A reckless gamble that may make things worse

Hey there, time traveller!
This article was published 01/02/2025 (308 days ago), so information in it may no longer be current.

While in opposition, Manitoba New Democrats repeatedly criticized our previous Progressive Conservative government for implementing poorly planned, ideologically driven cuts to our health-care system that would worsen the quality of care in our province.

Sixteen months into their mandate, however, Manitoba’s NDP government is engaging in the same conduct they previously complained about.

In September of last year, the Kinew government ordered the province’s health-care authorities to redirect eight per cent of their funding from the bureaucracy to the front lines and clinical services. In December, the government then ordered those same authorities to cut millions in administrative costs, saying again that it intends to redirect that money to the front lines of health care in the province.

At the same time, the government also prohibited health-care service delivery organizations from entering into new contracts with private nursing agencies. It said that it had issued a request for proposals to reduce the number of contracted agencies and establish controls for the rates they charge.

The deadline for proposals to be submitted was Jan. 6. A total of 37 were received for the five health regions in the province. The government’s review of those proposals reportedly began this week.

Also this week, the government ordered Prairie Mountain Health to cut its private nursing costs by 15 per cent by no later than March of 2026, which is just 13 months from now.

With that chronology in mind, it is difficult to understand how the government realistically expects Prairie Mountain Health to implement those cuts and administrative changes within such a short period of time.

Beyond that, there are several puzzling aspects to this latest cost-cutting order, beginning with the fact that it only applies to Prairie Mountain. Regional health authorities and other government-funded health-care organizations across the province are all spending millions of dollars annually on private nursing services. Why has PMH been singled out for deep cuts, but not the others?

Second, the reason for issuing the request for proposals in December was the goal of reducing health authorities’ reliance on private nursing agencies. Why would that same government order cuts in PMH’s spending on private nursing services while the proposals are still being evaluated?

It is possible that one or more proposals could accomplish the 15 per cent savings — or perhaps even greater savings — without the need for a heavy-handed cost-cutting order. It is also possible that organizations that submitted proposals could regard the government’s cost-cutting order as “moving the goal posts” and improperly interfering in the RFP process.

Third, if the government honestly believes that the nursing shortage in the PMH region can be easily solved by ordering a reduction in the amount of money being spent by the health authority on private nursing agencies, why didn’t previous governments do that? Why did the current government wait so long into its mandate to take such a simple step?

Fourth, the government is apparently convinced that PMH can cut millions of dollars in spending on private nursing services over the next 13 months without compromising patient care. The cut translates into tens of thousands of hours currently being worked by agency nurses throughout the year, however — hours of care that nurses working within the public system would have to provide in order to maintain the existing standard of care.

The government is assuming that reducing the money that is currently being paid to private nursing agencies will result in dozens, if not hundreds, of nurses deciding to switch from those agencies to the public system. It is a reckless gamble that could backfire, however, with patients suffering the consequences.

As we have pointed out before, every nurse who has chosen to work for a private agency, as opposed to working within the public system, had compelling reasons for making that decision. For some, the reason may be higher wages. For others, however, it could be flexible scheduling, avoiding mandatory overtime and/or less-stressful or dangerous working conditions.

If those issues still remain in the public system, why would agency nurses willingly go back? Why would they willingly choose to work in a more stressful setting, for lower wages?

Manitoba Nurses Union president Darlene Jackson is correct to emphasize that convincing nurses to join or re-join the public system requires that RHAs invest time and money to make the public health-care system a place where people want to work.

Cutting off funding and bullying nurses to make tough choices doesn’t do that. In fact, it may make the situation worse.