The emergency room in Selkirk, Man., is the scaling back the hours of additional doctors on duty as the health region attempts to cut $7 million in spending to balance its budget.
An internal memo sent to emergency department physicians by the Interlake-Eastern Regional Health Authority's chief medical officer, Dr. Myron Thiessen, said as of Sept. 4, the Selkirk Regional Health Centre is cutting four hours of staffing from its current complement of doctors.
"That's a tough pill to swallow," said Selkirk Mayor Larry Johannson. Selkirk's hospital is important not only for residents in the town, he said, but also to smaller communities in the Interlake region.
"We're surrounded by highways, we're surrounded by other communities," Johannson said, adding that he will have to wait and see before deciding whether the cut to doctor hours is worth the savings.
On Tuesday, a spokesperson for the health region clarified earlier statements made by the health authority and its CEO, who stated the department would only have one doctor in the ER during peak hours.
Spokesperson Lauralou Cicierski corrected statements made to CBC News and added that two doctors will be on staff at the ER from 1:30 p.m. to 10 p.m. each day.
In March, all of the province's five health regions and special units like Diagnostic Services Manitoba, CancerCare and the Addictions Foundation of Manitoba were told to cut costs by millions of dollars this year and lay off 15 per cent of their managers.
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The emergency room in Selkirk added the four hours of doctor staffing in September of 2015. The objective was to care for patients in person and answer phone calls from nurses at other Interlake hospitals who do not have emergency room doctors.
The decision to eliminate those additional four hours in Selkirk helps the region meet its balanced-budget target of finding $7 million in savings this year and the extra staffing was no longer medically required, said Ron Van Denakker, chief executive officer of the Interlake-Eastern Regional Health Authority on Monday.
"The four hours of additional ER time was never funded so that was a deficit that we had," said Van Denakker.
"Could we use an extra four hours? You can always use extra bodies but I would say the way we're staffed right now is the appropriate way."
The extra hours were a short-term solution to a problem the health region has worked hard to solve in recent years — attracting and retaining doctors in the Interlake.
As of May, the Interlake-Eastern health region had 31 vacant family physician positions. With 84 positions in the region, that represents a vacancy rate of about 37 per cent, according to figures provided by the health region.
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For years, Selkirk has helped absorb patients who couldn't find care at hospitals closer to where they live or "fill gaps in physician coverage." Now, things are changing, said Van Denakker.
The region has hired additional doctors and does a better job of keeping track of hospital schedules online, he said.
Patients can now find out which hospitals have doctors on staff, and when, using the Interlake-Eastern website. Van Dennaker expects that to reduce the pressure on Selkirk to have a doctor available at all times.
'We still face difficulty'
Dr. Thiessen's internal memo offers differing motivations for the reduction in doctor hours at the Selkirk emergency room.
The health region was "obligated" to cut the extra hours for budget reasons even though the hospital continues to see extra patients, Thiessen said.
"While we still face difficulty in Emergency Department closures throughout the region, we are now in a time of increased fiscal restraint and scrutiny by government," wrote Thiessen.
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His memo, dated Aug. 14, was obtained by CBC through an access to information request.
The New Democrats' new health critic, Andrew Swan, said the cut to physician hours at the Selkirk emergency room is evidence the government is willing to put austerity measures before patient care and may increase wait times.
"Even something as basic as making sure an emergency room is properly staffed is something that would offend this new government's approach to austerity," said Swan.
"The folks in Selkirk have been doing a really good job and it's a shame that this government's new approach to health care is going to leave people with worse care."
The announcement to end extra hours in the ER came just months after the province opened the brand new $111-million Selkirk Regional Health Centre to the public.
Health Minister Kelvin Goertzen's office declined an interview Monday.
According to the Interlake-Eastern Regional Health Authority's latest public schedule, from Sept. 16 to Sept. 30, only two hospitals out of 10 in the region have doctors available 24/7: at Dr. Evelyn Memorial Hospital in Stonewall and at Selkirk Regional Health Centre.
Selkirk is a city of 10,000 people about 35 kilometres north of Winnipeg.
The hospital's emergency department had 34,403 visits in 2016.
We initially reported that the cut to on-staff doctor hours would leave the department with only one doctor during peak hours. In fact, while hours are being cut, two doctors will be on staff in the department from 1:30 p.m. to 10 p.m.Sep 26, 2017 3:58 PM CT