Rushed changes to the system put health care at serious risk

Publish date: Thursday, June 28, 2018

An op-ed by MNU president Sandi Mowat, printed in Winnipeg Free Press, Thursday, June 28, 2018.

Manitoba’s public health-care system is at a crossroads. At a time of sweeping changes, it’s incumbent upon all of us to take notice and decide whether the course we’re on reflects our values as Manitobans.

Public opinion polls show that Canadians overwhelmingly support our single-payer public system. Nurses share these values. We believe everyone deserves the highest quality care regardless of income or social status.

It’s no secret our public health system is facing challenges associated with an aging population with increasingly complex health-care needs. Unfortunately, instead of bolstering our public system, the Pallister government has targeted health for cuts and rushed into massive changes looking for savings, which has jeopardized the quality of patient care.

The effects of Phase I of its restructuring plan have radiated across Winnipeg. St. Boniface Hospital, which saw the largest scale of change affecting almost half of the nursing workforce, has been facing outrageous mandatory overtime rates since implementation.

In mid-March, nurses had reported over 300 incidents of mandatory overtime in 2018, already more than they had for all of 2017. The Winnipeg Regional Health Authority (WRHA) and Health Minister Kelvin Goertzen said the flu was mainly to blame. As of June 25, the number has risen to 799 reported incidents.

Of course, it was never just the flu. The women and child program, cardiac sciences and surgery all experienced major increases that couldn’t possibly be flu-related. Nurses have known all along it was due to Phase I changes. Patient volumes at St. Boniface were anticipated to increase by six per cent following the changes; instead, they have increased by 30 per cent, union representatives were told by the employer during a meeting.

Excessive overtime can lead to more sick time, burnout and stress-induced leaves, which only compounds the problem and seriously jeopardizes patient care while increasing costs.

Health Sciences Centre, long faced with chronic short-staffing, also saw a significant increase in patient volume following the changes. Prior to Phase I, HSC’s emergency department (ED) averaged roughly 160 visits per day. Since the changes, it now receives more than 200 patients per day, with a recent peak of 236. As a result, the ED is seriously overcrowded, as anyone who has visited recently can attest. As services are concentrated, patient acuity is also increasing, meaning nurses are not only treating more patients, but also sicker ones.

The government didn’t consult nurses; it forced the WRHA to rush implementation — and has now made existing problems significantly worse. Nurses worry that they are being stretched too thin, compromising patient care.

The Pallister government has attempted to deflect our criticisms by claiming median ED wait times declined by 15 per cent relative to last year. Even if we accept the terribly reductive logic that the success of our health system could be measured by this one small sample, it’s still misleading to suggest a decrease was due to these recent changes. In fact, wait times are up following the implementation of Phase I.

In October 2017, the median wait time in a Winnipeg ED was 1.35 hours. Last month, it was 1.67 hours. At Seven Oaks Hospital, wait times were 1.8 hours, up from 1.63 hours in April — and far above their one-hour wait time in May 2017.

Meanwhile, Goertzen and WRHA officials are patting themselves on the back for minimizing nursing layoffs through their reorganization.

Unfortunately, Manitoba’s supply of nurses is set to be reduced. Red River College recently announced its nursing program will eliminate 50 of 225 seats due to government funding cuts — a 22 per cent reduction, despite increasing student demand and hospital staffing needs.

Despite these challenges, there are signs the government might be recognizing its folly.

Though Winnipeggers have said they would prefer to see it cancelled or postponed indefinitely, Phase II is at least significantly delayed following the ongoing struggles with Phase I. We’re told ED expansions are underway at the HSC and St. Boniface. Though the "connected care" walk-in clinic replacing the Concordia ED in June 2019 is a paltry half-measure, it represents an admission that removing services entirely from that community was a bad idea.

With Phase II’s delay, there’s still time for Manitobans to make their voices heard. Our public health care system is a tremendous asset that embodies our core values of compassion, fairness and equality. We must continue to speak out and remind the government that an accessible public health care system is a service we cherish, not one to be reduced.

Sandi Mowat has served as president of the Manitoba Nurses Union for the past 10 years, representing over 12,000 nurses across the province. She is retiring at the end of her term on June 30.

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