Rebuilding Our Health System: Manitoba Liberals Release Plan to Rebuild Community Health Care

July 14, 2019



WINNIPEG – Manitoba Liberal Leader Dougald Lamont outlined his party’s plan to stabilize and rebuild Manitoba’s health care system today.


Lamont said that a Manitoba Liberal Government will end decades of over-centralized power in the hands of RHAs by merging them back with Manitoba Health and return greater control and decision-making to the local level across the province — community hospitals, clinics and personal care homes.


“Even as the Pallister Government is closing ERs, urgent cares and front-line workers are losing their jobs, the Pallister government is creating another, fourth level of bureaucracy, ‘Shared Services’,” said Lamont. “The PCs deliberately created a health care system without accountability. We’re going to restore accountability to the system and work together with doctors, nurses and health care experts to rebuild our health care system.”


The Manitoba Liberal plan is to ensure that Manitobans can get better care closer to home, whether it is in Winnipeg, rural Manitoba or northern Manitoba. The health system will be more accountable and responsive to community needs. 


Along with increased and reliable investment in health care, Manitoba Liberals will: 

Improve local medical care across Manitoba by giving communities and institutions more freedom and more say in their administration and services, especially recruitment of doctors and nurses and other essential health care workers. 

Restore accountability to provincial decision-making by reducing four levels of health bureaucracy to two and merging RHAs and Shared Services back into a single, public department: Manitoba Health. Manitoba Health will set provincial funding, policy, and standards; support province-wide specialist and information networks, and provide bulk purchasing for Manitoba’s health care system. In order to be responsive and support community-based care, Manitoba Health will still maintain regional hubs. 


Lamont said under the Manitoba Liberal plan, patients and communities across Manitoba would get better care, and Seven Oaks, Concordia, and Victoria Hospitals would all be able to choose to keep their ERs open — as doctors, communities and health care workers have requested. Concordia’s role as a specialist hospital for joint replacements depended on having an ER. The same is true for Seven Oaks specializing in renal (kidney) treatments.  


Manitoba Liberals have already committed to lifting the Pallister freeze on health spending, which has been in place since 2016, and ending the hiring freeze to allow staffing levels to stabilize. The Pallister Government’s actual spending on health has not increased since 2016, despite an increase in annual federal transfers by over $700-million, as well as an additional ten-year commitment of $400-million for health dedicated to mental health and homecare.


 “The PCs have put accountants in charge of our health care system. Manitoba Liberals will build a system that puts patients first, restores morale among health workers, and improves the quality of care,” said Lamont.


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MANITOBA LIBERAL PLAN FOR REBUILDING MANITOBA HEALTH CARE

Backgrounder


The Pallister Government is currently dismantling our primary care and emergency health care systems. Many who have worked in the system for decades say that it has “never been worse.”

The PC Government is dissolving every health unit under Manitoba Health and handing over policy from government to Shared Services. This is a serious and damaging change to our health care system that reduces democratic accountability and the ability of elected officials to implement policy changes for which they received a mandate.


When Manitobans want answers for the chaos in our health care system, The Pallister Government has repeatedly made the administration of the WRHA other RHAs, and hospitals to answer for changes that were dictated by the Health Minister or Premier.


While on paper they are independent, RHAs have little choice but to follow exactly what the government of the day requires them to do. As such, supposedly independent officials are pressed into defending and promoting the government’s line. This blurs accountability and gives politicians cover for their decisions.


Winston Churchill said that accountability is absolutely essential to democracy. Under the NDP and the PCs alike, Manitobans have a health care system where no one is to blame for its failures. This is unacceptable.


RHAs have often struggled to recruit nurses and doctors. Municipalities and communities have had to set up additional organizations and spend funds for recruitment.


The PCs and the NDP alike have been withdrawing services from local communities. The result is enormous costs on travel for individual patients, their families, and the public purse. The cost of travel for emergency flights alone is over $100-million.


Manitoba Liberals will merge Shared Health and RHAs — transferring administration to Manitoba Health to ensure accountability of Government in Health Care.


Under the current RHA system we have a patchwork of programs, policies and systems across the province which require layers of administration to be able to communicate and function together.

Manitoba Liberals will take the four levels of health bureaucracy in Manitoba and reduce them to two.

  Manitoba’s Current System  



   Proposed System


The goal of this change is NOT to reduce spending or cut. It is to improve care and spending by introducing accountability into a system where it is has been missing. We expect it will be cost-neutral.


Shared Services and Regional Health Authorities will be taken over and merged with Manitoba Health, while local health care delivery in hospitals, and clinics will be given greater autonomy and decision making.


- “Shared Health” will be moved to Manitoba Health, which will continue to be responsible for setting provincial policy, standards of practice, and bulk purchases of pharmaceuticals and medical supplies for economies of scale. 


- Provincial policy will still apply: all health care must conform to the Canada Health Act, and we will provide care based on need, not the ability to pay. 

- Centralized and improved information networks will help to connect every community in Manitoba to quality health care.


- These changes will allow hospital administrators to better serve the needs of both staff and patients by working locally.


- In order to ensure province-wide care, we will further develop Specialist Networks similar to   CancerCare Manitoba. We will have networks for Brain and Mental Health, Heart health, Diabetes, Women’s Health and Indigenous Health.


- The Manitoba Liberal Plan is based on the governance principle of subsidiarity – that decisions on health care are best made (for quality, cost and social organization reasons) at the local level of governance, except where there is an overarching province-wide need for decisions. 


Thus, specialist networks which serve the whole province will fall under the province’s Manitoba Health (as Cancer Care has done for many decades) while hospital, clinic and care home management and provision of home care will fall under local control.


Funding to Hospitals under the New Model


In order to properly fund health services, we need to change the way hospitals and services are funded. Historically, hospitals received the majority of funding as global funding based on funding from previous years that ended up capping services once the budget ran out. This does not take into account complexity of patients, service levels, costs, nor did it provide incentives for performance.


Patient-based funding is an evidence-based model with incentives to deliver the highest quality, most efficient care. Liberals believe that funding should be based on how many patients they care for, the services delivered, the evidence-based quality of those services, and the specific needs of the population they serve. This reduces the perverse incentive of ever-increasing administration and provides funding based on actual services delivered.  Services would require quality assurance and the inclusion of preventive approaches to keep people healthy to ensure the best quality health care is being provided to Manitobans.


- By starting slowly with 10% of hospital budgets moving to Patient-based funding model annually, the Manitoba Liberal approach will give government and hospitals the time to identify challenges and correct them before further changes are made. 

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