WINNIPEG – As the Manitoba Women’s Institute gathered in Winnipeg to talk about health-care reform, striking home-care workers were waving placards along Portage Avenue, mustering support in their fight to stop the provincial government from privatizing some of their jobs.
“Right now, (health care) is a hot, hot topic in Manitoba,” said Hila Willkie of Manitoba Health Organizations, a group representing hospitals and personal care homes.
Willkie traced the start of reform back to 1992, when the first discussions started about regionalization, “a very dirty word in those days.”
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She told institute members that regional health associations will get their first crack at providing services next year, when the provincial government gives each board money based on population, geography and historical disease patterns.
The Canada Health Act governs how money should be spent on health care, and states core services must be a top priority.
Madeline Boscoe, who works with the Women’s Health Clinic in Winnipeg, said the need for fiscal restraint, efficiency and consumer participation are driving health reform in the province.
She told institute members to look at reform as an opportunity, as well as a threat. She said communities could get a chance to trade expensive physician services for creative, cheaper but more effective public health services.
At her clinic, women who call with questions about hormone replacement therapy meet with a nurse and other women.
“Those women find that interaction is much more useful than sitting down with a doctor. You get to hear the pros and cons and then make up your own mind.”
But Boscoe told institute members they need to press for a list of public core services so communities can debate which are most needed.
“We are in the process of, whether we know it or not, interpreting the Canada Health Act,” Boscoe said. “No one has ever in this country written down what we mean by ‘medically necessary’ or ‘core services.’ “
Boscoe said rural women must make sure they’re at the table when the meaning is discussed.
“A cardiac surgeon has a very different version of what a core services list is compared to a public health nurse or an 85-year-old woman living at home alone.”
Women over the age of 50 may be particularly affected by health-care reform because they are more likely to have to “pick up the slack” in caring for older relatives, children and grandchildren if home care is scarce or hospital beds gone.
So far, there aren’t enough women on regional health boards, Boscoe said. She encouraged MWI members to run for the boards and help form advisory committees.
“We need to develop a critical analysis about what we are told we need and ask ourselves whose research is it, who paid for it and what they get out of it,” Boscoe said.
“We don’t do with health services what we do when we’re buying household appliances.”
