What next? Experts look to future under single Sask. health authority

Experts are weighing in with their thoughts following the announcement of some big changes to the provincial health system.

Ministry will reduce 12 health regions to single body by fall

Experts across the province are asking for more details on plans to consolidate the province's health regions into one super-region. (Jonathan Bachman/Reuters)

Experts are weighing in with their thoughts following the announcement of some big changes to the provincial health system.

By this fall, Saskatchewan will have a single administrative body controlling its health care system, replacing the current 12 health regions across the province. 

Health Minister Jim Reiter said Wednesday the move will result in better administration and less duplication, while still maintaining patient care.

However, one expert in health care administration says it's still too early to say what will happen following the changes. While he said that there are efficiencies to be found, he's not convinced consolidating health regions will necessarily fix the situation.

"Better coordination, better integration, standardizing some things like [information technology], they're all perfectly reasonable goals," said health care analyst Stephen Lewis.

"The question is whether you need to get rid of regional governance and regional administration to do that."

Daniel Béland, Canada research chair on public policy at the Johnson Shoyama Graduate School of Public Policy, said Saskatchewan is undertaking an ambitious plan. (Chanss Lagaden/CBC)

Daniel Béland, Canada research chair with the Johnson Shoyama Graduate School of Public Policy, said if saving money is a major goal, it may not be realized by reducing administration.

"You might save money on administration, but it's only a fraction of the actual cost of running a modern health care system."

A lot of challenges in a short time

Lewis said Saskatchewan is a difficult place for a single health care administrative body to represent. With more than a million people scattered across a huge geographic area, he said it will be challenging for one region to represent everyone in the province.

"How do you ensure that there is a good balance of care between urban Saskatchewan and rural Saskatchewan?" he asked. "There's nothing in the new structure that would prevent improvement there, but it's a long way from guaranteeing it, either." 

Béland added that along with figuring out who to put in charge and where to centralize them, there are a lot of questions as to how the system will be held accountable and how it will be perceived.

The province does have some precedent it can look at while it designs its new system. In 2008, Alberta consolidated its health regions under one provincial superboard. However, Lewis said the results from that experiment remain inconclusive.

"Things are still not crystal clear and settled down in the wake of that," he said. "It takes a long time. You've got to dismantle the boards, you've got to rearrange your administration, you have to figure out the roles of administrators."

Béland said there are things to learn from how Alberta stumbled, but with the plan to have the single health authority in place by fall, there may not be time. 

"To change course, you have to plan, and there are risks involved."

Rural concerns

Meanwhile, the Saskatchewan Association of Rural Municipalities (SARM) has questions about rural health care it would like answered. While the group was consulted during health region discussions last year, SARM hadn't heard anything more about the process until Wednesday morning.

"We have more questions right now than answers, to be honest," said president Ray Orb. 

Orb said he's concerned about whether the new superregion will focus on rural health issues, and whether the Ministry of Rural and Remote Health will continue to operate.

"We still need the contact people here in rural areas to get our problems and our issues across," he said. "I think we'd have more of a concern about the delivery of emergency services … They're looking at changing, perhaps, the planning and the process of how EMS is delivered."

SARM representatives are hoping to meet with provincial health ministers in the next few weeks to voice their concerns.

"We're asking [that] the system that we have now be enhanced, rather than diluted," he said. "I think a meeting with the ministers would probably resolve that issue."


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