhaul and newly introduced legislation will continue to erode and worsen health services we all rely on.
Recently, the head of the Winnipeg Regional Health Authority, Réal Cloutier, emailed a letter to 28,000 staff in an attempt to alleviate concerns and the increasingly low morale that plagues the staff of health facilities. He recognized the generally depressed state of health-care workers but told them to hang on, stating that they were experiencing a common feeling referred to in change management as the "valley of despair."
The term refers to the low point people go through when experiencing major workplace changes. They often feel depressed and sense that they have lost control. Cloutier was attempting to calm their fears and boost morale by assuring them that they would eventually pass through the valley, and that hope was on the other side.
On the surface, the letter at least finally acknowledges how staff members are feeling, but it does nothing to address the concerns expressed by many health-care workers across the province. From overworked neonatal nurses at St. Boniface Hospital to those facing increases in mandatory overtime, from inadequate staffing levels to the sudden closure of the Family Medical Centre, and from the closure of the maternity ward in Flin Flon to impending closures of more ERs, the experiences of those caring for our sick, ill and injured must be taken seriously.
Those on the front line know what is and is not working, but despite continued requests to be consulted about changes, they are ignored. Instead they receive Cloutier’s letter, which diminishes the importance of their years of experience and ignores their urgent request to slow down on the health-care overhaul.
The "valley of despair" will undoubtedly widen with the recent introduction of Bill 10, legislation that would amend the Regional Health Authorities Act to become the Health System Governance and Accountability Act. Contained within this legislation is the creation of "Shared Health" governance. Imagine a pyramid, with Health Minister Cameron Friesen at the top, followed by Shared Health, then the regional health authorities and CancerCare Manitoba. Addictions Foundation of Manitoba will be absorbed by Shared Health.
The shifts in responsibilities and oversight under this legislation will affect all stakeholders in the health-care system. The consequences of this legislation will be far-reaching, including paving the way for a new super agency and a one-size-fits-all model of health-care service delivery.
We only need to look to Nova Scotia, which in 2015 went straight to a "super agency." The change resulted in a number of detrimental consequences to the delivery of care. Inadequate financial resources, clumsy handling of the amalgamation and the failure of the one-size-fits-all model all had negative effects on Nova Scotians’ access to quality care. Such a model is not sufficiently responsive to adapt to changing needs and demands in a given region of a province.
For example, some emergency rooms in Nova Scotia currently issue "pink letters" to patients who will not be seen by a doctor during operational hours. The letter explains they will not be able to see a doctor today because they have been assessed at a low urgency level and they are to come back later.
The inability to staff local hospitals in Nova Scotia is chronic, leading to unexpected closures of ERs and the inability of existing staff to take time off. Some groups contend that the new model of health care is leading to higher levels of political interference in the operation of the system.
The fact that Manitoba is headed in a similar direction is frightening, as it could seriously compromise quality of care. We should be asking, is this really the road we should head down? We think not.
If Manitoba’s government is serious about improving health care, then why rush through another major change in the administration of service delivery in this province? Is scoring political points worth the consequences to our delivery of quality, considerate access to universal health care?
If this government continues to ignore repeated warnings from our front-line workers, the valley of despair will only grow deeper and longer.
Brianne Goertzen is the provincial director of the non-partisan Manitoba Health Coalition and a Canadian Centre for Policy Alternatives — Manitoba steering committee member. She serves as a school trustee for Ward 3, River East Transcona School Division.