A University of Saskatchewan professor says the province should learn from the “cautionary tale” of Alberta’s shift to one health region.
Daniel Béland, Canada research chair in public policy at the Johnson Shoyama Graduate School of Public Policy, noted the myriad problems Saskatchewan’s neighbour went through when shifting to a centralized medical authority system.
“They faced major problems,” he said. “It caused some real issues for the PC government at the time.”
Béland pointed to Alberta Health Service’s first CEO resigning after just 18 months, AHS’ entire board being fired in 2013 and former premier Jim Prentice’s promises to shift back to a decentralized system as troubles plagued the system change.
“It’s a big undertaking,” Béland said. “It’s like turning around a 747 – it doesn’t turn on a dime.”
Prentice ended up losing the election and Rachel Notley’s government decided to maintain the centralized authority.
Béland added the “devil is in the details” for whether Saskatchewan can avoid similar issues. He said it was promising that the three-member panel who recommended the shift have acknowledged shortcomings in Alberta.
“They’re aware of the challenges,” he said. “But it’s about how they’ll do it, and who they put in these top positions…it might go well, but there are risks attached.”
Béland also warned not to expect massive cost savings from decreasing the number of health regions.
“There are other factors that drive prices up, like how we pay doctors and nurses,” he said. “That’s not about regionalization.”
Saskatchewan’s nurses are approaching a major overhaul to the province’s health care system with cautious optimism.
The president of the Saskatchewan Union of Nurses, Tracy Zambory, said she still has a lot of questions over plans to merge regional health authorities into one superboard.
“Change is coming. What it’s exactly going to look like, we don’t know yet,” Zambory said.
But she’s being clear on the approach SUN is taking from the outset.
“We see this as an opportunity to do things right for the patients of Saskatchewan,” Zambory said.
“We are very well aware that there is a fiscal challenge in this province and we want to make sure health care stays vibrant and that it keeps the patient front and centre.”
Health region CEO reacts
As the government moves to restructure health regions into one provincial body, it might want to seek the advice of Keith Dewar.
The current CEO of the Regina Qu’Appelle Health Region played a big part in the process in Prince Edward Island when that province moved to a single authority in 2010.
“Theoretically, when you eliminate things like accounting or IT, you can actually use the single structure to help really focus the care and resources around the delivery of care,” Dewar explained.
But in spite of those benefits, Dewar adds the process is not without its problems particularly – on the human resources side.
“If people aren’t sure if they have a job tomorrow, or until there is some clarity over what opportunities exist, there will be some challenges for them,” Dewar said.
Dewar believes those within the Ministry of Health are already in conversation with Alberta, with a provincial health body, along with Nova Scotia, that went through the same process and is similar in population size and scope to Saskatchewan.
‘A wing and a prayer’
One team not on board with the government’s plan is Saskatchewan’s New Democratic Party.
The opposition doesn’t believe the government knows what it is doing.
“This government doing things on a wing and a prayer has gotten us into this financial mess,” health critic Danielle Chartier said Wednesday.
“Amalgamation across the board you look at, historically – whether it is here or anyone else –amalgamation is an opportunity for governments to cut.”
The NDP established 32 health regions in Saskatchewan in 1992 and amalgamated them to the current 12 regions in 2002.
-With files from Sarah Mills and Chris Carr