This year has been a challenging one for many people across this province. Next year promises to be equally uncertain.
The year began with the Government’s decision to amalgamate 12 regional health authorities into a single health authority which would be known as the Saskatchewan Health Authority. Health Ministry officials stated that improvements to patient care were the overriding goal. This was to be achieved by ensuring that under one provincial health authority there would be seamless boundaries or “invisible boundaries”, and patients would not notice a difference in the services delivered on Day 1. In addition, Health Ministry officials predicted savings in dollars spent as there would be a lesser bureaucracy with lighter levels of Senior and Upper management. Some health authority leaders went as far as to say that front line staff and services would not be affected by the changes to the health region structure, as the transition to one provincial health authority took place.
The reality has looked somewhat different. In the spring, the provincial budget for 2017-2018 was introduced in the Legislature. It will likely be remembered as the most devastating budget experienced by the people of Saskatchewan in this province’s history. It included cuts to publicly funded health programs which had been providing services to Saskatchewan residents for decades. Affected were parenting programs, the Hearing Aid Plan, and the Podiatry program. The Hearing Aid Plan saw five audiologist positions deleted bringing the total number of 12 Audiologists employed by the health authorities, to 7 – a cut of almost 50% to one profession/program alone. Saskatchewan already had the lowest number of audiologists working in the province (privately and publicly). With these cuts, longer wait times for seeing an audiologist in the health regions has risen with recent reports of approximately 400 children waiting to see an audiologist in Saskatoon. Additional frontline cuts were made in August bringing the total number of layoffs to over 27 full time equivalents (FTEs) of specialized health care professionals, since the passage of the spring budget. These short-sighted cuts saw a loss of Health Educators, Health Promotion Practitioners, as well as Nutritionist, Dental Health Educator, Dietitian, Public Health Inspector, Psychologist, Recreation Therapist, Addictions Counsellor, Social Worker, Assessor Coordinator, and Epidemiologist classifications. The Health Educator/Health Promotion Practitioners/Nutritionist classifications alone realized a reduction of over 11 FTEs across the province (as of October 28th). To date, this constitutes over 40% of the overall loss of professionals and the services they provided. An email to staff in RQHR indicated that the cuts to Health Promotions Practitioner/Health Educator/Public Health Nutritionist classifications were a “provincial approach,” with provincial funding for health promotion and prevention programs reduced by just over $1.3 million.
Clearly, this has been a difficult time for HSAS members and for the recipients of the essential programs they delivered. HSAS Labour Relations staff have been working closely with those members affected by layoffs, ensuring that throughout the process they are informed of their rights and options under the Collective Bargaining Agreement.
These specialized health care professionals worked in our communities, in multi-disciplinary teams, with individuals, agencies and organizations to create healthy environments, healthy communities and healthy individuals. The ability of the remaining specialized health care professionals to provide the care that is needed, has been reduced substantially. This will negatively affect the quality of our health care, and the health of our society today and in the years to come.
HSAS disagrees with those who prematurely predicted that patient care “will not be affected”. We have already seen how patient care has been adversely affected. Rather than implementing decisions that result in a loss of appropriate care, HSAS believes that real savings and efficiencies can be realized in our health care by investing in health prevention and early intervention programs. We need programs and specialized professionals who have the skills to keep patients and clients out of hospitals, and in their community, maintaining their independence and living with an improved quality of life. HSAS believes that this can be accomplished with a positive vision for health care through publicly funded, publicly delivered and publicly administered health care. HSAS will continue to advocate for an increase in health care spending for all citizens of Saskatchewan, as an investment, not a cost.
Health is not just about the presence of illness, but is also about a state of wellness. Vulnerabilities of families can include other factors such as economic difficulties, lack of social supports, social exclusion, poor mental health, physical health or disabilities. The health of an individual, family or even community is affected by challenges they may face in every aspect of their lives. To ignore those factors invites failure. As we move forward to one provincial health authority, HSAS will continue to advocate for the health care services Saskatchewan residents need.
Another aspect which will be impacted by health region amalgamation is HSAS member seniority. Seniority will be provincially based as opposed to region based as it has been. HSAS will ensure that the Collective Bargaining Agreement is honored. Working conditions should be consistent across the province, from site to site, community to community and compliant with the Collective Bargaining Agreement, and the Saskatchewan Employment Act.
December 4th is fast approaching. Many questions remain concerning the full impact of health region amalgamation. The new Saskatchewan Health Authority leadership has indicated that the full metamorphosis may take years. We will be here- through the good, the bad and the ugly.