In each of our public meetings as part of our effort to see where health care is at, we asked several questions. 1) What is working well? This question is important because the starting place for improving our health care system is understanding what is working well. Items that fall in this category need to be supported and indeed built upon and used as models of good care to improve the system. 2) What is not working? This is an important question because it identifies where there are problems which need to be understood and addressed to improve the system. 3) Where do we need to invest? This is a critical question because it identifies areas which will need additional funding in order to correct the deficiency. We have also begun asking a fourth question 4) What is needed to improve or restore trust in Health Care in Manitoba. We are asking this question because we have found too many people are losing or have lost trust in Manitoba's health care system.
We had an excellent turn out for our meeting in Thompson. People were very engaged and were able to identify items in each of the four categories. A brief mention of some of these items is below: It is not exhaustive. A more complete report will come when we have finished our public meetings;
What is working well?
- Cancer Care navigation and care approach is working well,including the use of telehealth.
- Retinal screening for those with diabetes is a good program and it is working well.
The diabetes program including education, nutrition information and exercise is working well.
- The University College of the North nursing training program has been successful in providing more nurses for northern Manitoba. The midwife program has been well received.
- Wait times in the Emergency Room are generally short
- There has been some improvement in mental health care, but there is still a long way to go.
-What is not working?
- Physician recruitment and retention is managed poorly. The result is a high turnover of doctors. People are very upset that there is no consistency in their family physician and feel that the whole approach to recruiting and retaining doctors needs to focus on having long term doctors rather than short term doctors.
- Dialysis could be improved. To many people now go to Winnipeg for dialysis because the program in Thompson does not work well for them.
- There are major problems with the current approach to sending and supporting people who have to go to Winnipeg for health care. First, there are too many unnecessary visits for 5 minutes to see a specialist which should be handled over telehealth. One man had ten trips to Winnipeg, most of which were not necessary. Second, when people have to go to Winnipeg, the level of support is not sufficient for new patients or those with disabilities. We were told northern transportation needs three weeks notice which often is too long and does not match how doctors set appointments.
- The clinic hours ( 9 am to 5 pm) are not convenient for many people who must work during the day, and so they have to go to the Emergency Room as the only place for care in the evening.
- the lack of full coverage for life-saving drugs
- Much improved continuing health education , through UCN and the RHA and telehealth support is needed for nurses working in smaller communities - like Thicket Portage along the Bay Line.
- People feel they are not kept adequately informed of what is happening. They were disturbed to learn, after the fact, that here was not a surgeon in Thompson for 8 days over Christmas. The health authority needs to be more open and transparent to have the trust of people.
- Right now the system is viewed as essentially hopeless in helping a child or adolescent who is suicidal. An adolescent was described who tried to kill herself once or twice a week for a year and a half. The system was no help. The family had, on its own, to have family and friends involved to watch the child around the clock for this period.
Where do we need to invest and improve our health care system?
- There should be a telehealth system operating 24/7 from Thompson to support northern communities.
- A northern health information network is needed linking UCN health faculty, all northern communities, and with telehealth accessibility for specialist help from Winnipeg. More training of health professionals in the north - including considering making Thompson hospital a teaching hospital for University of Manitoba medical and health programs.
- .Physician recruitment and retention needs to be changed to focus on long term retention of physicians instead of a system which is primarily designed to recruit short term physicians at present.
- There needs to be an assessment of what people are going to Winnipeg for. Much including - pre-op assessments, follow-up specialist appointments, blood work, EKG etc, etc should be done through telehealth at lower cost and greater convenience to all.
- .Extend the clinic hours into the evening for greater convenience for people.
- The health advisory group for the RHA needs to have increased representation from the indigenous community.
- The RHA needs to be more open and better communicating with northern residents, including for example an active presence on facebook which is widely used in the north.
- Better address the fact that too many people are still developing type 2 diabetes and are dying too young from complications of diabetes.
What needs to be done to improve or restore trust in our health care system?
- Address the inconsistencies which are frustrating people
- Close the gap in health care coverage for those in northern Manitoba compared to southern Manitoba.
- Ensure there are long term doctors who know people better in northern Manitoba
- End the centralization of everything in Winnipeg
- Give people in northern Manitoba more say in what happens in the health care system
- Improve the coordination of support services from home to hospital and back
- Ensure there is support for youth who are suicidal
- The current place for mental health in Thompson only keeps children and adolescents for three days which is not seen as long enough.
- Improve support for families. One child had to be placed in voluntary placement with CFS for three months. During this time she did not go to school, was unable to get help and was missing a number of times.
- move forward on self regulation for Radiation Technologists.
- Better support families. One child had to be placed in voluntary placement with CFS for three months. During this time she did not go to school, was unable to get help and was missing a number of times.