On Wednesday March 24th, I spoke at the Manitoba Legislature on Bill 10 The Regional Health Authorities Amendment Act, a bill which establishes the organization Shared Health. My comments (from Hansard) are below.
Bill 10–The Regional Health Authorities Amendment Act
(Health System Governance and Accountability)
Hon. Jon Gerrard (River Heights): I want to talk about
Bill 10 and the ramifications of this bill. First of all, this bill, with
only minor modifications since, was first introduced December 2nd, 2019 – a year and a half ago, roughly, now. It was debated at second reading last
year, but then the government decided that it was going to take June, July and
August off, and so the bill sat there.
This is an important bill, and it has taken five years to get to this
point from where we are now. One has to ask why this government took so long.
Now, I'm going to address several things: first of all, CancerCare Manitoba
and concerns that the CancerCare network–especially the network as it now
organized–will suffer. CancerCare has been unquestionably the best
specialist network that we have.
It
has got outreach centres around the province. It is organized well so that
there are centralized epidemiology and research and forward-planning, as well
as the clinical care organized so that while the protocols can be set up centrally,
a lot of the care can be distributed all over the province and carried out all
over the province under very high standards.
I
am concerned whether CancerCare will be able to adequately
continue in the future. I hope so. I hope, in fact, that the organization of
CancerCare can, in fact, be a model for some other specialist networks around
the province to be able to deliver care.
Second I want to talk about the relevance of the principle of
subsidiarity, and that is that actions, management, care be looked after at the
level where it is most appropriate to look after it. And we see that there are
certain functions which need to be done at the provincial level: procurement;
specialist networks, looking after them; some emergency services; following up
on medical errors; having an oversight with regard to research provincially and
provincial prevention services. That is the framework for the delivery of
prevention services in an effective way.
The
government has set up Shared Health to do this. This is, in fact, an additional
layer of bureaucracy. They continue to have the regional health authorities,
as well as the local community hospitals and care homes.
What we believe it would be smarter, instead of another layer of
bureaucracy, that the Manitoba Health directly deliver those services which are
critical provincially and that, rather than have the requirement, as we have
now, for the regional health authorities, that there could be much more local
control with local hospitals and local care homes under the
framework provided provincially to ensure high-quality care. So we see that
the government has actually increased the level of bureaucracy in Health, rather
than decreasing it rather than streamlining it, and we're sorry that
that's what the government has chosen to do. Even as they talk one way about
reducing bureaucracy, they continue to increase it.
I
want to talk a little bit about what happened under the COVID pandemic. There
was clearly poor preparation for the second wave, that the organizational
structure was not as good as it could have been. The attention to preparation
for the second wave was nowhere near what it should've been. I see good
clinical research in hospitals, in intensive-care units, going on in Manitoba,
but I don't see the preventative research, which could have helped a lot, being
followed up and performed with a central view as to ensuring that the options
for improving prevention were thoroughly studied, investigated and implemented
here in Manitoba.
We
had huge problems in personal-care homes. The standards for personal-care homes
were not what they should have been. That is partly the fault of the NDP
government over many years and partly the fault of the Conservative government which didn't pay attention to personal-care homes and ensuring that the
standards and approaches to having people work in personal-care homes were
there in a way that would have been much more effective than has happened.
We
think that the government has a long way to go in terms of improving the
situation in personal-care homes, and that is something that we'll be watching
very closely, including, as my colleague, the MLA for Tyndall
Park, has proposed and has been a long-time advocate for many years for a seniors advocate in
the province. We had a forum just last night, in fact, talking about the
steps that need to be taken to really get this implemented well, including a
virtual Zoom meeting which involved BC's seniors advocate to help us better
understand the situation there.
There is clearly a need to make major strides in mental and brain health,
including addictions. The situation at the present time clearly leaves a lot
to be desired. There are long waits for detox because there isn't adequate
service in this area. There are big gaps in helping those with addictions.
The
situation with eating disorders is that the wait times are very, very long at the
moment. And, clearly, the government has not been very quickly responsive in
this area. One of the things that you really need to do is to have a
government which is going to be able to respond as a situation changes, and
eating disorders–not just here, but elsewhere–have increased, and yet the
government has not provided an approach that would address this. And so instead
of it being well addressed and people being well served, you have long, long
and longer wait times–I think about two years at the moment.
So there is a lot to do in mental and brain health and addictions. It is, of course, a challenge for the new minister, and I wish her well, but I was disappointed that the overall Minister of Health, the MLA for Tuxedo, was not better able to provide details of, who within Shared Health was responsible for mental health and addictions and brain health, and more about the organizational structure and how this was working so it would actually solve some of the critical issues which exist today.
When
I spoke a year ago on this bill at second reading, as it was then, I mentioned
that there had been a young lady who had died as a result of suicide - Taylor Pryor. We're still waiting for a report and some major changes to
health care as a result of the unfortunate things that happened in her care,
and I hope that will be forthcoming and that the minister can release such a
report in the near future to let us know what is happening.
With those comments, I look forward to this moving on. We will not support it
because we don't believe this is the right approach.
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