The 2022 Newfoundland and Labrador provincial budget included sweeping changes to health care — but it isn’t yet clear how those changes will affect patients.
Newfoundland and Labrador spends more per capita on health care than any other province, and it will spend even more this year. The government plans to spend about $3.4 billion on health care in 2022, representing 38 per cent of this year’s budget.
All four regional health authorities are being integrated into one, which will govern the whole province. During her budget speech, Finance Minister Siobhan Coady said the amalgamation is being done to avoid duplication and provide consistency.
“It will improve decision-making with streamlined processes, effective reporting structures, data management and accountability,” she said.
The 2021 report by the premier’s economic recovery team recommended integrating Eastern Health, Central Health, Western Health and Labrador-Grenfell Health into one provincewide health authority, but this is the first concrete step in that direction.
Health Minister John Haggie said Thursday the amalgamation will take 12-18 months, and most of the changes will involve administration, rather than front-line workers.
“This is about back end. This is not about health-care provision at the front end,” Haggie said.
Local input vital: Opposition
PC opposition health critic Tony Wakeham, former CEO of Labrador-Grenfell Health, said the government needs to ensure the new provincial health authority doesn’t neglect rural parts of the province, particularly Labrador.
“It’s critical that Labrador be recognized for the uniqueness and the challenges that it has in terms of health-care delivery,” Wakeham said.
Interim NDP Leader Jim Dinn said he isn’t convinced the amalgamation will save money in the long run.
“It’s going to come down to the devil in the details. What do you mean by efficiencies? And how is that money going to be reinvested?” Dinn said.
Haggie did not say where the new health authority will be headquartered, but said it will emphasize local input.
“As an MHA from an area outside of the Avalon and having spent several decades in health care myself, that is something I want to make sure to address up front in the governance structure.”
Health-care system can’t afford job losses: union
Haggie said the CEOs of the regional health authorities were told about the amalgamation on Wednesday evening — and they saw the changes coming. He said the Health Department will be looking for a new CEO to govern the new provincial health authority.
He said some people may leave their current roles but would be offered “comparable” roles, while others may retire.
“This is not about mass layoffs or layoffs of any kind,” he said.
Jerry Earle, president of the Newfoundland and Labrador Association of Public and Private Employees, insisted that no jobs should be lost in the transition from four regional health authorities to one.
“There is nowhere in health care right now where we can afford the loss of a single person,” he said.
Health-care workers in Newfoundland and Labrador have struggled with understaffing, mandatory overtime and 24 hour shifts. Just this week, Haggie said some surgeries may be delayed this summer because of a shortage of nurses — adding to the existing backlog of surgeries.
Changes to emergency services
Emergency services in Newfoundland and Labrador are being streamlined and emergency dispatch is being centralized — a change that follows the provincial government’s plan to bring 911 operations under the Justice Department.
The Health Accord N.L. recommended amalgamating the province’s air ambulance service and more than 60 ground ambulance operators. The 2022 budget signals that work will begin to “modernize and integrate” ground and air ambulance, though there is no timeline yet.
The Health Accord also recommends closing emergency rooms in some rural areas and using virtual emergency services instead. The budget does not specifically recommend closing any emergency rooms, but it does include $3 million for virtual emergency services.
“The concept of virtual emergencies is very helpful for rural communities,” Haggie said.
Newfoundland and Labrador Medical Association president Dr. Susan MacDonald panned the possibility of closing emergency services in rural Newfoundland and Labrador. She said she would’ve liked to see the province spend more on retaining and recruiting family physicians.
“Virtual care has a role to play, for sure, but it does not replace having a family physician,” she said.
The province is spending $10 million to renovate the emergency room at the Health Sciences Centre in St. John’s. Haggie said some of the renovations are related to the construction of the mental health and addictions hospital next door, which will use the same emergency room.
Haggie said the project will be completed in three phases, with the final phase schedule for completion in 2025 or 2026.
A new faculty of health
The provincial government is bringing post-secondary medical programs, including pharmacy and nursing, under one provincewide faculty of health.
“I think it will be welcome at Memorial University to have a comprehensive medical program there,” said Haggie.
MacDonald said she is cautiously optimistic about the plan because it will give students studying different aspects of health care the opportunity to collaborate.
“I don’t know how that’s going to play out, and I’d like to see a lot more details about that,” MacDonald said.
The government is also spending $3 million to increase the number of seats in Memorial University’s nursing program by 25 per cent.
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