Since taking office 18 months ago, Manitoba’s Progressive Conservative Premier Brian Pallister has taken the scissors to many portions of the public sector in an attempt to drive the province’s debt down and erase decades of NDP work. Such is the ebb and flow of politics.
However, as his popularity with voters continues to drop – dipping to 36 per cent according to a recent Winnipeg Free Press Poll – our premier seems to have hit a major snag, one that will undoubtedly affect everyone in the province in some way.
Following the recommendations of two studies commissioned by the province, the Pallister government gave the Winnipeg Regional Health Authority (WRHA) a mandate to cut $83 million in spending from the province’s $6.1 billion healthcare budget.
Part of this plan involves shuttering three of Winnipeg’s six emergency rooms (ERs), leaving only Grace Hospital, St. Boniface General Hospital, and the Health Sciences Centre (HSC) with open ERs, and converting the Victoria General Hospital and Concordia Hospital ERs into urgent care facilities.
While drops in wait times, low layoff numbers, and decreased ER intakes have been reported in the early stages of the transition, by taking these reports at face value we lose sight of the actual substance of these changes.
The decrease in wait times and intake can just as easily be explained by the fact that some would-be patients – who previously lived within walking distance of an emergency room – now live too far from HSC or St. Boniface to facilitate them seeking care.
Misericordia Health Centre, which lost its urgent care facilities, is located in the heart of the city, less than two kilometres from the Manitoba Legislature. In June, the public was notified that the urgent care clinic onsite would be closed as of Oct. 3, placing some of the most vulnerable Winnipeggers in a tough spot.
Now, residents of the surrounding neighbourhoods must travel to HSC – four kilometers away – or St. Boniface – five kilometers away – for medical emergencies. It takes an estimated 11 minutes to drive to St. Boniface from Misericordia, or around eight minutes to HSC – and these are only estimates based on Google Maps. Anyone that has driven downtown during rush hour will tell you that the trip will certainly be longer than eight or 11 minutes.
For many lower-income Manitobans, driving to the nearest ER is simply not an option. The same goes for cabbing, or having family or friends offer a ride. These are easy options for many middle-class Winnipeggers, but not so much for those who are less fortunate. Not everyone has family able to drop everything and take them to the hospital, nor can everyone afford cab fare on the spot.
From this, you could easily conclude that the decrease in wait times being reported by the Free Press and Winnipeg Sun, and based on figures taken from the WRHA itself, is likely not representative of the actual situation. To this point, nobody has tracked the dispersion of urgent care and emergency room patients. The numbers could be a wash.
Yes, numbers are down. But we need to ask why they are down. Beyond this, we need to look at how nurses are bearing the brunt of these changes.
According to the WRHA’s website, the rationale behind the closures and reorganization was to concentrate resources at certain hospitals, in order to decrease wait times and get patients through the hospital system quicker. However, recent events have shown this to be questionably true at best.
In the past week, 1,000 nurses in various wards at St. Boniface received deletion notices, including those with the most seniority. Deletion notices inform nurses when their position, or shift combination, is being removed from the hospital’s scheduling system.
Hospitals are reducing the number of shift combinations from 80 to 22, removing 58 options from nurses who have lives outside the hospital. To add to this, 40 nurses were recently laid off at Victoria, one of the hospitals losing its emergency room.
The WRHA has argued that this does not mean that nurses are losing their jobs – they are being funnelled into positions in different wards. To me, this does not sound like concentrating resources. If the WRHA were concentrating resources, authorities would have simply moved highly trained health professionals to a similar ward at a different hospital.
By closing emergency rooms while not adequately addressing the need for more personal care home beds and permanent healthcare staff, we are just increasing the demand at a smaller number of locations. Our premier seems incapable of grasping this basic business logic.
The provincial government would have you believe that this has been done to provide better continuity of care, and to make sure that the hospitals are adequately staffed throughout the day. However, actions taken so far have reduced nurses – living, breathing people with families, lives, and their own mental and physical health to worry about – to numbers in a computer system.
Of the 40 nurses laid off at Victoria, 10 chose to leave voluntarily. It is unlikely that career nurses are now deciding to pursue a new career or retire early: they made a tougher choice.
I wager nurses bowed out of a fight they were continually losing. It was done so they could look after their children: watch their hockey games, go to their dance recitals. So they could see therapists, and rest from a 12-hour shift where they were yelled at, swore at, and spit on by unhappy patients and their families.
The problem with applying a numerical and statistical approach to human lives is that it takes context out of the equation. Pallister and the WRHA care more about cutting costs and making wait times drop than the people whose job it is to care for the sick.
The government and the WRHA have taken people and shoved them into a computer program that cares more about efficiencies than what is good for nurses, and by extension their patients.
It can be argued that nurses are not losing their jobs, and that they are just being funnelled into open positions in different wards. This, once again, is focused on numbers in place of human substance.
There is a staggering difference between the type of work done in the operating room and the ER. A nurse trained to work with geriatric patients will not decide one day to take on patients in the ER, nor could they easily manage the change.
ER nurses may be the healthcare professionals most ready to tackle anything, but we need them where they are, taking on the dirty and tough job that others simply can’t. You can put an ER nurse in a burn ward or palliative care, but we need them where they are, helping the most vulnerable Winnipeggers.
These changes will have a negative impact on the healthcare system as a whole in this province. Health is not a numbers game. Nurses will burn out and leave in greater numbers, patients will die, and the next government will be left to pick up the pieces.