Will amalgamation affect rural health?

The Saskatchewan government’s move to consolidate health-care services have rural residents and communities on edge

There are still many unknowns as Saskatchewan moves to a single provincial health authority from 12 regions later this year, including what financial savings there might be and how rural residents might be affected.

The provincial government announced its decision last week, saying it had accepted recommendations from a three-member panel to better co-ordinate health services across the province.

This includes consolidating clinical services such as laboratory and diagnostic imaging, and the planning, dispatch and delivery of Emergency Medical Services (EMS).

A single board of directors will be in place by fall, said Health Minister Jim Reiter, but further changes will take longer.

“We want to do this quickly but it’s also important that we get it right,” he said.

Greg Ottenbreit, minister responsible for rural and remote health, said community advisory networks already in use in some regions and recommended by the panel will help maintain local links.

The panel noted that rural care and facilities must be maintained.

Saskatchewan's decision to consolidate its 12 health regions into one has rural residents questioning whether services will deteriorate. What do you think?

“We can’t lose sight of rural health care,” Ottenbreit said.

“We have to keep that capacity in rural areas because if we start minimizing a lot of the rural services, it ends up exacerbating problems in the tertiary centres and the regional centres.”

Panel member Dr. Dennis Kendel said most of the change would be in administration rather than front-line care.

“We believe one single provincial health authority focused on seamless care delivery and integration of services will improve the patient experience,” he said. “At the same time, the provincial health authority must maintain close ties with local communities, and management capacity must still exist where services are delivered.”

Health worker unions largely lined up against the government’s decision.

“We are of the view that this move has the potential to negatively impact both patient care and the provision of health-care services,” said Barbara Cape, president of SEIU West.

CUPE, the largest health-care union in the province at about 13,000 workers, said it worried about impacts on patients.

“We are concerned that one central super board will be less responsive and harder to navigate for patients and communities,” said Gordon Campbell, president of CUPE’s Health Care Council.

“Will this lead to reduced services and a loss of decision-making in communities, especially in rural communities?”

But Reiter said if the transition is done properly, the average person won’t notice any change.

He couldn’t say exactly how much money would be saved through consolidating administration.

The government said early estimates show savings of $10 to $20 million in 2018-19. It expects to save by consolidating things like accounting, information services and legal departments.

However, there will also be severance costs to workers who lose their jobs.

NDP health critic Danielle Chartier said consolidation is just code for cuts.

“If this government was really concerned about front-line care, they wouldn’t be spending money on expensive restructuring and creating chaos, which is exactly what amalgamation does,” she said.

NDP governments amalgamated the system in 1992, establishing 32 districts and closing more than 50 rural hospitals, and then again in 2002 when the current 12 regions were implemented.

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