One health board may be better

By Murray Mandryk

There are some things about the proposed changes to health governance in Saskatchewan that rural people might not like.
Or at least, they might not like them until they can be convinced that one health authority addresses problems in the system that the current 12 boards couldn’t address.

The first pronouncement of Premier Brad Wall’s government in 2016 was a big one – a call for the reorganization of the current 12 health regions into a single provincewide health authority.

Unfairly, rural Saskatchewan people are sometimes labelled as resistant to change. Virtually no other Canadians have seen as much disruption to their communities, economies and very way of life as Saskatchewan rural folk who have had to adapt to dwindling communities caused by the mechanization of farming.

That said, there are times when rural people have fought hard against changes to their governance structure.

It lobbied, intensely, against the mere suggestion of changing the existing system of 296 rural municipalities. And opposition to such change hasn’t always been completely rational.

That said, while there is a 111-year attachment to the existing rural municipal system, the same can’t be said about the short life span of the existing 12 health districts.

In fact, since the demise of the myriad of local hospital and ambulance boards a quarter century ago, the current 12 health region system has often been considered the worst of both worlds.

Regions are too small and powerless to take on the power of government. But they were often too big to represent concerns in specific local communities.

Moreover, if one looks at the borders for the regions, they simply don’t make any sense.

Sticking Moosomin in the Regina Qu’Appelle Health Region reflects the holus-bolus nature of regions that did not reflect trading areas or neighbouring communities.

And the complaints of overpaid, local administration and endless bureaucracy have been endless.

Of course, it’s questionable whether the new single authority governance model will achieve the “significant savings’ that Health Minister Jim Reiter talked about when he announced his government was accepting his independent advisory panel.

While Reiter did cite savings in information technology, payroll, procurement and less board management, his government could only quote a $10- to $20-million savings on board governance by 2018-19.

More recently, the government added the health department spends an estimated $160 million on information technology including the IT system for the current health regions, the Saskatchewan Cancer Agency and eHealth. However, its consolidation would only produce savings of about $9 million a year.

In total, that amounts to less than $30 million in savings – a drop in the bucket in a health system costing us $5.7 billion, annually.
And then there is the fear that when a government talks about “amalgamation” in health care, it may be talking about hospital closures like the 1992 closure of 52 rural hospitals under the Roy Romanow government.

But Reiter was adamant that what his Sask. Party contemplates “is not a consolidation of the frontline health care.”

And if that doesn’t rural people solace, there are other things emerging from the panel recommendation that should.

The panel’s work was largely predicated on the notion that all people in Saskatchewan – regardless of where they live – should be entitled to equal health care access.

With inequitable boards, that didn’t always happen.

For example, one of the key areas addressed in the panel’s recommendations is consistency in ambulatory care.

Currently, some towns don’t have access to paramedics because the health region has deemed that a less affordable expense.

Of course, there are worries. It would help to have we had independent health ombudsman to arbitrate.

But a single authority mandated to ensure equality may better address such issues.

One board may just be better than 12.

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