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Brodie Thomas
Northern News Services
Published Monday, October 27, 2008

SOMBA K'E/YELLOWKNIFE - This year the province of Alberta merged nine regional health authorities and three boards into a single "superboard" as a way to streamline services and perhaps reduce costs. The province of New Brunswick is in the process of merging its eight health authorities into two.

Mergers seem to be a cost-cutting tool of the 21st century. Governments claim they can eliminate waste by doing more with less. Examples of mergers can be seen not only with health boards but also with municipalities and cities.

Cities such as Toronto and Halifax have undergone mergers during the past 20 years, swallowing up outlying communities and streamlining services such as fire, police, and municipal works.

Last week, the GNWT announced it will be refocusing its board structure, reducing 70 regional boards to seven. Six regional boards will be established to oversee and program delivery for health and social services, education and housing. The seventh will be a co-ordinating committee including board chairs and cabinet ministers.

The NWT currently has eight regional health authorities. Each authority has its own board and administrative team. Administrative titles and structure varies from region to region. Some regions are responsible for long term care while others have no long-term care facilities at all.

These discrepancies can make navigating the territorial health system a confusing proposition for the average person.

At a glance it seems bureaucratic and inefficient.

In a time when the territorial government is proposing new taxes as a way to avoid a deficit, would an Alberta-style health merger help the territory cover its $40 million budget shortfall?

It's one thing to tell taxpayers that the government is going to streamline and reduce costs. It's another thing to tell taxpayers that jobs are going to be cut and facilities closed.

In New Brunswick, authorities with the health department said that the merger meant very few job cuts.

"The point was not to make any job cuts. There was less duplication in the payroll for instance. Instead of eight pay rolls there will be two," said Johanne Leblanc, media relations co-ordinator for the New Brunswick Health Department.

In Alberta, the government touted its merger of nine boards into one to be a huge success. Alberta had already slimed down its health boards from 17 to nine in 2003. The announcement to go from nine boards to one was made and implemented within two months this year.

At the time, Alberta Premier Ed Stelmach raised questions about "the number of people walking around with pencils." His suggestion was loud and clear: Alberta's health bureaucracy is too big. The premier got his merger, despite objections from the nine boards.

Six months later the new Alberta Health Board doesn't want to talk about job cuts or money saved. Alberta Health Board spokesperson John Tuckwell said the merger was not meant to save money but rather to ensure equitable service among different regions.

"The minister has never said the goal is real cost savings, other than saying we can't continue to have the growth in healthcare spending that we've seen over the past couple of years," said Tuckwell.

Alberta began its health board merger in May. In August, media outlets in Alberta learned that the bill for initiating the single superboard was $80 million. That money went to severance packages for outgoing board executives, new computers, and other startup costs.

Cost aside, not everyone agrees that having one provincial board is making the service more efficient.

Carol Secondiak, chair of the now defunct Palliser Regional Health Board, thought the nine boards provided good local representation for the money spent.

Board members applied to sit on the board and were appointed by the government. Each board member was paid for the meetings they attended. Secondiak said she received about $6,000 a year for attending meetings.

She said the Palliser board spent less than half a per cent of its total budget on the board, and for that money constituents received good local representation.

"It almost seems like they've now done away with local representation," she said.

With regional boards now disbanded, Albertans with concerns about health care are being told to speak to their MLA. Secondiak said this is a bad idea because MLAs have enough on their plate without having to learn the ins and outs of a complicated health system.

The biggest cost saving measure, according to Secondiak, was eliminating the nine CEOs for the nine regions and hiring one to replace them all. The CEOs were responsible for oversight of their region. They made six-figure salaries doing it.

"The CEOs are very well educated," said Secondiak. "They usually have an MBA and they're managing huge numbers of people and huge budgets."

Now she worries about a disconnect between rural services and the bureaucracy in major centers.

Streamlining services is a double-edged sword. Governments say they are going to avoid duplication, but they don't like to mention jobs that will be lost in the downsizing process.

Premier Stelmach's "pencil" comment stuck with Secondiak.

"The government likes to call them pencil-pushers," she said, adding she finds the term insulting. Nobody wants to believe their job is pointless or redundant. While she agrees there are many ways that governments can streamline management and reduce costs, such as bulk purchases, she doesn't think eliminating rural jobs and hiring people in Edmonton or Calgary to do the work is fair.