As health-care budgets remain tight, Saskatchewan may have to close more of its smaller rural hospitals, says the chair of the Saskatchewan Association of Health Organizations.
Brian Rourke told a meeting of urban municipalities last week that daily use of hospital beds in small-town and rural Saskatchewan is slipping.
In a later interview, Rourke, who heads the group representing the 30 health districts, said he expects two to three dozen of the small hospitals might have to close within the next 10 years.
In 1993 when the province reformed the health system to deal with a lack of money, 52 rural hospitals were closed or converted to health clinics. Today the province has 73 hospitals, at least half of which are in the small-town and rural category. Yet the statistics show 10 or fewer beds are occupied daily in 36 of these facilities, said Rourke.
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He said the problem is that rural residents are driving to the cities of Regina and Saskatoon to get health care, including appointments with family doctors. And that is because rural communities can’t retain their doctors and they either get a new one every year or lose the service.
“I’m absolutely convinced that’s the problem,” said Rourke. “People get tired of telling their story (health history) to another doctor.”
Rourke said the answer lies in having communities establish group practices of three or more doctors who can provide coverage for each other. The gap in service might also be filled, he said, by advanced clinical nurses who perform more sophisticated medical tasks under the direction of a doctor.
Rourke said he expected to be unpopular after making his remarks but said the response to his closure suggestion was “surprisingly positive.”
Saskatchewan health minister Pat Atkinson confirmed that the category of beds in rural hospitals has been shifting, as the population ages, to more observation and palliative care than acute care. Also the trend is continuing for hospitals to convert to health centres with nursing homes attached.
Atkinson said recruiting and retaining rural doctors is “an ongoing dilemma.” She also suggested advanced clinical nurses and telemedicine could work to “give citizens access to primary care.”
