Health-care changes face many barriers

Hey there, time traveller!
This article was published 09/11/2023 (876 days ago), so information in it may no longer be current.

It is a perfect example of why it is so hard to fix overburdened health-care systems throughout Canada.

Yesterday, Alberta Premier Danielle Smith announced that her government plans to reorganize the way in which health-care services are delivered in that province. Under her plan, the responsibilities of Alberta Health Services, currently the single service provider, will be divided among four new organizations. They will deliver services in primary care, acute care, continuing care and mental health and addiction care.

The primary focus of Alberta Health Services, which will apparently become the “Acute Care Organization,” will be the delivery of hospital care, urgent care, cancer care, clinical operations, surgeries and emergency services and will work directly with other health service providers.

A separate primary care organization will apparently be responsible for ensuring that every Albertan has a family doctor, while a continuing care organization will be responsible for the operations of continuing care facilities, including personal care homes. Some of those homes may be sold to private service providers, much the same as we have here in Manitoba.

Finally, a mental health and addictions organization will be responsible for working with the Alberta Department of Mental Health and Addictions to design, implement and operate a “recovery-oriented” response to those issues. Whether such an approach will be effective is a matter of great debate.

Smith claims that the changes she is proposing are necessary because “Alberta’s health system isn’t working the way it should and the way Albertans deserve, and fixing it is critically important to improving Albertans’ quality of life.”

She blames “structural issues” in the current system for overly long wait times, staffing shortages and a shortage of specialists. She says that her plan will result in faster care and better outcomes for Alberta patients.

On its face, Smith’s plan appears to be a reasonable attempt to streamline a centralized, monolithic health-care delivery system that isn’t meeting the needs of Albertans. Wait times are too long, too many Albertans don’t have a family doctor, and it takes too long to be seen by a specialist.

Despite those facts, however, the reaction to Smith’s plan has been wildly negative. Opposition NDP Leader Rachel Notley says that the Smith government “created this crisis, and now they want to blow up our health-care system completely.”

Chris Gallway, who leads an organization named Friends of Medicare, is quoted in a CBC report as alleging that the Smith government is “bent on further disruption at the expense of solving pressing issues such as a shortage of health workers.” He adds that “People in this province deserve to know that our public health care is being protected and strengthened, not dismantled and thrown into disarray to fulfil the political whims of the government or premier of the day.”

If you are wondering how proposed changes to Alberta’s health-care system are relevant to Manitoba, the reality is that our province faces the same challenges as Alberta’s, but ours are more urgent. Our wait times are longer, and there is an even greater shortage of family doctors and specialists. Beyond that, Manitoba’s health-care system is also largely run by a centralized monolith — Shared Health — that many experts in this province blame for many of the system’s problems.

They argue that Manitoba’s health-care system would deliver better, faster care to patients if Shared Health was removed from the picture. They claim that reasonable measures can and should be taken to ensure that all Manitobans have their own family doctor, and that patients navigate the system more quickly.

The solution here in Manitoba could largely resemble Smith’s plan in Alberta, but the reaction would likely be the same as well. It’s that skepticism, distrust and inertia among various stakeholders in our health-care system that, to a great extent, continues to be an impediment to improving the quality of health-care delivery in this province.

That has to stop. Manitoba’s health-care system is broken. We rank worst or near-worst in the nation in several categories, and that’s causing avoidable suffering for Manitobans. A solution in the form of major restructuring is obviously needed.

When the Kinew government comes forward with a reasonable plan for change, let’s hope that it cannot be derailed by stakeholders who are more concerned about their interests than the interests of patients.

Rather, let’s consider the plan with an open and hopeful mind. We cannot allow our fear of change to stand in the way of improvements that are clearly necessary and overdue.