Saskatchewan says the move to consolidate health regions will reduce administration and duplication in services such as legal, IT or accounting.FabioBalbi/Getty Images/iStockphoto
The Saskatchewan government says it will consolidate the province's 12 health regions into one provincial health authority to be created this fall.
"What we hope it'll mean is a more effective way of delivering health care and, if we do this in a proper manner, the average person, frankly, won't notice a difference," Health Minister Jim Reiter said at a news conference Wednesday.
"The average person is worried about front-line health care, not management structure."
Mr. Reiter said the move will reduce administration and duplication in services such as legal, IT or accounting.
However, the minister could not immediately provide a dollar figure for the savings or the number of jobs affected. That will be determined by a transition team, he said.
"But I think I should also note that cost savings is not the primary driver of this.… This is about better and more effective ways to deliver health care to Saskatchewan," Mr. Reiter said.
The government plans to appoint a single board of directors to govern the health authority. There could also be four zones created to co-ordinate care.
The announcement comes after the goverRnment appointed an advisory panel last summer to recommend options for fewer health regions and more efficient service.
A report released on Wednesday by the panel says patients with singular, immediate needs are often well served by the health system. But it says that's often not the case for patients with multiple chronic or complex conditions.
Panel member Dr. Dennis Kendel said health regions and services have been working as if they're silos.
"The regional health authorities have created some boundary issues that, in fact, have sometimes hampered seamless patient care," he said on Wednesday.
The report also recommends consolidating dispatch and delivery for emergency medical services, which it says are delivered by a large number of vendors with poor integration.
There are just more than 100 ambulance services in Saskatchewan.
Provincial Auditor Judy Ferguson said last month the boundaries for a region are artificial when it comes to ambulance service and, in some cases, service in another region may be closer to an emergency.
The panel received more than 300 submissions from the public, doctors and organizations.
The report said while there was excitement about the potential for better care, there was also concern rural and remote communities will get lost in a bigger system and fears the restructuring is motivated by money rather than improving quality.
The province is trying to save money because of a big drop in natural-resource revenue that has pushed the government's deficit for this year close to $1-billion.
"With the Saskatchewan Party government, consolidation is code for cuts and closures – cuts to frontline services, cuts to jobs and closures of health-care facilities," New Democratic health critic Danielle Chartier said.
Cheryl Camillo, assistant professor at the University of Saskatchewan's Johnson-Shoyama Graduate School of Public Policy, says how the government communicates with the public and how feedback is used will be key.
"Ultimately, your everyday patient is less concerned about how many managers there are over the health-care system and they care more about the services they receive," Ms. Camillo said.
"But they need to understand where to receive those services, and who they are going to need to contact to receive those services and where they go for them."
It's not the first time health regions have been consolidated in Saskatchewan.
There were 32 health districts formed in 1992. In 2002, the province created the current 12 health regions plus the Athabasca Health Authority.
The system serves about 1.2 million people with a budget of $5.1-billion.
Alberta took similar action in 2008, when it rolled all regional health authorities into the centralized Alberta Health Services superboard to save money and improve care.
But the AHS has struggled. There have been scandals over large executive payouts, questionable expense spending, organizational confusion, bureaucratic turf wars, queue-jumping and long wait lists for care.
Dr. Kendel says the Alberta experience has provided lessons for Saskatchewan, including the need for rigorous, advance planning.
"The fundamental flaw in the Alberta model is they hadn't thought out a management structure – essentially, there was a single entity, Alberta Health Services, and nobody knew the next day who was actually accountable for what," Dr. Kendel said.