Manitoba·Q&A

ER overhaul a 'Manitoba model' other provinces will look at, architect of change says

The first phase of a major health-care overhaul in Winnipeg is slated to move forward next week, with one emergency department converting to an urgent care centre and one urgent care centre shutting its doors.

Victoria Hospital ER to become urgent care centre next week, Misericordia urgent care centre to close

Dr. David Peachey was in Manitoba on Tuesday to speak at a news conference for the first time since he presented his report, Provincial Clinical and Preventive Services Planning for Manitoba: Doing Things Differently and Better. CBC's Erin Brohman spoke to him to hear his thoughts on the province's progress. 5:45

The first phase of a major health-care overhaul in Winnipeg is slated to move forward next week, with one emergency department converting to an urgent care centre and one urgent care centre shutting its doors.

Manitoba Health Minister Kelvin Goertzen has called the reform the biggest change to health care "in a generation," and says it will result in more efficient, higher-quality care for patients.

Critics of the plan say it's moving too quickly, reducing quality of care and will cost front-line jobs.

The changes are guided by a report commissioned by the former NDP government in 2015 and completed by a team led by Nova Scotia-based consultant Dr. David Peachey.

Peachey was in Manitoba on Tuesday to speak at a news conference for the first time since he presented his report, Provincial Clinical and Preventive Services Planning for Manitoba: Doing Things Differently and Better, in April.

CBC's Erin Brohman spoke to him to hear his thoughts on the province's progress.

This transcript has been edited for length and clarity.

You said things are rolling out quite well. Why do you say that? This is a time of a lot of disruption and change and upset for a lot of people.

You know what I was really impressed with, is that the things that were key to start, is that there's an infrastructure put in place by the shared health services, there are clinical leadership groups put in place, there's a clinical governance put in place, and then you take the information we saw today has really saw through the granularity of what change will mean.

I think you've gone as quickly as you possibly could and it's really comprehensive, so quite honestly I'm thrilled with how it's unfolding.

You made a lot of recommendations in consolidating the emergencies and having a more efficient system that way. Do you think the changes are happening maybe a little too fast, in light of the fact that that's what your report found?

I don't. I think, in fact, they're being put forward in a graduated fashion that's logical. I guess part of me would've said why don't we do things faster? That's just sometimes the urge. But at the same time, the transition period that's taking place now, rolling into the spring of 2018, will be as painless as possible for people and it will still achieve the goals.

Dr. David Peachey was in Manitoba on Tuesday to speak at a news conference for the first time since he presented his report, Provincial Clinical and Preventive Services Planning for Manitoba: Doing Things Differently and Better. CBC's Erin Brohman spoke to him to hear his thoughts on the province's progress. 0:37
What do you see as a good city to model?

The honest answer? If you look at what is happening in Manitoba right now, I think across this country people are going to talk about the Manitoba model. I think you are doing things that are original, are logical and you can take it right down to primary care.

I'm excited about the primary care transformation where you get the My Health Teams with about a dozen different kinds of providers who are working in a collaborative model, who are aligning themselves with remote communities. People get a consistency of treatment and ready access. I think there's some really exciting things with models of care that other people are going to be able to learn from you.

People are quite concerned, though, that there's not an increase in investment in things like mental health services and that mental health was kind of left off of the agenda in terms of what we're investing into.

I'm not sure where the investment part is going. I'll say this about mental health and addictions: It was one of our five priorities in the report and it still is today.

Part of the mental health approach is that there has to be a new model of care. The new model of care realigns with what psychiatrists are doing and we've spoken with the lead of psychiatry. There is a real deficit in Manitoba of clinical psychologists. You've got about 19 per 100,000 versus 39 to 40 [per 100,000] on a national basis, so there probably will need to be an investment in clinical psychology.

So I think that's an area where money will have to come forward I think that's a policy decision of the government but it's clearly one of the five big priorities. And if mental health gets failed, then I think the whole plan gets failed.

Your report actually didn't say anything about slashing occupational therapy and physiotherapy outpatient services …

All I can say about OT and PT is that we saw OT and PT as being part of the My Health Team collaborative care unit, but we didn't go beyond that.

What is happening now has been a WRHA initiative. You'd have to ask them, really, where their reasoning is.

Would you suggest that those services should continue to exist [in hospitals]?

I'd like to see OT and PT, particularly PT, as part of the My Health Teams and as part of an outreach program to varying remote parts of the provinces.

At the end of the day, I mean, we spoke to physiotherapy and we spoke to OT, tried to get a feel for where they're going and how they can align with the programs. If there's a great efficiency, you may or may not need a greater number. I don't know that.

Is there anything else you'd like to say?

I think Manitoba is in a leadership role, that they've got the right pieces and they've got the right people. They're going to have to have some rearrangement of those pieces and some new ones as well.

But you're going to see things happen in this province that will make you feel very good.

With files from Erin Brohman