Southern Health Regions finds $1.2M in savings, larger plan for rural health care remains a mystery

In total, over $1.2 million in savings targeted by the authority has been approved by the province, while the remaining millions are still awaiting approval by the government.

Health authority will cut programs, reduce spending

Manitoba Health Minister Kelvin Goertzen says the province's plan for health care in rural Manitoba will likely be announced early next year. (Riley Laychuk/CBC )

The Southern Health-Santé Sud Region is eliminating adult day programs and cutting spending at affiliated long-term care homes in search of $11 million in savings, but the majority of plans for health care in rural Manitoba remain a mystery.

In total, over $1.2 million in savings proposed by the region have been approved by the province, while proposals for the remaining millions are still awaiting approval by the government.

And it's not alone.

The three other health regions outside Winnipeg submitted their proposed savings to government earlier this year, but the lion's share of the planning — including any clinical changes — remains unapproved and not implemented.

Day programs cut in Winkler, Morden

The Southern Health Region, which serves almost 200,000 people in southern Manitoba, has found a few ways to cut costs.

Seven affiliated organizations — meaning they are not operated by the authority, but the authority provides some funding — have been asked to slash one per cent from their books, according to a recent freedom of information disclosure to CBC News.

Menno Home for the Aged, Tabor Home Inc., Prairie View Lodge, Rock Lake Health District Personal Care Home, Villa Youville Inc., Rest Haven Nursing Home and Salem Home have all been asked to find one per cent savings within their organizations.

The authority hopes to save $425,000 in salary costs and and operational costs through this measure and by cutting two adult day programs at Salem Home in Winkler and Tabor House in Morden.

Sherry Hildebrand, Tabor Home's CEO, wrote in the memo dated May 5 that after 30 years of service, there are other supports in place for seniors to access meals and activities.

The authority will also save $250,000 by cancelling a private-security contract, $26,000 by cutting the number of flu clinics this year and $51,300 by reviewing which services should be offered by mental-health proctors in the region, among other cost-saving measures.

None of these approved plans will reduce care hours or change the hours that any of the authority's facilities operate, according to a note by a freedom of information co-ordinator.

Most measures not implemented or approved

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.

Prairie Mountain Health Region — which serves Brandon, Dauphin and other areas in the Westman region — has been told to find $17.5 million in savings this year, while the Interlake-Eastern Regional Health Authority and the Northern Region Health Authority have been told to find $7 million and $5 million in savings, respectively.

All the health authorities told CBC they were still awaiting approval from the province for their longer-term plans, outside of routine program reviews.

While the Winnipeg Regional Health Authority has undergone massive changes as part of its mandate to find $83 million in savings, Health Minister Kelvin Goertzen said any clinical changes that would include emergency rooms or hospitals in the other four RHAs won't be approved until early next year.

"The rural regions came forward with their own proposals. They were not quite as co-ordinated as we saw in Winnipeg," Goertzen told reporters last week.

"When it comes to clinical re-organizations impacting hospitals or emergency rooms, certainly those must [still] come for approval."

What the Peachey report says

Unlike Winnipeg, the other regions didn't have a 233-page report created by Dr. David Peachey to guide the changes, Goertzen said.

However, while Peachey's report — commissioned by the former NDP government — wasn't as specific when it comes to rural RHAs, it did make several recommendations.

Dr. David Peachey led the report, Provincial Clinical and Preventive Services Planning for Manitoba, which recommends using nurse practitioners and paramedics to staff emergency rooms overnight in rural Manitoba. (Kelly Malone/CBC)

In his report, Peachey makes reference to the number of hospitals in Manitoba, stating 73 is "a large number" for a population of 1.3 million.

Many smaller, rural hospitals are, "de facto providers of long-term and personal care, even though funded as hospitals," he states in the report.

Outside Winnipeg, he recommends centralizing surgical and speciality services in regional hubs.

He also writes that the "provincial delivery of emergency care will be incomplete without collaborative emergency centres (CECs)," which are utilized in Saskatchewan and Nova Scotia.

A CEC will staff a regional emergency room overnight with a registered nurse and paramedic to provide urgent care assessments, with physicians available for assessments through a centralized service.

The idea is to prevent the closure of an emergency department due to doctor shortages.

In Manitoba, between Feb. 25 and Sept. 1 of this year, 23 rural emergency departments saw closures for more than 24 hours, due primarily to doctor shortages. For example, Arborg and District Health Centre in the Interlake had its emergency department closed for 104 of the 188 days recorded, according to data provided by Manitoba Health.

Over that period, the 23 hospitals experienced a combined total of more than 800 days of closures.

The province has recently announced the recruitment of more than 40 new doctors within the rural RHAs, which is expected to help ease these closures.

How Manitoba will become the model for health care

5 years ago
Duration 0:38
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.

New health organization will oversee major changes in rural areas

Goertzen said the government has asked the newly created Shared Health Services Manitoba — a provincial health organization created to centralize clinical and business services for the regional health authorities — to look over the proposed plans and ensure it makes sense for the province as a whole.

"We don't want to be doing something in one region that causes a problem in another region," Goertzen said. "Likely in the new year, [Shared Health Services] will be providing us with some of their feedback on that."

The Southern Health Authority declined to give CBC an interview with its CEO, Jane Curtis.

The Interlake-Eastern Health Authority's CEO, Ron Van Denakker, provided few specific details, citing the lack of approval from the province, but said the plans for savings are "synergistic" with the other regions.

"What I can tell you is that we are looking at rolling out an overall provincial integrated plan for the very first time that is intended on improving access," he told CBC News.

"I am very hopeful that at some point in the not-too-distant future we are going to be able to share with Manitobans the good work that the province has done."

One thing that won't happen in his region is the closure of any hospitals, he said.

"I will not be closing hospitals," he said emphatically. 

When asked about the CEC model, in which nurse practitioners can staff an emergency department overnight, he didn't rule it out.

"What I can tell you is that the use of all kinds of paraprofessionals is very important in any kind of health-care system," he said.

"It can't be just be the responsibility of physicians anymore, because first of all, it is not an effective use of a doc's time."