Nine municipalities in southwestern Manitoba have formed a task force to seek a regional solution for rural health care.
Officially launched on April 12, the Southwestern Manitoba Health and Long-Term Care Task Force has identified accessibility as the No. 1 priority.
"Even though health-care delivery is not a responsibility of local government, the local governments together recognize that they are critical stakeholders," said Gordon Daman, president of Red River Group and task force consultant.
"Having an on-the-ground understanding and feel of what residents are saying and experiencing … they feel they need to step up to be able to be part of the solution."
Frequent closures of emergency departments continue to plague rural Manitoba.
It is an ongoing challenge to recruit and retain doctors and other medical professionals in rural areas. Currently, Prairie Mountain Health’s public alerts show a list of six dates in May that the emergency department is closed at the Carberry and Glenboro health centres.
A recent report submitted to Manitoba’s Ministry of Health, Seniors and Active Living suggests the government close ineffective rural ERs.
"If it isn’t an emergency department, then don’t call it an emergency department," states the Provincial Clinical and Preventive Services Planning for Manitoba report, submitted by David Peachey.
The report has prompted a lot of discussion on the issue, especially in southwestern Manitoba.
Killarney-Turtle Mountain Mayor Rick Pauls, said, at best, rural "emergency rooms" are in reality urgent care centres.
"And to be honest, a lot of them … aren’t even urgent care centres," he said. "We definitely need to rethink it."
For years, Pauls has spoken out about the need for a regional hospital in southwestern Manitoba, similar to the Boundary Trails facility located between Winkler and Morden.
"I believe that our facility here, the Tri-Lake Health Centre is in the best position for that, simply because of our numbers, our amount of docs and our lab and infrastructure that we presently have in place," he said.
"I truly believe that we need to do that."
The municipalities involved in the task force include Boissevain-Morton, Cartwright-Roblin, Killarney-Turtle Mountain, Pipestone, Brenda-Waskada, Deloraine-Winchester, Two Borders and Prairie Lakes. The Town of Melita is also on board.
The Town of Carberry has its own health action committee, and Mayor Stuart Olmstead said health care is always a concern.
"You’re only one retirement or one vacation away from not having basically an open ER within your community," he said.
Residents are concerned about the idea of funnelling resources to a larger centre, as that could mean a 45-minute trip to the nearest ER.
"We went from having 24 (hour) on-call here, to now … on-call as a shared service between ourselves and Glenboro, and now we even have blackout periods," Olmstead said. "So it does seem over time, we’ve already had our cutbacks."
Daman said 24-7 emergency departments are difficult to maintain and are "frightfully expensive," not just on the human resources side but on the equipment side as well.
When looking at admissions to emergency rooms, Daman said it is often for issues that would be classified under urgent care — stitches, X-rays, casts, etc.
"Emergent care are those items that are basically threat to life or limb, within a very short period of time," he said.
Depending on the situation, Daman points out that paramedics may be more equipped to respond to an emergency in a more fulsome manner than a family doctor who may only see a few emergency situations a year.
"Often … a 911 call with an ambulance, is actually safer with the paramedics attending because they can come to the home," he said.
The population across the nine municipalities is an estimated 14,000 people. Daman explained that patient loads for family doctors are in the range of 1,500 and 2,100.
"If we say even at 1,500 or 1,600 patients per doctor, with the 14,000 people, you’re only looking and needing about seven or eight doctors for that particular population base," he said. To have appropriate on-call coverage at any hospital, a team of six doctors would be needed.
"So that would mean if we were to maintain the four hospitals that are in that catchment area: Melita, Deloraine, Boissevain and Killarney, you’d essentially need to have 24 doctors, when the population base only really requires seven or eight," Daman said.
A solution being considered is operating urgent care centres instead of ERs, which can be staffed with nurse practitioners or physician assistants. They would have the ability to call a group of doctors, who could answer questions but don’t necessarily have to be at the hospital.
"The current system is not sustainable, based on the hard evidence of the Peachey report, and on the reality that we’re in a fiscal environment that’s strained and limited," Daman said.
A solution is going to require a new way of thinking, he said, and it may not look like the traditional emergency rooms that have been commonplace in the past.
The task force meets monthly, with community consultations planned for Melita, Deloraine, Boissevain and Killarney this fall, prior to the final recommendations being formulated. The goal is to present recommendations to Prairie Mountain Health and Manitoba Health by the end of the year.
» Twitter: @jillianaustin