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On Monday, Saskatchewan’s health minister and premier unveiled a new health-care plan they touted as “patient first”.
The plan is meant to inform how the province’s health-care system works into the coming years and help the province meet its health-care goals.
Health Minister Jeremy Cockrill joined The Evan Bray Show on Tuesday and provided more detail on the 31-page plan.
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Listen to Jeremy Cockrill on The Evan Bray Show:
This interview has been edited for clarity and length.
EVAN BRAY: So that announcement yesterday contained a number of things, can you explain for us what are some of the new things in the plan?
JEREMY COCKRILL: A couple of the big things, first of all – really accelerating the change of the role of nurse practitioners in our province. And we’ve already been working on this with the independent contracts for primary care.
But what was announced yesterday is saying we see a much larger role for nurse practitioners, not only in the primary care world but also in emergency rooms, urgent care centres, long-term care homes across the province.
And then also allowing nurse practitioners in those independent contracts to hire registered nurses, or LPNs or other allied professionals to build out their own primary care teams that can be led by nurse practitioners right across the province. That one’s really exciting.
The other one that I’m really excited about is the addition of virtual care. We already have been doing some virtual care in different contexts of the health-care system, but we’re going to be targeting specifically patients that don’t have a primary care provider right now. Those are the folks that are going to emergency rooms for things that don’t need to happen in emergency rooms.
So, when we talk from a system perspective about making sure that people are getting the right care at the right time in the right place, the virtual care piece is going to be pretty significant in this province.
BRAY: Both of those things you just talked about, the nurse practitioners and the virtual care, are these stop-gap fixes to get us to where we need to be? Or are these now going to be a permanent part of how healthcare is delivered in the province?
COCKRILL: I see them being permanent pieces of how our system works. You think about everything in our lives that we do virtually now, right? And I think about my own family, you know, my wife at home with kids. Sometimes it’s gonna be easier to have a virtual appointment rather than loading the kids up and taking them down to the clinic across town.
I think that applies for all ages right across the system. And I think, especially on the nurse practitioner piece, I think there’s been a shift in the public in terms of understanding what nurse practitioners can do and what they’re capable of. I think that’s something that we should celebrate and try and improve.
BRAY: What did the consultation look like for this? Was it formal? Was it informal? What were you hearing? And did it include healthcare providers? Is some of what’s contained in this from the professionals that deliver the health care?
COCKRILL: I think, sometimes, there’s this fixation on formal consultations. In my role, both as an MLA and as a minister, I feel like I’m consulting every single day. I go down to Regina General (Hospital), meet providers, meet staff who run the hospital. I’m consulting with them on understanding what pressure they’re facing today, what are the challenges and how we fix that.
I am visiting facilities large and small, having meetings with patients in my office here in Regina, and then as well at home in the Battleford. So we’re always consulting.
We do that with the whole spectrum of health-care providers, whether that’s physicians or nurse practitioners, our union partners as well, and a lot of that feedback is in this document.
But most importantly, there’s 1.25 million people in this province. We’re all patients, we’re all gonna need the health-care system at one point or another. We want to understand from them how it’s working for them and how we make it better.
BRAY: We are getting more urgent care centres in the province, so we’re going to need people to work in these facilities. We’re seeing the urgent care centre in Regina not being able to maintain the hours they’ve got right now based on physician availability. Is that a worry for you?
COCKRILL: Staffing is a challenge right across the country, and I think that’s why you see the additional training seats that we’ve added. We’ve already been adding training seats for allied professions in the last few years, significantly increasing training capacity.
There really is no finish line when it gets to health care. We’re dealing with people, and people are ever-evolving and dynamic beings, so I don’t think there’s a finish line when we get to health care.
But it’s about improving the system as it is today, and I’m confident in the partnerships that we have with our educational institutions as we’ve increased training capacity to get us to a better spot.
I get asked about the Regina Urgent Care Centre hours all the time, but it’s about making sure that we’re using all the resources in the system efficiently. So being open 24 hours, that wouldn’t be a good use of staffing resources. That would be better used at Regina General and Regina Pasqua, based on the numbers that we’re seeing.
BRAY: What is driving the increased demand on health care?
COCKRILL: I think there’s lots of threads there you can pull there — population is definitely one of them. We’ve seen significant growth in this province.
I think age is a massive factor. As I get older every year, I have noticed that I need to use the health-care system probably a little bit more each year.
We all need to take better care of ourselves, too. I’m probably not the best person to speak on that, but I think there’s increasing complexity with patients, and so government’s going to put the right access doors in place.
BRAY: An interesting part of of this plan is the use of private care providers, publicly funded. Is that a more efficient way to do it? Why use private care providers as opposed to building that capacity in the existing public system?
COCKRILL: We need to do both. Sometimes in health care, we get into these either-or discussions — it has to be this, or it has to be that.
The conversation that we’ve already been having with patients right across the province as we build up the public system is we need more specialist capacity, more diagnostic capacity. There are also options for privately delivered but still publicly funded care.
We see that with MRIs and CTs already here in the province. We’re seeing that with our surgical partner in both Regina and Saskatoon. We’re going to see that very soon with endoscopy specifically in Saskatoon —provide more room for patients in the hospital and deliver that service out in the community where it’s a better fit for patients.
BRAY: There will be critics that will say this is a step towards privatization of health care, do you see it that way?
COCKRILL: The way that I see it is more options. We’re not moving away from a public health-care system in Saskatchewan or Canada, but we have to make sure that the system actually has all the options that patients need.
That’s where I think we have to widen our gaze a little bit, widen what we’re willing to do — both in this province and right across the country — in terms of making sure that there’s as many options for patients as possible.
BRAY: Some people have a tough time having a family doctor, but I also know specialists are in high demand. Do you see this plan making inroads to secure specialists for the province?
COCKRILL: Absolutely. You see deficits right across the country but where else are you going to see a nearly 20 per cent increase in College of Medicine seats? Here in Saskatchewan, and we announced that as part of our plan.
We’re going to be educating more doctors and we also made the target with the College of Medicine to have 95 per cent of those students being Saskatchewan kids — and that’s incredibly important in terms of long term recruitment and retention.
The second piece is the Saskatchewan Healthcare Recruitment Agency and Terri Harris and her team are going to be the sole body responsible for all external recruitment.
That means that we have a single door for folks looking to come into the health-care system, and a more unified brand and narrative out there that we can take to the U.K., Ireland, U.S. and say, ‘this is what it means to practice in Saskatchewan, here’s the opportunities we have.’
We’ve seen incredible success in the last year on pediatric specialists and bringing those to the province. We know there’s more work to do, especially in those very small specialties like dermatology. We know that one’s challenging, but there’s work going on there.
BRAY: How do you go after those kids that are in high school in Saskatchewan right now and get them thinking about not only a career in health care, but a career in health care in this province?
COCKRILL: We’ve been working with the Saskatchewan Distance Learning Centre on some health-care initiatives to get kids in high school already engaged in a health-care career.
We have a very interesting pilot in terms of getting high school kids into continuing care aid roles, and giving kids that kind of firsthand experience early on to see what it’s like to work in health care.
When we talk about the College of Medicine and ensuring that there’s as many Saskatchewan kids as possible, I think that’s incredibly important. I live in the Battlefords, I want to know, as a resident of the Battlefords, that there’s kids from the northwest of our province in med school. That’s incredibly important to me as a taxpayer and a patient.
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